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Intrathoracic Migration of Gastric Sleeve Affects Weight Loss as well as GERD–an Analysis of Remnant Gastric Morphology for 100 Patients at One Year After Laparoscopic Sleeve Gastrectomy

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Abstract

Purpose

Laparoscopic sleeve gastrectomy (SG) is now frequently performed as a definitive bariatric procedure. The aim of the study was to evaluate the detailed morphology of remnant stomachs after SG with respect to volume and sleeve migration.

Materials and Methods

We performed a review of prospectively collected data on patients that completed a 12-month postop examination, which included CT volumetry of the sleeve, and a questionnaire that addressed postop food tolerance. CT volumetry study included total sleeve volume (TSV), tube volume (TV), antral volume (AV), tube/antral volume ratio (TAVR), and the presence of intrathoracic sleeve migration (ITSM).

Results

One hundred patients were included in this study. Mean %TWL (total weight loss) at 12 months postop was 31.1% (14.3~55.5), and mean TSV, TV, AV, and TAVR were 188.3 ± 67.3 ml, 81.3 ± 38.5 ml. 107.0 ± 45.1 ml, and 0.846 ± 0.514 respectively. TSV was not correlated significantly with %TWL at 12 months postop (r=−0.140, p=0.164). Thirty patients (30/100, 30%) showed ITSM. Patients with ITSM had a significantly lower mean GER score (5.9 ± 2.3 vs. 7.5±1.9, p=0.001), and a higher proportion showed suboptimal weight loss (43.3% vs. 15.7%, p=0.003).

Conclusions

Mean TSV was not found to be significantly correlated with %TWL at 12 months postop. The presence of ITSM indicated more frequent GER symptoms and a higher probability of suboptimal weight loss.

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Authors and Affiliations

  1. Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea

    Seung Joon Choi

  2. Department of Surgery, Gil Medical Center, Gachon University Gil Hospital, Gachon University College of Medicine, 1198, Guwol-dong, Namdong-Gu, 405-760, Incheon, Republic of Korea

    Seong Min Kim

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Correspondence to Seong Min Kim.

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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.

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Choi, S.J., Kim, S.M. Intrathoracic Migration of Gastric Sleeve Affects Weight Loss as well as GERD–an Analysis of Remnant Gastric Morphology for 100 Patients at One Year After Laparoscopic Sleeve Gastrectomy. OBES SURG 31, 2878–2886 (2021). https://doi.org/10.1007/s11695-021-05354-5

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  • DOI: https://doi.org/10.1007/s11695-021-05354-5

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