Impact of Resected Gastric Volume on Postoperative Weight Loss after Laparoscopic Sleeve Gastrectomy

Stefano D'Ugo, Vittoria Bellato, Emanuela Bianciardi, Paolo Gentileschi, Stefano D'Ugo, Vittoria Bellato, Emanuela Bianciardi, Paolo Gentileschi

Abstract

Among the bariatric surgery community, it has recently emerged the idea of a possible association between resected gastric volume (RGV) and weight loss after laparoscopic sleeve gastrectomy (LSG). If the size of the sleeve depends on the bougie caliber, the resected volume of the stomach remains something which is not possible to standardize. The aim of the study was to investigate a possible relationship between RGV and weight loss after LSG. We developed a mathematical method to calculate the RGV, based on the specimen size removed during LSG. Ninety-one patients (63 females and 28 males) affected by morbid obesity were included in the study. They underwent LSG between 2014 and 2016. Mean preoperative BMI was 45 ± 6.4. At 1 year after LSG, the mean BMI was 30 ± 5.3 and the EWL% was 65 ± 20.2. The statistical analysis of RGV, BMI, and EWL% at 1-year follow-up did not find any correlation between the volume of stomach removed and the weight loss after LSG. Further studies in the future should clarify the potential role of RGV during LSG. This trial is registered with ClinicalTrials.gov NCT03938025.

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Copyright © 2019 Stefano D'Ugo et al.

Figures

Figure 1
Figure 1
Geometrical characteristics of the ellipsoid.
Figure 2
Figure 2
EWL% vs resected gastric volume trend at 1 year.

References

    1. Haslam D. W., James W. P. T. Obesity. The Lancet. 2005;366(9492):1197–1209. doi: 10.1016/S0140-6736(05)67483-1.
    1. Gentileschi P. Laparoscopic sleeve gastrectomy as a primary operation for morbid obesity: experience with 200 patients. Gastroenterology Research and Practice. 2012;2012:4. doi: 10.1155/2012/801325.801325
    1. Ali M., el Chaar M., Ghiassi S., Rogers A. M., American Society for Metabolic and Bariatric Surgery Clinical Issues Committee American Society for Metabolic and Bariatric Surgery updated position statement on sleeve gastrectomy as a bariatric procedure. Surgery for Obesity and Related Diseases. 2017;13(10):1652–1657. doi: 10.1016/j.soard.2017.08.007.
    1. Singh J. P., Tantia O., Chaudhuri T., Khanna S., Patil P. H. Is resected stomach volume related to weight loss after laparoscopic sleeve gastrectomy? Obesity Surgery. 2014;24(10):1656–1661. doi: 10.1007/s11695-014-1250-x.
    1. Obeidat F. W., Shanti H. A., Mismar A. A., Elmuhtaseb M. S., Al-Qudah M. S. Volume of resected stomach as a predictor of excess weight loss after sleeve gastrectomy. Obesity Surgery. 2014;24(11):1904–1908. doi: 10.1007/s11695-014-1330-y.
    1. McCracken J., Steinbeisser M., Kharbutli B. Does size matter? Correlation of excised gastric specimen size in sleeve gastrectomy to postoperative weight loss and comorbidities. Obesity Surgery. 2018;28(4):1002–1006. doi: 10.1007/s11695-017-2975-0.
    1. Du X., Luo R., Chen Y.-y., Peng B.-q., Hu J.-k., Cheng Z. Resected gastric volume has no influence on early weight loss after laparoscopic sleeve gastrectomy. Surgery for Obesity and Related Diseases. 2018;14(2):129–135. doi: 10.1016/j.soard.2017.11.005.
    1. Robert M., Pasquer A., Pelascini E., Valette P.-J., Gouillat C., Disse E. Impact of sleeve gastrectomy volumes on weight loss results: a prospective study. Surgery for Obesity and Related Diseases. 2016;12(7):1286–1291. doi: 10.1016/j.soard.2016.01.021.
    1. Pawanindra L., Vindal A., Midha M., Nagpal P., Manchanda A., Chander J. Early post-operative weight loss after laparoscopic sleeve gastrectomy correlates with the volume of the excised stomach and not with that of the sleeve! Preliminary data from a multi-detector computed tomography-based study. Surgical Endoscopy. 2015;29(10):2921–2927. doi: 10.1007/s00464-014-4021-9.
    1. Bekheit M., Abdel-Baki T. N., Gamal M., et al. Influence of the resected gastric volume on the weight loss after laparoscopic sleeve gastrectomy. Obesity Surgery. 2016;26(7):1505–1510. doi: 10.1007/s11695-015-1981-3.
    1. Ferrer-Márquez M., García-Díaz J. J., Moreno-Serrano A., et al. Changes in gastric volume and their implications for weight loss after laparoscopic sleeve gastrectomy. Obesity Surgery. 2017;27(2):303–309. doi: 10.1007/s11695-016-2274-1.
    1. Vidal P., Ramón J. M., Busto M., et al. Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obesity Surgery. 2014;24(3):359–363. doi: 10.1007/s11695-013-1113-x.
    1. Braghetto I., Cortes C., Herquiñigo D., et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2–3 years after sleeve gastrectomy. Obesity Surgery. 2009;19(9, article 9874):1262–1269. doi: 10.1007/s11695-009-9874-y.
    1. Elbanna H., Emile S., El-Hawary G. E.-S., et al. Assessment of the correlation between preoperative and immediate postoperative gastric volume and weight loss after sleeve gastrectomy using computed tomography volumetry. World Journal of Surgery. 2019;43(1):199–206. doi: 10.1007/s00268-018-4749-9.
    1. Hanssen A., Plotnikov S., Acosta G., et al. 3D volumetry and its correlation between postoperative gastric volume and excess weight loss after sleeve gastrectomy. Obesity Surgery. 2018;28(3):775–780. doi: 10.1007/s11695-017-2927-8.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren