Fernandez Ananin Sonia, PhD, Rodriguez-Otero Carlos, Balague Ponz Carmen, Gonzalo Prats Berta, Pernas Canadell Juan Carlos, Garay Solá Meritxell, Targarona Soler Eduardo. Hospital de la Santa Creu i Sant Pau
Laparoscopic sleeve gastrectomy (LSG) has enormously grown in popularity as a stand-alone procedure for the treatment of morbid obesity. The aim of this study was to assess if the resected and the remnant gastric volumes (measured by multi-detector CT scans) were predictors for effectiveness of weight loss at 1 year after surgery.
Material and Methods: Sixty-four patients with BMI >40 kg/m2 or >35 kg/m2 and medical comorbidities underwent LSG between January 2012 and October 2016 included into a RCT (NCT02144545) study comparing different bougie sizes (33 Fr vs 42 Fr). Multi-slice CT scans were performed preoperatively, 2 months, and 1 year after surgery in those patients, to evaluate the gastric volume with a dedicated examination protocol. Parameters were compared to percentage of excess weight loss (%EWL) at 1 year.
Results: Females accounted for 68.7% of patients. Mean age was 50.2 years. Mean preoperative BMI was 44.5 kg/m2, and mean preoperative gastric volume measured by CT volumetry was 686.8 ml. %EWL at 1 year was 60.1 ± 19.3%. Mean remnant gastric volume was 103.5 ml at 2 months and 178.5 ml at 1 year, this increase was statistically significant (p<0.001). No differences were found between the gastric volume increase after surgery (2 months volumen/1 year months volume months) with weight loss results at 1 year (r=0.016, p=0.92).
No significant differences were found in %EWL (61% vs 59%) with the different bougie sizes (p=0.327). A significant correlation was found between the percentage of resected stomach (preoperative volume /2 months volume) and %EWL (r=0.322, p=0.043). We also found a correlation between the resected volume (preoperative volume /2 months volume) with weight loss results at 1 year (r=0.384, p=0.014).
Conclusion: LSG is an effective treatment for inducing weight loss, and it seems that the bougie size should be tailored in each patient to resect a suitable gastric volume. Gastric dilatation does not seem to have an impact in short-term results.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95122
Program Number: P044
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster