Kemal Dogan1, Jens Homan2, Edo O Aarts2, Cees J H M van Laarhoven3, Ignace M C Janssen2, Frits J Berends2. 1. Department of Surgery, Rijnstate Hospital, Postal Number 1190, PO box 9555, 6800 TA, Arnhem, The Netherlands. dogan.research@outlook.com. 2. Department of Surgery, Rijnstate Hospital, Postal Number 1190, PO box 9555, 6800 TA, Arnhem, The Netherlands. 3. Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Abstract
BACKGROUND: The Roux-en-Y gastric bypass (RYGB) still remains the gold standard in bariatric surgery. However, no consensus exists on the optimal limb lengths to induce maximum weight reduction. The aim of the present study was to assess the effect of a longer alimentary limb (AL) length on weight reduction after RYGB. METHODS: A retrospective analysis of a prospectively collected database of patients who underwent a primary laparoscopic RYGB between January 2001 and March 2011 was performed. Patients received a short AL (SAL; 100 cm) or a long AL (LAL; 150 cm). Primary outcome was weight loss, and secondary outcomes were short- and long-term complication rates. RESULTS: A total of 768 patients received a RYGB during the study period. Of these, 730 consecutive patients were included for long-term analysis and had a mean follow-up (FU) of 37 ± 26 [range 0-120] months; 360 (47 %) patients received a SAL RYGB. Overall %TBWL was 33 ± 9 % after 2 years (FU 74 %) and 28 ± 12 % after 5 years (FU 20 %). No significant differences in %TBWL were found between SAL RYGB and LAL RYGB during the study period. The 30-day mortality rate was 0.13, 9 % overall short-term complication rate and 19 % cumulative long-term complication rate. No differences in complications were found between SAL and LAL RYGB patients. CONCLUSION: Lengthening of the alimentary limb from 100 to 150 cm did not affect post-RYGB weight loss. Overall complication rates were low and comparable in this series of RYGB patients.
BACKGROUND: The Roux-en-Y gastric bypass (RYGB) still remains the gold standard in bariatric surgery. However, no consensus exists on the optimal limb lengths to induce maximum weight reduction. The aim of the present study was to assess the effect of a longer alimentary limb (AL) length on weight reduction after RYGB. METHODS: A retrospective analysis of a prospectively collected database of patients who underwent a primary laparoscopic RYGB between January 2001 and March 2011 was performed. Patients received a short AL (SAL; 100 cm) or a long AL (LAL; 150 cm). Primary outcome was weight loss, and secondary outcomes were short- and long-term complication rates. RESULTS: A total of 768 patients received a RYGB during the study period. Of these, 730 consecutive patients were included for long-term analysis and had a mean follow-up (FU) of 37 ± 26 [range 0-120] months; 360 (47 %) patients received a SAL RYGB. Overall %TBWL was 33 ± 9 % after 2 years (FU 74 %) and 28 ± 12 % after 5 years (FU 20 %). No significant differences in %TBWL were found between SAL RYGB and LAL RYGB during the study period. The 30-day mortality rate was 0.13, 9 % overall short-term complication rate and 19 % cumulative long-term complication rate. No differences in complications were found between SAL and LAL RYGB patients. CONCLUSION: Lengthening of the alimentary limb from 100 to 150 cm did not affect post-RYGB weight loss. Overall complication rates were low and comparable in this series of RYGB patients.
Authors: Jens Homan; Bark Betzel; Edo O Aarts; K Dogan; Kees J H M van Laarhoven; Ignace M C Janssen; Frits J Berends Journal: Obes Surg Date: 2015-09 Impact factor: 4.129
Authors: Francesco Rubino; Michel Gagner; Paolo Gentileschi; Subhash Kini; Shoji Fukuyama; John Feng; Ed Diamond Journal: Ann Surg Date: 2004-08 Impact factor: 12.969
Authors: Kamal K Mahawar; Parveen Kumar; Chetan Parmar; Yitka Graham; William R J Carr; Neil Jennings; Norbert Schroeder; Shlok Balupuri; Peter K Small Journal: Obes Surg Date: 2016-03 Impact factor: 4.129
Authors: Cornelis Klop; Laura N Deden; Edo O Aarts; Ignace M C Janssen; Milan E J Pijl; Anneline van den Ende; Bart P L Witteman; Gabie M de Jong; Theo J Aufenacker; Cornelis H Slump; Frits J Berends Journal: Obes Surg Date: 2018-07 Impact factor: 4.129