Correlation of Gastric Volume and Weight Loss 5 Years Following Sleeve Gastrectomy.

Abstract

The volume of the gastric reservoir (VGR) after sleeve gastrectomy influences weight loss in the short-term, but long-term results are scarce. The aim was to analyze the correlation between the VGR and weight loss at 5years of follow-up. It is a prospective observational study of 50 patients undergoing sleeve gastrectomy (SG) from February 2009 to December 2013. An upper gastrointestinal series was performed at 1month and at 1 and 5years after surgery. A composite formula was used for VGR estimation. Weight loss-related data included the following: body mass index (BMI), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL) at 1month and at 1 and 5years. Uni- and multivariate analyses were carried out to determine other factors that might influence long-term weight loss results. The %EWL at 1year was 74.5(63.8-86) vs. 55.5(47-74.3) at 5years (p < 0.001). The VGR 1month after surgery was 114.9 (90.5-168.3) mL. The VGR increased from 216.7 (155.1-278.6) to 367.5 (273-560.3) mL (p < 0.001) at 1 and 5years. Although a significant inverse correlation was observed between VGR and BMI, %EWL, and %EBMIL at 1year, it disappeared at 5years. In the multivariate analysis, the main factor to predict worse weight results at 5years was a pre-surgical BMI ≥ 50kg/m2. The VGR increased progressively during the study period. Although an inverse relationship between VGR and weight was found at 1year, this correlation did not remain at 5years. A preoperative BMI ≥ 50kg/m2 is the main predictive factor of poor weight outcomes.