Background:The objective of this prospective randomized study was to study the effect of the residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy and to evaluate the effect of antral resection on weight reduction and complications after LSG.
Patients and Methods: Sixty patients underwent LSG as a primary bariatric procedure from November 2016 to March 2019 were randomized into two groups depending on the distance from the pylorus at which gastric division begins. In group (A), the distance was 2 cm from the pylorus, whereas the distance was 6 cm in group (B). The follow-up period was at least 6 months. Baseline and 3 and 6 month outcomes were analyzed including assessments of the percent excess weight lost (% EWL), reduction in BMI, morbidity, mortality, reoperations, quality of life, and co-morbidities.
Result(s): Sixty patients included in this study, whose mean pre-operative age was (32.48± 7.92) years, three (5%) patients were males and 57(95%) patients were females with a mean pre-operative BMI was (53.45 ± 8.00) Kg/m2. In group A, the mean % EWL was (33.1 ± 7.15) and (51.37 ± 8.57) at 3 and 6 months respectively. In group B the mean % EWL was (29.29 ± 6.1) and (46.44 ± 9.85) at 3 and 6 months respectively. Patients with the first staple line started 2 cm from the pylorus had better weight loss than those started 6 cm from the pylorus after 3 and 6 months, but this difference statistically insignificant.
Conclusion(s): LSG with 2 cm or 6 cm first staple firing from the pylorus produces significant weight loss after surgery. The 2 procedures are equally effective regarding %EWL, morbidity, quality of life, and improvement of co-morbiditieswith insignificant superiorities of 6 cm group.