Laparoscopic Sleeve Gastrectomy, With Or Without Antrum Preservation and Its Effects On Food Tolerance, Body Composition and Quality of Life.

M Paris, A Molina, F Sabench, A Bonada, E Raga, S Blanco, A Sanchez, A Munoz, M Hernandez, M Vives, Ml Pinana, J Domenech, Daniel Del Castilo. Hospital Universitari Sant Joan de Reus. Universitat Rovira i Virgili

OBJECTIVES: To assess the optimal distance between the pylorus and the beginning of the section of Laparoscopic Sleeve Gastrectomy (LSG), evaluating its effects on food tolerance, body composition and quality of life.

MATERIAL AND METHODS: A prospective randomized study with two intervention groups, according the section from pylorus (3 and 8 cm). Body composition measured by bioelectrical impedance, food tolerance (Suter test) and quality of life (Moorehead – Ardelt Quality of Life Questionnaire II-QOL) were recorded.

RESULTS: We have evaluated 26 patients (69.2% ?/30.8% ?). Baseline (before surgery) in 3cm group (n=11): mean weight 132.2 kg (± 24.5), mean BMI 50.1 kg/m2 (± 6.4). Average percentage of body fat 51.0 % and average of muscle mass 60.6 kg. QOLtest -1.0 (± 0.4). 8cm group (n =15): mean weight 134.8 kg (± 28.1) and mean BMI 50.7 kg/m2 (± 7.3). Average percentage of body fat 50.8 %, mean body fat 69.1 kg and 62.5 kg of muscle mass. QOLtest -0.9 (±1.5). Three months after surgery: Group 3 cm (n =11): mean weight 110.0 kg (±20.6) and mean BMI 41.7 kg/m2 (± 5.5). Average percentage of body fat 44.8 %, and 56.1 kg of muscle mass. Average score of 22.3 (±1.8) in food tolerance test and 1.0 (±0.8) in QOLtest. 8cm group (n =15): mean weight 113.8 kg (±22.6) and mean BMI 42.9 kg/m2 (± 5.9). Average percentage of body fat 44.7 % and average percentage of muscle mass 59.3 kg. Food tolerance test 21.4 (±4.6) and QOLtest 1.5 (±0.5).

CONCLUSIONS: Three months after surgery there is a significant improvement in quality of life compared to preoperative values. There is a trend towards a marked improvement in the quality of life in the 8cm group. Quality of life is classified as "good" (range 1.1 / 2 ) at three months after surgery in the group 8cm and "acceptable " (range -1 / 1 ) in 3cm group. The level of food tolerance after three months of surgery was similar to obtained in other investigations. There are no significant differences in body composition at the moment.