Mehmet Mihmanli, Sinan Omeroglu, Emre Bozkurt, Uygar Demir, Cemal Kaya, Ozgur Bostanci, Pinar Yazici. Sisli Hamidiye Etfal Training and Research Hospital
OBJECTIVE: To identify the effect of the extent of antral resection on the residual gastric volume (RGV) and excessive weight loss (EWL) among patients who underwent laparoscopic sleeve gastrectomy(LSG) due to the obesity.
METHOD: The demographical data, operation details, postoperative morbidity, mortality and the percentages of EWL in the postoperative 3rd, 6th and 12th months of the patients who underwent LSG between January 2014 and August 2015 were analyzed. These patients were divided into three groups regarding to the distance between the antral resection margin and pylor: group1 (n=80) distance to the pylor<3cm, group2 (n=35) distance to the pylor between 3-6cm, group3 (n=30) distance to the pylor>6cm. The distance to the pylor was measured by using an endo-grasper which was marked previously. Following the complement of staple line, the RGV was measured by injection of methylene blue through the bougie which was pushed back to the level of eosophago-gastric junction. The resected gastric volume measurement was then achieved by filling the specimen with isotonic solution.
RESULTS: 145 patients (mean age 38±5.8 year, 42 male and 103 female) were included in the study. Mean preoperative body mass index was 48.2±7 kg/m2. There was no difference between the three groups in terms of the demographical properties. The mean stapler count was significantly higher in group1 than the other groups (group1: 6.5, group2: 5.7, group3: 5.1 count, p<0.01). The mean RGVs were measured as 29.3 cc , 32.1 cc and 36.6 cc respectively. The resected gastric volume was 1440±14 cc ,1412±20cc, 1374 ± 17 cc respectively for group1, group2 and group3 again. The postoperative EWL evaluation in the 3rd, 6th and 12th months were 43.2±6%, 65±6% and 81.2±6% respectively. For group2 patients it was 42.8±7%, 64.3±5% and 79.2±5% respectively. Among group3 patients the measures were 40.4±5% , 61.4±6% , 75.7±5% respectively. EWL rates in group1 and group2 were significantly higher in comparison with group3 in all postoperative periods (p<0.05). There wasn’t any complication requiring any intervention among the three groups.
CONCLUSION: In our study, it was suggested that the enlargement of the antral resection led to decreased operation cost, however; there was an opposite effect on EWL especially for group3 patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80281
Program Number: S122
Presentation Session: Bariatric surgery – Sleeves, Conversions and More
Presentation Type: Podium