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Does antrum size matter in sleeve gastrectomy? A prospective randomized study

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A Correction to this article was published on 04 August 2020

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is a safe and effective bariatric procedure in terms of excess weight loss. Nevertheless, controversies still exist on several technical and operative aspects of LSG. The aim of this study is to evaluate variations in anthropometric features in subjects with a LSG gastric resection starting from 2 cm or 6 cm from the pylorus. Secondary aim was the evaluation of differences in morbidity, food tolerance, and GERD incidence studied with upper endoscopy (UE) and GERD Health-Related Quality-of-Life score.

Methods

Patients were prospectively randomized into 2 groups: Group A (at 2 cm proximally to the pylorus) and Group B (at 6 cm proximally to the pylorus). All patients were followed-up at 3, 6, 12, and 24 months. UE was performed in all patients at 12 or 24 months.

Results

One hundred and fifty met the inclusion criteria and were enrolled in the study. The anthropometric features (BMI, %EWL, %TWL) resulted statistically different in the first 12 months (24.2 ± 3.4 vs 27.5 ± 4.3, 63.7 ± 14.1 vs 59.6 ± 12.5 and 42.9 ± 7.4 vs 38.2 ± 6.2), in favor of group A. At 24 months the differences disappeared (25.2 ± 4.4 vs 26.2 ± 3.3, 62.8 ± 13.1 vs 61.6 ± 10.5 and 41.9 ± 7.4 vs 40.2 ± 6.2). An increased GERD was found in both groups postoperatively with a higher incidence in group A at 6-month follow-up.

Conclusion

Performing the LSG with a radical antrectomy could improve weight loss at 12-month follow-up but expose to lower food tolerance and higher transitory GERD. The differences seem to be reduced to a 24-month.

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Authors and Affiliations

  1. Department of Surgery, Hospital “A. Rizzoli”, Aslnapoli2nord, Naples, Italy

    Francesco Pizza & Dario D’Antonio

  2. Division of General, Mininvasive and Bariatric Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Francesco Saverio Lucido, Claudio Gambardella & Salvatore Tolone

  3. Bioinformatics and Biostatistics Unit, Biomedical Research Institute (INCLIVA), Valencia, Spain

    Juan Antonio Carbonell Asíns

  4. Department of Infectious Diseases, AORN “Dei Colli”, Naples, Italy

    Chiara Dell’Isola

Authors
  1. Francesco Pizza
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  2. Dario D’Antonio
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  5. Juan Antonio Carbonell Asíns
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  7. Salvatore Tolone
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Correspondence to Francesco Pizza.

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Disclosures

Francesco Pizza, Dario D’antonio, Francesco Saverio Lucido, Claudio Gambardella, Chiara Dell’Isola, Juan Antonio Carbonell Asíns and Salvatore Tolone declare that they have no competing interests or financial ties to disclose.

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This article was updated to correct Juan Antonio Carbonell Asíns' name in the author listing: Juan Antonio (given name) Carbonell Asíns (family name).

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Pizza, F., D’Antonio, D., Lucido, F.S. et al. Does antrum size matter in sleeve gastrectomy? A prospective randomized study. Surg Endosc 35, 3524–3532 (2021). https://doi.org/10.1007/s00464-020-07811-1

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  • DOI: https://doi.org/10.1007/s00464-020-07811-1

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