How does the extent of antral resection affect the residual gastric volume and excessive weight loss?

AIM

To identify the effect of the extent of antral resection on the residual gastric volume (RdGV) and excess weight loss (EWL) among patients who underwent laparoscopic sleeve gastrectomy(LSG) due to the obesity.

MATERIAL AND METHODS

The demographical data, operative details, postoperative morbidity, mortality and the percentages of EWL in the postoperative 3, 6 and 12 months of the patients who underwent LSG between January 2014 and August 2015 were analyzed. These patients were divided into three groups regarding the antral resection margin (ARM): Group 1(n=80): ARM≤3cm; Group2 (n=35): 3 <ARM < 6 cm; Group3 (n=30): ARM ≥6cm. The ARM was measured by usinga ruler. RdGV measurement and leak test were performed by filling methylene bluethrough the bougie.

RESULTS

A total of 145 patients were included in the study. Demographic features were similar between three groups. The mean RcGV was significantly higher in Group 1, whereas RdGV was significantly higher in Group 3. The patients in Group 1 had significantly higher EWL% than Group 3 at 12 monthspostoperatively. The mean number of stapler used for gastric resection was significantly higher in Group1. No significant complications such as hemorrhage, staple line leakage, abscess, etc.that required any interventional management were observed in all groups.

CONCLUSIONS

Enlargement of the antral resection margin (>6cm from pylorus) resulted in reduced operating cost and decelerated reach to optimal EWL% with similar postoperative outcomes.

KEY WORDS

Antral resection margin, Excess weight loss, Laparoscopic sleeve gastrectomy, Residual gastric volume, Surgical technique.