Does gastric resection volume influence sleeve gastrectomy results? a prospective study

Sista, Federico; Abruzzese, Valentina; Colozzi, Sara; Schietroma, M; Carlei, F; Mattei, Antonella Souza; Clementi, Marco; Carandina, Sergio; Barrat, Christophe; Amicucci, Gianfranco

doi:10.18203/2349-2902.isj20160209

Cited by 9 publications

(8 citation statements)

References 32 publications

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“…Another central factor being discussed as a predictor of both postoperative complications and weight loss results after LSG is the GRV. Although its impact has been widely discussed, the results are mainly discordant, thus fueling an ongoing debate [16][17][18][19]27]. Here, a recent prospective study suggested that GRV is impacting the outcomes subsequent to LSG during short-term and midterm follow-up while at the same time predicting the weight loss results in terms of percentage of excess weight loss (%EWL) and control of obesityrelated metabolic complications [19].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, a larger gastric remnant volume could be responsible for lower weight loss after LSG, and nevertheless, the gastric resected volume (GRV) is strictly related to the residual volume [16]. Even though some authors strictly exclude possible impact of GRV on weight loss after LSG [17,18], a recent prospective study by Sista et al demonstrated that the GRV is affecting outcomes after LSG, therefore being a predictive factor for weight loss and reduction of comorbidity [19]. Recently, a prospective study by Kim et al could associate preoperative stomach volume assessed by three-dimensional computed tomography with visceral fat volume and BMI, thus pointing out towards a more tailored therapeutic approach in bariatric surgery based on preoperative variables [20].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Resection Volume/Stapler Firings-Ratio on Perioperative Complications and Weight Loss After Laparoscopic Sleeve Gastrectomy

et al. 2020

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Background Major postoperative morbidity after laparoscopic sleeve gastrectomy (LSG) is often related to staple line leaks (SLL). Of note, a recent study suggested a central role of the absolute numbers of stapler firings as a predictive factor for postoperative morbidity due to SLL. In addition, a larger gastric remnant volume could be responsible for lower weight loss after LSG, and nevertheless, the gastric resection volume (GRV) is strictly related to the residual volume. Methods Prospectively, collected data of 384 consecutive patients with complete follow-up at 12 months after LSG at our institution were retrospectively analyzed. Patients were stratified according to three different variables (i.e., number of stapler firings, GRV, and GRV/stapler firings-ratio), and respective impact on postoperative complications and weight loss was analyzed. Results High absolute number of stapler firings was linked to increased intraoperative and postoperative bleeding and prolonged hospitalization, but was not associated with SLL, transfusion rate or revisional procedures. Absolute GRV showed no impact on both complications and outcome after LSG. Interestingly, higher ratio of GRV/stapler firings was not only linked to decreased intraoperative bleeding and shorter hospital stay but also to higher Excess Body Mass Index Loss (EBMIL) at 12 months after LSG. Conclusions Here, we introduce GRV/stapler firings-ratio as a simple predictive factor for identifying patients at risk for postoperative complications and impaired weight loss that is superior compared with absolute number of stapler firings or GRV alone.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Resection Volume/Stapler Firings-Ratio on Perioperative Complications and Weight Loss After Laparoscopic Sleeve Gastrectomy

et al. 2020

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“…Significant differences in the results of LSG for RGV>1200 ml were showed in the literature [ 4 , 5 , 13 ]. Other authors have also shown that very high or low RGV cut-off do not determine significant differences between the samples [ 13 , 15 ]. Weiner and al.…”

Section: Discussionmentioning

confidence: 99%

“…In our study we used a RGV of 1500 ml as a cut-off to compare the results of LSG: we have chosen experimentally a cut off 1500 ml with a minimum RGV of 1100 ml for Group A because several studies [ 4 , 13 ] show that the average range of RGV is between 900 ml and 1400 ml with a median of Gaussian distribution around 1100 ml and other authors have described HRGV values above 1500–1800 ml [ 13 , 15 ]. The Authors believe that, although arbitrary, an RGV>1500 defines well a High Gastric Resection Volume.…”

Section: Discussionmentioning

confidence: 99%

High Resected Gastric Volume and poorly controlled DM2 in laparoscopic sleeve gastrectomy

Sista

Abruzzese

Guadagni

et al. 2018

Annals of Medicine and Surgery

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BackgroundOur aim is to evaluate the effects of High Resected Gastric Volume(HRGV) on poorly Type 2 Diabetes Mellitus(DM2) after Laparoscopic Sleeve Gastrectomy(LSG).Methods256 patients were divided into two groups according to the RGV: < 1500 mL(Group A: 131 pts) and > 1500 mL(Group B: 147 pts). % excess body mass index loss (%EBMIL), Fasting Blood Glucose (FBG), HbA1c, C peptide were assessed before surgery and at the 3rd day, 6th,12th,24th,36th month after LSG.ResultsA significant difference in %EBMIL between the two groups at 24 and 36 months was found. RGV was not significantly associated with DM2 in the multivariate logistic regression. FBG levels showed no differences between the two groups. A significant decrease of Hb1Ac at 6 and 12 months was found in group B. The C-peptide level showed a significant reduction at 6 and 12 months in group B.ConclusionThe HRGV may play a role in the regulation of the glucose metabolism in the first year after LSG without influence in poorly DM2 control. Further studies are needed to confirm these findings.

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“…In conclusion there are neither certain data which evidence a correlation between obesity and GCT, nor data to support the hypothesis of a higher incidence of GCT after bariatric surgery. Based on our experience in obese patients [19,20], the finding of neuroendocrine tumors in the pre-operatory phase is not a contraindication for bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

Which is the correlation between carcinoid tumor and Laparoscopic Sleeve Gastrectomy? A case series and literature review

Sista

Abruzzese

Carandina

et al. 2018

Annals of Medicine and Surgery

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IntroductionGastric Carcinoid Tumors (GCT) are very rare in general population, but some studies evidenced a higher incidence among bariatric surgery patients. Laparoscopic Sleeve Gastrectomy (LSG) is a widely accepted procedure for the surgical treatment of morbid obesity. LSG acts both in reducing food intake and interfering with hormonal balance in the gut-brain axis. In these patients, incidental GCT diagnosis can occur both during pre-bariatric surgery investigation and during post-operative follow-up.MethodsWe retrospectively analyzed the database of obesity patients submitted to LSG in two different centers to find out incidence of GCT in patients treated by surgery from May 2013 to March 2018.ResultsFrom the 560 obese consecutive patients underwent LSG, we recorded two cases of patients with GCT (0.36%): the case 1 was a patient who had a pre-operative diagnosis of GTC receiving a curative LSG which totally included the carcinoid in the resected portion; the case 2 was a patient that received a curative endoscopic resection 42 months after LSG.Discussionthe predisposing factors that can correlate GCT with obesity and LSG and in particular the hormonal changes have been discussed. We illustrated our experience about the management of these tumors in obese patients.Conclusionthere are neither certain data which evidence a correlation between obesity and GCT, nor data to support the hypothesis of a higher incidence of GCT after bariatric surgery. Based on our experience in obese patients the finding of GCT in the pre-operatory phase is not an absolute contraindication for bariatric surgery.

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Does gastric resection volume influence sleeve gastrectomy results? a prospective study

Cited by 9 publications

References 32 publications

Impact of Resection Volume/Stapler Firings-Ratio on Perioperative Complications and Weight Loss After Laparoscopic Sleeve Gastrectomy

Impact of Resection Volume/Stapler Firings-Ratio on Perioperative Complications and Weight Loss After Laparoscopic Sleeve Gastrectomy

High Resected Gastric Volume and poorly controlled DM2 in laparoscopic sleeve gastrectomy

Which is the correlation between carcinoid tumor and Laparoscopic Sleeve Gastrectomy? A case series and literature review

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