Patricio Cal, MD, Luciano Deluca, MD, Tomas Jakob, MD, Diego Lonardi, MD, Ezequiel Fernandez, MD. CRQO
Introduction: Sleeve gastrectomy has become the most performed bariatric surgery. Removing part of the stomach causes weight loss by restricting food intake and regulating the production of incretins, particularly ghrelin. However, prognostic factors to weight loss after sleeve gastrectomy have been difficult to find. The goal of this research was to study the correlation between the volume of resected stomach and weight loss.
Methods & Procedures: Volume of resected stomach of 217 patients undergoing sleeve gastrectomy was measured. A standard laparoscopic technique was used. Calibration was performed tightly around a 28 Fr bougie, and stapling started 4-6 cm from the pylorus. The standardized technique for measurement involved insufflation with a 14G catheter with saline solution to a pressure of 18 cmH2O immediately after removal of the specimen. Resected stomach’s volume, gender, age, BMI, height and % of total weight loss (%TWL) at 6 months and 1 year were prospectively recorded. Correlation between variables was analyzed with Pearson’s test and linear regression models. Comparison between groups was carried on with t-test or Chi-square test as required. A significance level of 0.05 was established.
Results: Out of 217 patients, 174 (80.2%) were female. Mean BMI was 45.7±6.2, height 1.62±0.09 m, age 43.9±9.5 years. Average resected stomach was 436.5±120 ml (95%CI 420-452 ml). Volume was significantly larger in men (525 vs 414 ml, p<0.0001). On the bivariate analysis, age and BMI were not correlated to volume, while a moderate correlation was found with height (Pearson r=0.35, P=0.0001; Linear regression F=31.1, P=0.00001, Adj R2=0.13; predicted volume 367 ml + 4.3 (height in cm)).
Follow up was 87.5% at 6 months and 79.3% at 1 year. No significant correlation was found between remnant volume and %TWL at 1 year (Pearson r=0.16, P=0.016; Linear regression F=5.8, P=0.016, Adj R2=0.04).
Patients were divided into two groups according to resected gastric volume [group A (≤400 ml, n=101) and group B (>400 ml, n=116)]. After adjusting by gender, BMI and height, there was no significant difference between the two groups in %TWL at 6 months (27.9% vs 29.1%, P=0.2) or %TWL at 1 year (31.6% vs 32.6%, P=0.37).
Conclusion: Removed stomach was larger on men than women and its size slightly correlated to height. However, volume of resected stomach did not seem to have an incidence on short term-weight loss. Gastric size should not be considered as a prognostic factor for weight loss in patients undergoing sleeve gastrectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86607
Program Number: P545
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster