Background
The objective of this study was to study the effect of the residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy (LSG) and to evaluate the effect of antral resection on weight reduction and complications after LSG.
Patients and methods
This retrospective study was carried out on the prospectively collected data of patients, who underwent LSG at Safwet Elgolf Private Hospital from February 2015 to July 2016. According to antral resection, the patients were divided into two groups: group A (=54) underwent a 6-cm antral resection and group B (=54) underwent a 2-cm antral resection. All patients who completed at least 24 months of follow-up postoperatively, the percentage of excess weight loss (%EWL) was calculated at 3, 6, 12, and 24 months as well as the postoperative complication rate.
Results
In our study, 110 patients were included. Patients in group B experienced statistically significant greater weight loss than patients in group A. Statistically significant greater weight regain was seen in group A. The mean BMI was 46.1±7.9 kg/m. In group A, the mean %EWL was 38.1±14.1, 54.9±19.9, 65.6±22.8, and 66.8±28.4% at 3, 6, 12, and 24 months, respectively. However, in group B, the mean %EWL was 42.1±13.4, 63.8±19.8, 80.0±22.1, and 81.5±22.9% at 3, 6, 12, and 24 months, respectively. Group B had a higher incidence of reflux symptoms and vomiting (six patients, 11%) than group B (four patients, 7.1%).
Conclusion
Radical antral resection in association with LSG safely potentiates the restrictive effect achieved and results in greater and better maintained weight loss, and in higher incidence of reflux symptoms and vomiting.