Laparoscopic subtotal gastrectomy in morbid obese patients: a valid option to laparoscopic gastric bypass in particular circumstances (prospective study)
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Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) without resection of the distal stomach is largely performed over the world for morbid obesity. Potential risk of gastric remnant carcinoma development has been suggested.
To present the results obtained after LRYGB with resection of distal stomach.
This prospective study includes 400 consecutive patients. The mean body weight was 105.9 ± 16.8 Kg (range 83–145 kg), and body mass index (BMI) was 38.5 ± 4.4 kg/m2 (32.9–50.3). Postoperative morbid–mortality and follow-up were analyzed.
Operative time was 128.5 ± 18.7 min, hospital discharge occurred at 3rd postoperative day, postoperative complications occurred in 9.25%, early surgical complications were observed in 3% and medical complications 4%, late surgical complications occurred 2.25%, no mortality was observed. At 1 year follow-up, BMI was 25.3 ± 2.7 kg/m2 with % of weight loss (%WL) of 84.6 + 19.1%. At five years follow-up very similar values were observed.
The results obtained after LRYGB with resection of distal stomach are similar to results published after non resection LRYGB regarding early and late results and can be indicated in high risk areas of gastric carcinoma.
KeywordsLaparoscopy Gastric Bypass Gastric resection
Compliance with ethical standards
Conflict of interest
All authors declare they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 7.Cunha Medeiros A, Meneses Rego A, Medeiros Azevedo I, Ferreira Carvalho M, Brasil Medeiros V, Araujo F. Metabolism and gastric remnant changes after Roux-en-Y gastric bypass in rats. J Invest Surg 2011;24:109–14Google Scholar
- 9.Carrodeguas L, Szomstein S, Soto F, Whipple O, Simpfendorfer C, Gonzalvo JP et al (2005) Management of gastrogastric fistulas after divided Roux-en-Y gastric bypass surgery for morbid obesity: analysis of 1,292 consecutive patients and review of literature. Surg Obes Relat Dis 1:467–74CrossRefPubMedGoogle Scholar
- 15.Orlando G, Pilone V, Vitiello A, Gervasi R, Lerose MA, Silecchia G et al. A Gastric cancer following bariatric surgery: a review. Surg Lap Endosc Perc Tech 2014;24:400–405Google Scholar
- 24.Tinoco A, Gottardi LF, Boechat ED (2015) Gastric cancer in the excluded stomach 10 years after gastric bypass. Case Rep Surg 468293Google Scholar
- 29.Haenen FW, Gys B, Moreels T, Michielsen M, Gys T, Lafullarde T (2016) Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass. A case report. Acta Chir Belg 6:1–12Google Scholar
- 39.Nogueira T, Artigiani RN, Herani BF, Waisberg J (2016) Helicobacter Pylori infection, endoscopic, histological aspect and cell proliferation in the gastric mucosa of patients submitted to Roux-en-Y Gastric Bypass with contention ring: a cross sectional endoscopic and inmunohitochemical study. Arq Gastroenterol 53:55–60CrossRefGoogle Scholar