title: Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) has been increasingly offered to high-risk bariatric patients as the first-stage procedure before gastric bypass or biliopancreatic diversion or as the primary weight loss procedure. The bougie size has varied by surgeon during LSG. The aim of this study was to determine whether short-term weight loss correlates with the bougie size used during creation of the sleeve.
  
  
  METHODS
  We retrospectively reviewed the data from all patients who had undergone LSG at our institution between 2003 and 2006. Revision LSG for failed bariatric procedures was excluded. The data analyzed included preoperative age, body mass index (BMI), bougie size, and percentage of excess weight loss (%EWL).
  
  
  RESULTS
  A total of 135 patients underwent LSG during the 4-year period. Most of these patients (79%) underwent LSG as part of a 2-stage operation (either gastric bypass or duodenal switch within a mean of 11 months). The mean preoperative age and BMI was 43.5 years and 60.1 kg/m(2), respectively. The mean BMI and %EWL at 6 months was 47.1 kg/m(2) and 37.9%, respectively. The mean BMI and %EWL at 12 months was 44.3 kg/m(2) and 47.3%, respectively. When stratifying the %EWL by bougie size (40F versus 60F), we did not find a significant difference at 6 months (38.8% versus 40.6%, P = NS) or 12 months (51.9% versus 45.4%, P = NS).
  
  
  CONCLUSIONS
  LSG results in significant weight loss in the short term. When stratifying outcomes by bougie size, our results suggested that a bougie size of 40F compared with 60F does not result in significantly greater weight loss in the short term. However, longer follow-up of the primary LSG group is required to determine whether a difference becomes evident over time.
authors.affiliation: Section of Laparoscopic and Bariatric Surgery, Department of Surgery, Cornell University Weill College of Medicine, New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Manish
authors.initials: M
authors.lastname: Parikh
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
authors.forename: Laura
authors.initials: L
authors.lastname: Heacock
authors.forename: Gladys
authors.initials: G
authors.lastname: Strain
authors.forename: Gregory
authors.initials: G
authors.lastname: Dakin
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D015431:Weight Loss