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Published on: December 27, 2024
Comparison of Mid- and Long-term Outcomes of Antrum-Resecting Versus Antrum-Preserving Laparoscopic Sleeve
Muhammed Taha Demirpolat1,2, Mehmet Muzaffer Islam3, Mehmet Erman Bacaksız4
1Department of General Surgery, Altınbas Medicalpark University Hospital, Istanbul, Turkey. dr_mtd23@hotmail.com.
Background:
The aim of this study is to compare the mid- and long-term results after laparoscopic sleeve gastrectomy (LSG) according to the distance of the first staple from the pylorus.
Methods:
This study is a retrospective analysis of prospectively collected data of patients who underwent LSG. While the distance of the first staple from the pylorus was 2-3 cm in group A, the distance of the first staple to the pylorus was 5-6 cm in group B. Laboratory parameters, comorbidity resolution, anthropometric measurements, and complications were documented at the end of the first, third, and fifth postoperative years.
Results:
Of the total 376 patients, 127 were excluded for various reasons, 102 patients were lost to follow-up, and 147 patients were included in the final analysis. Upon examining the follow-up data at the 1st, 3rd, and 5th years, a statistically significant difference was observed between the groups in terms of total weight loss (TWL%), excess body mass index loss (EBMIL%), and recurrent weight gain (RWG)%, with group A showing an advantage. The majority of the patients requiring conversional metabolic and bariatric surgery (MBS) were in group B, and the difference was significant (p = 0.017).
Conclusion:
The distance of the first staple from the pylorus may significantly influence the outcomes related to RWG%, TWL%, and type 2 diabetes mellitus (T2DM) resolution in the medium-long-term. Furthermore, additional research is needed to determine the optimal positioning for enhanced patient results.
