Does gastric resection volume influence sleeve gastrectomy results?a prospective study

Authors

  • Federico Sista Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy
  • Valentina Abruzzese Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy
  • Sara Colozzi Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy
  • Mario Schietroma Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy
  • Francesco Carlei Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy
  • Antonella Mattei Department of Medicine, health and environment Sciences-University of L’Aquila - L’Aquila, Italy
  • Marco Clementi Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy
  • Sergio Carandina Service de Chirurgie Digestive et Metabolique, Hôpital Jean Verdier Bondy France, Université Paris XIII, Paris, France
  • Christophe Barrat Service de Chirurgie Digestive et Metabolique, Hôpital Jean Verdier Bondy France, Université Paris XIII, Paris, France
  • Gianfranco Amicucci Dipartimento di Scienze Cliniche Applicate e Biotecnologie, University of L’Aquila Via Vetoio –Edificio Coppito 2-L’Aquila 67100, Italy

DOI:

https://doi.org/10.18203/2349-2902.isj20160209

Keywords:

Obesity, Sleeve gastrectomy, Volume resected, Bariatric surgery

Abstract

Background: Laparoscopic Sleeve Gastrectomy (LSG) is one of the most widespread procedures for the treatment of obesity. The results of LSG could be related to the gastric residual volume. Our aim is to evaluate the outcomes after LSG according to the resected gastric volume (RGV).

Methods: 105 patients were divided into three groups according to the RGV:  600-1200 mL (Group A: 34 patients), 1200-1800 mL (Group B: 38 patients), and >1800 mL (Group C: 33 patients). We evaluated the effects of LSG on weight loss (%EWL), gastroesophageal reflux (GERD), hypertension (HTA) and diabetes (DM2) at 3, 6, 12 and 36 months. Data were analyzed for normality of distribution with Shapiro-Wilk test.

Results: The overall %EWL at follow up was 34.8%, 42.6%, 53% and 57.7%. Statistically significant difference between group C and group A-B at 6 months was detected, as well as between group B-C and group A at 12 and 36 months. Overall prevalence of GERD was 63.8%, 62.9%, 61% e 43.8%, at 3, 6, 12 and 36 months respectively. An overall increase of GERD (40%) was observed at 12 months; this value decreased at 2.3% after 36 months. The HTA prevalence was 53.3%, 28.6%, 21% and 17.1%, with an overall reduction of 40% and 43.9% at 12 and 36 months. The DM2 prevalence was 28.6%, 18.1%, 12.4% and 9.5% at 3, 6, 12 and 36 months respectively, with an overall reduction of 31.5% at 36 months.

Conclusions: RGV influences outcomes of LSG on short-term and mid-term follow up and it predicts the results in terms of %EWL and improvement of DM2 and HTA.

Metrics

Metrics Loading ...

References

Arikh M, Gagner M, Heacock L. Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008;4:528-33.

Weiner RA, Weiner S, Pomhoff I, Jacobi C, Makarewicz W, Weigand G. Laparoscopic sleeve gastrectomy— influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297-305.

Rosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, Arvidsson D, Baker RS, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8-19.

Parikh M, Issa R, McCrillis A, Saunders JK, Ude-Welcome A, Gagner M. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257(2):231-7.

Baltasar A, Bou R, Bengochea M, Serra C, Pérez N. Laparoscopic gastric sleeve, subtotal antrectomy and omentoplasty. Obes Surg. 2015;25(1):195-6.

Ferraz AA, de Siqueira LT, Filho NE, de Araújo JG, Campos JM, de Barros-Correia TX et al. Revision surgery for treatment of weight regain after Roux-en-Y gastric bypass. Obes Surg. 2014;24(1):2-8.

Carandina S, Maldonado PS, Tabbara M, Valenti A, Rivkine E, Polliand C et al. Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve. Surg Obes Relat Dis. 2014;10(6):1085-91.

Angrisani L, Cutolo PP, Buchwald JN, McGlennon TW, Nosso G, Persico F et al. Laparoscopic reinforced sleeve gastrectomy: early results and complications. Obes Surg. 2011;21(6):783-93.

Metropolitan Life Insurance Co. New weight standards for men and women. Statistical Bulletin of the Metropolitan Life Insurance Company. 1959;40:1-4.

Wofford MR, Smith G, Minor DS. The treatment of hypertension in obese patients. Curr Hypertens Rep. 2008;10(2):143-50.

Gill RS, Birch DW, Shi X, Sharma AM, Karmali S. Sleeve gastrectomy and type 2 diabetes mellitus: a systemic review. Surg Obes Relat Dis. 2010;6:707-13.

Spivak H, Rubin M, Sadot E, Pollak E, Feygin A, Goitein D. Laparoscopic Sleeve Gastrectomy Using 42-French Versus 32-French Bougie: The First-Year Outcome. Obes Surg. 2014;24(7):1090-3.

Rebecchi F, Allaix ME, Giaccone C, Ugliono E, Scozzari G, Morino M. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation. Ann Surg. 2014;260(5):909-14.

Singh JP, Chaudhuri OTT, Khanna S, Patil PH. Is Resected Stomach Volume Related to Weight Loss After Laparoscopic Sleeve Gastrectomy? Obes Surg. 2014;24(10):1656-61.

Obeidat FW, Shanti HA, Mismar AA, Elmuhtaseb MS, Al- Qudah MS. Volume of Resected Stomach as a Predictor of Excess Weight Loss After Sleeve Gastrectomy. Obes Surg. 2014;24(10):1904-8.

Causey MW, Fitzpatrick E, Carter P. Pressure tolerance of newly constructed staple lines in sleeve gastrectomy and duodenal switch. Am J Surg. 2013;205(5):571-4.

Baraki YM, Traverso P, Elariny HA, Fang Y. Preoperative prediction of stomach weight to be removed in laparoscopic sleeve gastrectomy procedure. Surg Technol Int. 2010;20:167-71.

Singh JP, Tantia O, Chaudhuri T, Khanna S, Patil PH. Is resected stomach volume related to weight loss after laparoscopic sleeve gastrectomy? Obes Surg. 2014;24(10):1656-61.

Till HK, Muensterer O, Keller A, Körner A, Blueher S, Merkle R et al. Laparoscopic sleeve gastrectomy achieves substantial weight loss in an adolescent girl with morbid obesity. Eur J Pediatr Surg. 2008;18(1):47-9.

Csendes A, Burgos AM. Size, volume and weight of the stomach in patients with morbid obesity compared to controls. Obes Surg. 2005;15:1133-6.

Sabbagh C, Verhaeghe P, Dhahri A, Brehant O, Fuks D, Badaoui R et al. Two-year results on morbidity, weight loss and quality of life of sleeve gastrectomy as first procedure, sleeve gastrectomy after failure of gastric banding and gastric banding. Obes Surg. 2010;20:679-84.

Kotidis EV, Koliakos GG, Baltzopoulos VG, Ioannidis KN, Yovos JG, Papavramidis ST. Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment – a prospective study. Obes Surg. 2006;16:1425-32.

Abdemur A, Slone J, Berho M, Gianos M, Szomstein S, Rosenthal RJ. Morphology, localization, and patterns of ghrelin-producing cells in stomachs of a morbidly obese population. Surg Laparosc Endosc Percutan Tech. 2014;24(2):122-6.

Lee WJ, Chong K, Chen CY, Chen SC, Lee YC, Ser KH et al. Diabetes remission and insulin secretion after gastric bypass in patients with body mass index <35 kg/m2. Obes Surg. 2011;21(7):889-95.

Zhu Z, Yang X, Wang K, Wang Z, Zhao Y, Yu M. The effects of sleeve gastrectomy on hormonal regulation of glucose metabolism in Goto-Kakizaki rats. Eur Surg. 2014;46(5):189-96.

Hoogerboord M, Wiebe S, Klassen D, Ransom T, Lawlor D, Ellsmere J. Laparoscopic sleeve gastrectomy: perioperative outcomes, weight loss and impact on type 2 diabetes mellitus over 2 years. Can J Surg. 2014;57(2):101-5.

Leonetti F, Capoccia D, Coccia F, Casella G, Baglio G, Paradiso F et al. Obesity, type 2 diabetes mellitus, and other comorbidities. A prospective cohort study of laparoscopic sleeve gastrectomy vs. medical treatment. Arch Surg. 2012;147:694-700.

Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:1567-76.

Patel RT, Shukla AP, Ahn SM, Moreira M, Rubino F. Surgical control of obesity and diabetes: the role of intestinal vs. gastric mechanisms in the regulation of body weight and glucose homeostasis. Obesity (Silver Spring). 2014;22(1):159-69.

Teive MB, Russi RF, Vieira DS, Teive AM, Costa A, d'Acampora AJ. Quantitative immunohistochemical analysis of duodenal ghrelin cells after sleeve gastrectomy in Wistar rats. Acta Cir Bras. 2012;27(9):595-9.

El-Hadi M, Birch DW, Gill RS, Karmali S. The effect of bariatric surgery on gastroesophageal reflux disease. Can J Surg. 2014;57(2):139-44.

Chiu S, Birch DW, Shi X, Sharma AM, Karmali S. Impact of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis. 2011;7:510-5.

Howard DD, Caban AM, Cendan JC, Ben-David K. Gastroesophageal reflux after sleeve gastrectomy in morbidly obese patients. Surg Obes Relat Dis. 2011;7:709-13.

Sheppard CE, Sadowski DC, de Gara CJ, Karmali S, Birch DW. Rates of reflux before and after laparoscopic sleeve gastrectomy for severe obesity. Obes Surg. 2015;25(5):763-8.

Lakdawala M, Bhasker A, Mulchandani D, Goel S, Jain S. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1-6.

Nocca D, Krawczykowsky D, Bomans B, Noël P, Picot MC, Blanc PM et al. A prospective multi center study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity Surgery. 2008;18:560-5.

Vidal P, Ramón JM, Busto M, Domínguez-Vega G, Goday A, Pera M et al. Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg. 2014;24(3):359-63.

Barnard SA, Rahman H, Foliaki A. The postoperative radiological features of laparoscopic sleeve gastrectomy. J Med Imaging Radiat Oncol. 2012;56(4):425-31.

Downloads

Published

2016-12-13

Issue

Vol. 3 No. 1 (2016): January-March 2016

Section

Original Research Articles