Abstract
Objective:The impact of extended antral resection (AR) after laparoscopic sleeve gastrectomy (LSG) on clinical results is still not clearly elucidated with conflicting results. Our study aimed to determine whether AR is superior to antral preservation (AP) regarding clinical results.Methods:Patients were divided into two groups according to the distance of gastric division as AR group (2cm from pylorus) and AP group (6cm from pylorus). Postoperative excess weight loss percentile (%EWL) and total body weight loss percentiles (%TBWL) at the end of first, 6th and 12 months were compared. Secondly, metabolic parameters and complications were compared.Results:The first 68 patients underwent AP, and the following 43 patients underwent AR. Although statistically not significant, AR achieve more %EWL and %TBWL at the end of the first year, (P>0.05). On the other hand, metabolic parameters were similar at the end of the first year, (P>0.05). Resolution of comorbidities were statistically not different, (P>0.05). Staple line leak occurred in two patients of the AR group (4.7%) and two patients of the AP group (2.9%), (P>0.05).Conclusion:Both AR and AP seem to be equally effective in resolution of metabolic response. Although statistically not significant- AR provided more %EWL and %TBWL at the end of 12 months.
Highlights
Laparoscopic sleeve gastrectomy (LSG) was initially designed as the first step of a two-staged bariatric procedure
In the following years, LSG was found as effective as other bariatric procedures and has become increasingly popular as a stand-alone bariatric procedure.[1,2]
The simplicity of surgical technique, preservation of the pyloric functions, none development of marginal ulcers or internal herniation, less need of trace element and vitamin supplementation are the advantages of LSG over other bariatric procedures.[4,5,6]
Summary
Laparoscopic sleeve gastrectomy (LSG) was initially designed as the first step of a two-staged bariatric procedure. In the following years, LSG was found as effective as other bariatric procedures and has become increasingly popular as a stand-alone bariatric procedure.[1,2] Recently, LSG is the most performed bariatric procedure worldwide.[3] The simplicity of surgical technique, preservation of the pyloric functions, none development of marginal ulcers or internal herniation, less need of trace element and vitamin supplementation are the advantages of LSG over other bariatric procedures.[4,5,6] debate continues regarding the AR or AP on effective weight loss alterations and metabolic response. The distance from pylorus at which the
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