The effect of antral resection start point on post sleeve gastrectomy gastroesophageal reflux symptoms and weight loss outcomes

Meimand, Faridadin Ebrahimi; Pazouki, Abdolreza; Setaredan, Seyed Amin; Shahsavan, Masoumeh; Kermansaravi, Mohammad

doi:10.1007/s00464-023-10011-2

Cited by 4 publications

(2 citation statements)

References 42 publications

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“…Some studies have reported a reduction in GERD symptoms after sleeve gastrectomy. The reason for the improvement in GERD symptoms could be due to the reduction in the stomach's size and the decreased secretion of ghrelin hormone [21]. Also, weight loss can play a role in the decrease in GERD symptoms and frequency; this may support the data we found.…”

Section: Discussionsupporting

confidence: 86%

De Novo Gastroesophageal Reflux Disease Symptoms Are Infrequent after Sleeve Gastrectomy at 2-Year Follow-Up Using a Comprehensive Preoperative Esophageal Assessment

Tolone,

Conzo,

Flagiello

et al. 2024

JCM

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Pathological obesity is a growing public health concern, and its association with gastroesophageal reflux disease (GERD) poses challenges in selecting the appropriate bariatric procedure. Sleeve gastrectomy (SG) has become a popular choice due to its simplicity and effectiveness in weight loss. However, concerns regarding postoperative GERD have been raised. This study aimed to evaluate the association between preoperative assessment of esophageal function and the risk of developing postoperative GERD in patients undergoing SG. A comprehensive evaluation was conducted, including symptom assessment, upper endoscopy, high-resolution esophageal manometry (HRM), and 24 h esophageal pH impedance monitoring (MII-pH). A total of 500 obese patients were included, and their data were compared with 25 healthy volunteers. This study revealed that patients without GERD symptoms, normal endoscopy, HRM, and MII-pH were suitable candidates for SG, with low risk of developing postoperative GERD. The addition of fundoplication techniques to SG may be considered in patients with mild reflux or those at risk of developing it. This study emphasizes the importance of preoperative evaluation in selecting the appropriate bariatric procedure to minimize the risk of postoperative GERD and expand the indications for SG in obese patients.

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Section: Discussionsupporting

confidence: 86%

De Novo Gastroesophageal Reflux Disease Symptoms Are Infrequent after Sleeve Gastrectomy at 2-Year Follow-Up Using a Comprehensive Preoperative Esophageal Assessment

Tolone,

Conzo,

Flagiello

et al. 2024

JCM

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“…One of these issues is distance of resection margin from pylorus. Some consider a 2cm distance between pylorus and staple line more effective in causing excess weight loss 10 . On the other hand, many suggest a distance of 6cm from pylorus enhance gastric emptying by preserving gastric antrum 11 .…”

Section: Discussionmentioning

confidence: 99%

Effects of 6cm versus 2cm Resection Margin from Pylorus on Excess Weight Loss & Complication Rate for Laparo- Scopic Sleeve Gastrectomy: A Nine-Year Experience

Junaid Khan Lodhi,

Saba Tahir Bukhari,

Asma Munaf

et al. 2024

Proceedings S.Z.M.C

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Introduction: LSG is the gold standard sole bariatric procedure for morbid obesity. Small (2cm) and large (6cm) distance of resection margin from pylorus are both being used for neogastric sleeve formation however what is optimal distance remains controversial. Aims & Objectives: To assess excess weight loss results and complication rate with 6cm and 2cm distance of staple line from pylorus during a prolonged surveillance period. Place and Duration of Study: This retrospective cohort study was conducted at Fatima Memorial Hospital from Dec 2013 to Dec 2022 spanning 9 years. Material & Methods: Medical records of 50 morbidly obese patients aged 41- 50 yrs were segregated into two groups of 25 each based on the LSG procedure conducted. Group 1 had LSG with 6cm resection margin from pylorus while group 2 had a staple line distance of 2cm from pylorus for neogastric sleeve formation. The patients were subsequently followed up for excess weight loss (EXL) and BMI at 6 months, 1 year, 2 years, 3 years & 4-year interval. Data was entered and analyzed using SPSS version 21.P value ? 0.05 was considered significant. Results: EWL in Group 1 & 2 was 39.2± 6.77kg & 41.9± 4.35kg at 6 months,73.64± 6.49kg & 71.06± 7.77kg at 1 year, 65.52± 5.53kg & 63.92± 7.07kg at 2 years,58.16± 4.97kg & 57.28± 5.75kg at 3 years and 55.48± 3.39kg & 55.36± 3.72kg for 4 years were, not significant statistically. BMI in group 1 & 2 were 39.47± 5.11 & 35.88± 4.40 at 6 months, 29.22± 2.68 & 29.12± 2.00 at 1 year, 25.44± 1.96 & 24.73± 2.86 at 2 years, 22.84± 1.79 & 22.40±2.20 at 3 years and 21.66± 1.32, 21.67± 1.62 at 4 years were found to be statistically insignificant. Conclusion: With regards to extra weight loss, distance of resection margin from pylorus of 2cm or 6cm have identical effects but the latter has lowest complication incidence after 4 yrs of surveillance. Hence, a distance of 6cm is favoured to ensure safety of LSG for morbidly obese patients. And the findings of this study will help bariatric surgeons to improve technique of LSG in a safe and successful way for effective weight loss in morbidly obese patients.

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Leaks after laparoscopic sleeve gastrectomy: 2024 update on risk factors

Iossa,

Martini,

De Angelis

et al. 2024

Langenbecks Arch Surg

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The effect of antral resection start point on post sleeve gastrectomy gastroesophageal reflux symptoms and weight loss outcomes

Cited by 4 publications

References 42 publications

De Novo Gastroesophageal Reflux Disease Symptoms Are Infrequent after Sleeve Gastrectomy at 2-Year Follow-Up Using a Comprehensive Preoperative Esophageal Assessment

De Novo Gastroesophageal Reflux Disease Symptoms Are Infrequent after Sleeve Gastrectomy at 2-Year Follow-Up Using a Comprehensive Preoperative Esophageal Assessment

Effects of 6cm versus 2cm Resection Margin from Pylorus on Excess Weight Loss & Complication Rate for Laparo- Scopic Sleeve Gastrectomy: A Nine-Year Experience

Leaks after laparoscopic sleeve gastrectomy: 2024 update on risk factors

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