Maud Robert1, Arnaud Pasquer2, Elise Pelascini2, Pierre-Jean Valette3, Christian Gouillat2, Emmanuel Disse4. 1. Department of Digestive and Bariatric Surgery, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, Lyon, France. Electronic address: maud.robert@chu-lyon.fr. 2. Department of Digestive and Bariatric Surgery, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, Lyon, France. 3. Claude Bernard Lyon 1 University, Lyon, France; Department of Radiology, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France. 4. Claude Bernard Lyon 1 University, Lyon, France; Department of Endocrinology, Lyon Sud University Hospital, Hospices Civils de Lyon, Lyon, France.
Abstract
BACKGROUND: Causes of weight loss failure after sleeve gastrectomy (SG) are still controversial. The impact of the size of the sleeve continues to be debated. OBJECTIVE: The aim of our study was to determine the impact of sleeve volumes assessed at 3 months using gastric computed tomography (CT) on weight loss at 18 months. SETTING: University Hospital, France. METHODS: Sixty-seven obese patients eligible for SG were prospectively evaluated. Sleeve volumes were assessed postsurgery using 3-dimensional gastric CT with gas at 3 months and weight loss outcomes recorded up to 18 months. The population was divided into 2 groups: the first tertile (n = 22) with the smallest gastric volume was defined as the "small sleeve" group (SSG) and the rest of the population (n = 45) was defined as the "without small sleeve" group (WSSG). RESULTS: No patients were lost to follow-up. In the SSG, overall gastric volume was 133±7 mL versus 264±11 mL for the WSSG (P<.0001). Percentage excess body mass index loss (%EBMIL) during the first postoperative 18 months was significantly greater in the SSG compared with the WSSG (P = .04). Although the volume of the gastric tube was not correlated with weight loss (r =-.04, P = .78), there was a negative linear correlation between the volume of the antrum and the %EBMIL at 18 months (r =-.39, P = .005). A narrow gastric tube was also associated with a high digestive intolerance and reflux. CONCLUSION: Our data suggest that performing the sleeve with a not-too-small bougie size and a radical antrectomy could improve weight loss and digestive tolerance.
BACKGROUND: Causes of weight loss failure after sleeve gastrectomy (SG) are still controversial. The impact of the size of the sleeve continues to be debated. OBJECTIVE: The aim of our study was to determine the impact of sleeve volumes assessed at 3 months using gastric computed tomography (CT) on weight loss at 18 months. SETTING: University Hospital, France. METHODS: Sixty-seven obesepatients eligible for SG were prospectively evaluated. Sleeve volumes were assessed postsurgery using 3-dimensional gastric CT with gas at 3 months and weight loss outcomes recorded up to 18 months. The population was divided into 2 groups: the first tertile (n = 22) with the smallest gastric volume was defined as the "small sleeve" group (SSG) and the rest of the population (n = 45) was defined as the "without small sleeve" group (WSSG). RESULTS: No patients were lost to follow-up. In the SSG, overall gastric volume was 133±7 mL versus 264±11 mL for the WSSG (P<.0001). Percentage excess body mass index loss (%EBMIL) during the first postoperative 18 months was significantly greater in the SSG compared with the WSSG (P = .04). Although the volume of the gastric tube was not correlated with weight loss (r =-.04, P = .78), there was a negative linear correlation between the volume of the antrum and the %EBMIL at 18 months (r =-.39, P = .005). A narrow gastric tube was also associated with a high digestive intolerance and reflux. CONCLUSION: Our data suggest that performing the sleeve with a not-too-small bougie size and a radical antrectomy could improve weight loss and digestive tolerance.
Authors: Manuel Ferrer-Márquez; Juan José García-Díaz; Almudena Moreno-Serrano; José Miguel García-Díez; Manuel Ferrer-Ayza; Raquel Alarcón-Rodríguez; Enrique G Artero; Alberto Soriano-Maldonado Journal: Obes Surg Date: 2017-02 Impact factor: 4.129
Authors: Andrés Hanssen; Sergio Plotnikov; Geylor Acosta; José Tomas Nuñez; José Haddad; Carmen Rodriguez; Claudia Petrucci; Diego Hanssen; Rafael Hanssen Journal: Obes Surg Date: 2018-03 Impact factor: 4.129
Authors: Tone Nygaard Flølo; John R Andersen; Ronette L Kolotkin; Anny Aasprang; Gerd K Natvig; Karl O Hufthammer; Villy Våge Journal: Obes Surg Date: 2017-08 Impact factor: 4.129