Abstract
BackgroundLaparoscopic sleeve gastrectomy was recently described as an effective approach for the operative treatment of obesity, but the ideal procedure remains controversial. One of the most debated issues is the resection distance from the pylorus. We conducted this study to elucidate any potential differences in the short-term outcomes between 2 and 6 cm distance from the pylorus in laparoscopic sleeve gastrectomy.MethodsA prospective observational cohort study in a selected cohort of 96 patients was conducted from January 2018 to March 2019 in morbidly obese patients who had laparoscopic sleeve gastrectomy performed at Suez Canal University Hospital. Outcome was expressed by excess weight loss percentage, resolution of comorbidities, improvement of quality of life, and incidence of complications after laparoscopic sleeve gastrectomy. The morbidly obese patients (body mass index [BMI] > 40 kg/m2 or > 35 kg/m2 with obesity-related comorbidities) in the study were divided into two equal groups: (1) Group 1 (48 patients) underwent laparoscopic sleeve gastrectomy with a 2 cm distance from the pylorus resection distance and (2) Group 2 (48 patients) underwent laparoscopic sleeve gastrectomy with a 6 cm distance from the pylorus resection distance. Body weight, BMI, bariatric quality of life, lipid profile, and comorbidities were evaluated pre- and post-operatively for a duration of 12 months.ResultsStatistically, no significant differences between the two study groups regarding the excess weight loss percentage, comorbidity resolution throughout the postoperative follow-up, enhancement of the quality of life score throughout the postoperative follow-up, or incidence of complications (25% in Group 1 versus 25% in Group 2, p > 0.05) were found.ConclusionLaparoscopic sleeve gastrectomy was an effective and safe management for morbid obesity and obesity-related comorbidities with significant short-term weight loss; it also improved weight-related quality of life and had an acceptable complication rate. The distance from the pylorus resection distance did not affect the short-term effects of laparoscopic sleeve gastrectomy regarding excess weight loss percentage, resolution of comorbidities, change in quality of life, or occurrence of complications.
Highlights
Worldwide, more than one billion adults are overweight and more than 300 millions of them are obese [1]
People in each obesity class according to the World Health Organization (WHO) classification are at an increased risk of obesity-related illness compared to those with a normal body mass index (BMI) [1, 2]
Laparoscopic sleeve gastrectomy has been accepted as an effective approach to bariatric surgery
Summary
More than one billion adults are overweight and more than 300 millions of them are obese [1]. Laparoscopic sleeve gastrectomy has been accepted as an effective approach to bariatric surgery In this procedure, the greater curvature portion of the stomach is resected to produce a small, tubular stomach shaped like a banana in form and size [5]. The greater curvature portion of the stomach is resected to produce a small, tubular stomach shaped like a banana in form and size [5] This operation quickly drew considerable surgical attention because it does not require an anastomosis or bypass in the gastrointestinal tract, and it is less technically difficult than laparoscopic Roux-en-Y gastric bypass [6]. Laparoscopic sleeve gastrectomy was recently described as an effective approach for the operative treatment of obesity, but the ideal procedure remains controversial. We conducted this study to elucidate any potential differences in the shortterm outcomes between 2 and 6 cm distance from the pylorus in laparoscopic sleeve gastrectomy
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