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Influence of antrum size on gastric emptying and weight-loss outcomes after laparoscopic sleeve gastrectomy (preliminary analysis of a randomized trial).
Surg Endosc. 2018 06; 32(6):2739-2745.SE

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) has increased in popularity in recent years as a definitive bariatric procedure. Despite its growing popularity worldwide, the surgical technique is not well standardized. There is a lack of evidence on the matter of the antrum size and its relation to gastric emptying and weight-loss outcomes. The aim of the study is to evaluate the influence of antrum size over gastric emptying and weight-loss outcomes.

METHODS

Twenty-five patients were prospectively randomized according to the distance between the first firing and the pylorus: AR group (antrum resection-2 cm from the pylorus) and AP group (antrum preservation-5 cm from the pylorus). Gastric emptying (%GE) was evaluated by a gastric emptying scintigraphy before surgery, 2 months and 1 year after LSG. Antrum volume was measured using a MultiSlice CT Scan performed 2 months and 1 year after surgery. The percent of excess weight loss (%EWL) was calculated after 1 year follow-up.

RESULTS

At 2 months after LSG the mean %GE was 69.7 ± 18 in the AR group and 72.8 ± 20 in the AP group (p = 0.69). At 1 year it was 66.5 ± 21 and 74.2 ± 16 in the AR and AP groups, respectively (p = 0.30). A significant accelerated gastric emptying was observed at 2 months (p = 0.025) and at 1 year (p = 0.013) in the AP group. Meanwhile in the AR group this increase was not significant (p = 0.12 at 2 months and p = 0.21 at 1 year). Differences regarding the %EWL between groups were no statistically significant (p = 0.74).

CONCLUSIONS

After LSG there is a global tendency to an accelerated gastric emptying, although only significant in the antrum preservation group; however, no differences were observed regarding the %EWL between groups after 1 year follow-up.

Authors+Show Affiliations

Surgical Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. mgaray@santpau.cat.Surgical Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Surgical Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Surgical Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Department of Radiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Department of Epidemiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Surgical Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.Surgical Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29313122

Citation

Garay, Meritxell, et al. "Influence of Antrum Size On Gastric Emptying and Weight-loss Outcomes After Laparoscopic Sleeve Gastrectomy (preliminary Analysis of a Randomized Trial)." Surgical Endoscopy, vol. 32, no. 6, 2018, pp. 2739-2745.
Garay M, Balagué C, Rodríguez-Otero C, et al. Influence of antrum size on gastric emptying and weight-loss outcomes after laparoscopic sleeve gastrectomy (preliminary analysis of a randomized trial). Surg Endosc. 2018;32(6):2739-2745.
Garay, M., Balagué, C., Rodríguez-Otero, C., Gonzalo, B., Domenech, A., Pernas, J. C., Gich, I. J., Miñambres, I., Fernández-Ananín, S., & Targarona, E. M. (2018). Influence of antrum size on gastric emptying and weight-loss outcomes after laparoscopic sleeve gastrectomy (preliminary analysis of a randomized trial). Surgical Endoscopy, 32(6), 2739-2745. https://doi.org/10.1007/s00464-017-5972-4
Garay M, et al. Influence of Antrum Size On Gastric Emptying and Weight-loss Outcomes After Laparoscopic Sleeve Gastrectomy (preliminary Analysis of a Randomized Trial). Surg Endosc. 2018;32(6):2739-2745. PubMed PMID: 29313122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of antrum size on gastric emptying and weight-loss outcomes after laparoscopic sleeve gastrectomy (preliminary analysis of a randomized trial). AU - Garay,Meritxell, AU - Balagué,Carmen, AU - Rodríguez-Otero,Carlos, AU - Gonzalo,Berta, AU - Domenech,Anna, AU - Pernas,Juan Carlos, AU - Gich,Ignasi J, AU - Miñambres,Inka, AU - Fernández-Ananín,Sonia, AU - Targarona,Eduardo M, Y1 - 2018/01/08/ PY - 2017/03/13/received PY - 2017/10/29/accepted PY - 2018/1/10/pubmed PY - 2019/10/29/medline PY - 2018/1/10/entrez KW - Antrum size KW - Bariatric surgery KW - Gastric emptying scintigraphy KW - Pyloric antrum KW - Sleeve gastrectomy KW - Weight loss SP - 2739 EP - 2745 JF - Surgical endoscopy JO - Surg Endosc VL - 32 IS - 6 N2 - BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has increased in popularity in recent years as a definitive bariatric procedure. Despite its growing popularity worldwide, the surgical technique is not well standardized. There is a lack of evidence on the matter of the antrum size and its relation to gastric emptying and weight-loss outcomes. The aim of the study is to evaluate the influence of antrum size over gastric emptying and weight-loss outcomes. METHODS: Twenty-five patients were prospectively randomized according to the distance between the first firing and the pylorus: AR group (antrum resection-2 cm from the pylorus) and AP group (antrum preservation-5 cm from the pylorus). Gastric emptying (%GE) was evaluated by a gastric emptying scintigraphy before surgery, 2 months and 1 year after LSG. Antrum volume was measured using a MultiSlice CT Scan performed 2 months and 1 year after surgery. The percent of excess weight loss (%EWL) was calculated after 1 year follow-up. RESULTS: At 2 months after LSG the mean %GE was 69.7 ± 18 in the AR group and 72.8 ± 20 in the AP group (p = 0.69). At 1 year it was 66.5 ± 21 and 74.2 ± 16 in the AR and AP groups, respectively (p = 0.30). A significant accelerated gastric emptying was observed at 2 months (p = 0.025) and at 1 year (p = 0.013) in the AP group. Meanwhile in the AR group this increase was not significant (p = 0.12 at 2 months and p = 0.21 at 1 year). Differences regarding the %EWL between groups were no statistically significant (p = 0.74). CONCLUSIONS: After LSG there is a global tendency to an accelerated gastric emptying, although only significant in the antrum preservation group; however, no differences were observed regarding the %EWL between groups after 1 year follow-up. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/29313122/Influence_of_antrum_size_on_gastric_emptying_and_weight_loss_outcomes_after_laparoscopic_sleeve_gastrectomy__preliminary_analysis_of_a_randomized_trial__ L2 - https://dx.doi.org/10.1007/s00464-017-5972-4 DB - PRIME DP - Unbound Medicine ER -