Comparison of Mid- and Long-term Outcomes of Antrum-Resecting Versus Antrum-Preserving Laparoscopic Sleeve Gastrectomy.

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.