Laparoscopic gastric bypass for morbid obesity-a randomized controlled trial comparing two gastrojejunal anastomosis techniques.
OBJECTIVE
We present a randomized controlled trial of laparoscopic gastric bypass comparing 2 techniques of gastrojejunostomy in patients with morbid obesity.


METHODS
Eighty consecutive patients underwent laparoscopic Roux-en-Y gastric bypass between September 2005 and August 2006. Patients were randomly assigned to 2 groups by the use of sealed envelopes. In group A, the gastrojejunal anastomosis was performed with a 21-mm circular-stapler, and in group B, this anastomosis was performed with a 45-mm linear-stapler. The rest of the procedure was identical in both groups. Variables evaluated were complications involving the gastrojejunostomy, operative time, length of stay, and percentage of excess weight loss.


RESULTS
Both groups were similar in age and body mass index. No patients experienced leakage or gastrojejunal anastomosis fistula, but group A patients had a more frequent stricture rate (P<0.05). Operative time and hospital stay were comparable in both groups (P>0.05). Percentage excess weight loss at one year following surgery was satisfactory in both groups, without a statistically significant difference (P>0.05).


CONCLUSIONS
Gastrojejunal anastomosis does not seem to be a critical factor in excess weight loss for morbidly obese patients who underwent laparoscopic gastric bypass. The 2 techniques used in this experience are safe and effective; however, the 45-mm liner-stapler is preferable because it has a lower stricture rate.
Leyba
Jose Luis
JL
Universidad Central de Venezuela, Caracus, Venezuela. jlleyba@yahoo.es
Llopis
Salvador Navarrete
SN
Isaac
Jose
J
Aulestia
Salvador Navarrete
SN
Bravo
Carlos
C
Obregon
Francisco
F
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D013270:Stomach / Q000601:surgery; D013528:Surgical Staplers