Impact of sleeve gastrectomy volumes on weight loss results: a prospective study

M. Robert , A. Pasquer , E. Pelascini , P. J. Valette , C. Gouillat , Emmanuel Disse (1, 2)

1 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
2 HCL - Hospices Civils de Lyon

BACKGROUND: Causes of weight loss failure after sleeve gastrectomy (SG) are still controversial. The impact of the size of the sleeve continues to be debated. OBJECTIVE: The aim of our study was to determine the impact of sleeve volumes assessed at 3 months using gastric computed tomography (CT) on weight loss at 18 months. SETTING: University Hospital, France. METHODS: Sixty-seven obese patients eligible for SG were prospectively evaluated. Sleeve volumes were assessed postsurgery using 3-dimensional gastric CT with gas at 3 months and weight loss outcomes recorded up to 18 months. The population was divided into 2 groups: the first tertile (n = 22) with the smallest gastric volume was defined as the "small sleeve" group (SSG) and the rest of the population (n = 45) was defined as the "without small sleeve" group (WSSG). RESULTS: No patients were lost to follow-up. In the SSG, overall gastric volume was 133+/-7 mL versus 264+/-11 mL for the WSSG (P\textless.0001). Percentage excess body mass index loss (%EBMIL) during the first postoperative 18 months was significantly greater in the SSG compared with the WSSG (P = .04). Although the volume of the gastric tube was not correlated with weight loss (r =-.04, P = .78), there was a negative linear correlation between the volume of the antrum and the %EBMIL at 18 months (r =-.39, P = .005). A narrow gastric tube was also associated with a high digestive intolerance and reflux. CONCLUSION: Our data suggest that performing the sleeve with a not-too-small bougie size and a radical antrectomy could improve weight loss and digestive tolerance.

Mots clés: Adult; Female; Humans; Male; Prospective Studies; Obesity; Endoscopy; Gastrointestinal; Tomography; X-Ray Computed; Organ Size; Weight Loss/*physiology; Bariatric Surgery/*methods; Gastrectomy/*methods; Gastric computed tomography; Gastroesophageal Reflux/etiology; Obesity/pathology/*surgery; Sleeve gastrectomy; Stomach/*pathology; Volumetry; Weight loss

Domaines: Sciences du Vivant [q-bio]

M. Robert, A. Pasquer, E. Pelascini, P. J. Valette, C. Gouillat, et al.. Impact of sleeve gastrectomy volumes on weight loss results: a prospective study. Surgery for Obesity and Related Diseases, 2016, 12 (7), pp.1286-1291. ⟨10.1016/j.soard.2016.01.021⟩. ⟨hal-01850289⟩