Size really does matter-role of gastrojejunostomy in postoperative weight loss.
BACKGROUND
Although the published data have clearly related the size of the gastrojejunostomy anastomosis to the subsequent likelihood of a stricture, a correlation between the anastomosis size and postoperative weight loss has not previously been described.


METHODS
A retrospective comparison was made of 124 anastomoses accomplished with the 21-mm circular stapler followed by 100 anastomoses created with the 45-mm linear stapler technique at 6 community hospitals in Southern California. Age, gender, and preoperative weights were not significantly different between the 2 groups. The precise size of the anastomosis created using the linear stapler technique could not be determined, but it was calculated to be slightly larger than a 25-mm circular stapled anastomosis. Both weight loss trends were fit with a 1-phase exponential nonlinear regression analysis. The resulting curves were compared using an F test. A 1-tailed t test was also used to compare the weight loss at 12 months.


RESULTS
An F test comparison of the exponential weight loss curves generated by the 2 anastomosis groups showed a significantly different trend in weight loss (P <.001). A 1-tailed t test comparison of the 2 groups at 12 months revealed significantly different results (p <.0025).


CONCLUSIONS
The results of this study show that the size of the anastomosis has a clear correlation with postoperative weight loss. A smaller opening results in significantly more weight loss.
Owens
Milton L
ML
Coastal Center for Obesity, San Pedro, California, USA.
Sczepaniak
John P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002140:California; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss