The impact of roux limb length on weight loss after gastric bypass.
BACKGROUND
Extending the length of the Roux limb (RL) in gastric bypass (GBP) may improve weight loss in super obese patients (body mass index [BMI] > 50 kg/m(2)), but no consensus exists about the optimal length of the RL. We sought to determine the impact of RL length on weight loss in super obese patients 1 year after GBP.


METHODS
One-year weight loss outcomes were analyzed in all super obese patients who underwent consecutive and primary laparoscopic or open GBP between January 2003 and June 2006. Patients were divided into two groups according to RL length (100 vs. 150 cm). The RL length was at the discretion of the attending surgeon. Baseline and follow-up data were collected prospectively. Multiple linear regression was used to adjust for potential confounders in the weight loss outcomes.


RESULTS
Twelve-month follow-up data were available in 137 (85%) of 161 patients with a BMI >or= 50 who underwent GBP during the study period. An RL of 100 or 150 cm was used in 102 (74.5%) and 35 patients (25.5%), respectively. In multivariate analysis, patients with the 150-cm RL lost more weight (68.5 vs. 55.3 kg, p < 0.01), had a greater change in BMI (25 vs. 21 kg/m(2), p = 0.01), and had greater excess weight loss (64 vs. 53%, p < 0.01).


CONCLUSIONS
A 150-cm RL provides better weight loss outcomes in super obese patients at 1-year follow-up.
Bariatric Surgery Program, Department of Surgery, University of California San Francisco, 521 Parnassus Avenue, C-341, San Francisco, CA, 94143-0790, USA.
Ruxandra
R
Ciovica
Mark
M
Takata
Eric
E
Vittinghoff
Feng
F
Lin
Andrew M
AM
Posselt
Charlotte
C
Rabl
Hubert J
HJ
Stein
Guilherme M
GM
Campos
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009767:Obesity, Morbid / Q000601:surgery*; D015431:Weight Loss