Does Antrum Size Matter in Sleeve Gastrectomy? Volume II-A Retrospective Multicentric Study with Long-Term Follow-Up

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Obesity Medicine

Background:

• Laparoscopic sleeve gastrectomy (LSG) is a leading bariatric procedure, yet standardization and complication management, like gastroesophageal reflux disease (GERD), remain areas of focus.
• Variations in surgical technique, specifically the extent of antrum resection, may influence patient outcomes.

Purpose of the Study:

• To compare the long-term anthropometric outcomes and complication rates, particularly GERD, between wide antrectomy and small antrectomy during LSG in patients with morbid obesity.

Main Methods:

• A retrospective study evaluated 597 patients undergoing LSG, divided into wide antrectomy (Group A) and small antrectomy (Group B) groups.
• Data collected included body mass index (BMI), percentage of excess weight loss (%EWL), and GERD Health-Related Quality-of-Life (GERD-HRQL) scores at 5-year follow-up.

Main Results:

• While wide antrectomy initially showed greater weight loss improvements, these differences became insignificant by 24 months, with no long-term divergence at 5 years.
• The small antrectomy group reported significantly better GERD-HRQL scores up to 24 months, with comparable long-term results between groups.

Conclusions:

• Wide antrectomy offers short-term anthropometric advantages, but both wide and small antrectomy techniques result in similar long-term weight management and GERD incidence after LSG.
• Further prospective research is warranted to definitively establish optimal antrum resection strategies in LSG.