title: Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study).
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is a surgical technique that treats morbid obesity.
  
  
  METHODS
  Consecutive patients with morbid obesity treated by LSG at our department were evaluated. Patients enrolled in the study were randomized into group I (LSG begins the division 2 cm from the pylorus) and group II (LSG begins the division 6 cm from the pylorus). The primary outcome measure was the percent of excess weight loss (% EWL); secondary outcomes included postoperative morbidity and mortality and improvement of comorbidity.
  
  
  RESULTS
  One hundred five patients (79 (75.2 %) were females) were randomized into two groups of (GI) 52 patients and (GII) 53 patients. In group I, the mean % EWL was 51.8 ± 13.9, 63.8 ± 16.1 and 71.8 ± 12; however, in group II, the mean % EWL was 38.3 ± 10.9, 51.9 ± 13.6 and 61 ± 11.1 at 6, 12, and 24 months, respectively (P = 0.0001, 0.0001, 0.003). There was weight regain after 2 years in five patients in group II and only one patient in group I (P = 0.09). There was no significant difference between both group as regards gastric leakage, vomiting or GER. There was significant improvement in comorbidity after LSG in both groups, but no significant difference between them. Hospital mortality occurred in group II in one case as a result of gastric leakage.
  
  
  CONCLUSIONS
  LSG is a safe and effective procedure with good short-term outcome. Increasing the size of the resected antrum is associated with better weight loss without increasing the rate of complications significantly.
authors.affiliation: Surgical Department, Mansoura University, Mansoura, Egypt.
authors.forename: Emad
authors.initials: E
authors.lastname: Abdallah
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.forename: Tamer
authors.initials: T
authors.lastname: Youssef
authors.forename: Tamer
authors.initials: T
authors.lastname: Yousef
authors.forename: Hesham
authors.initials: H
authors.lastname: Abdallah
authors.forename: Mohamed Abd
authors.initials: MA
authors.lastname: Ellatif
authors.forename: Ahmed
authors.initials: A
authors.lastname: Lotfy
authors.forename: Mohamed
authors.initials: M
authors.lastname: Youssef
authors.forename: Abdelazeem
authors.initials: A
authors.lastname: Elganash
authors.forename: Ahmed
authors.initials: A
authors.lastname: Moatamed
authors.forename: Mosaad
authors.initials: M
authors.lastname: Morshed
authors.forename: Mohammed
authors.initials: M
authors.lastname: Farid
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss
references.citation: Obes Surg. 2009 May;19(5):595-600
references.pmid: 19224300
references.citation: Surg Endosc. 2013 Jan;27(1):240-5
references.pmid: 22752283
references.citation: Surg Today. 2007;37(4):275-81
references.pmid: 17387557
references.citation: Obes Surg. 2012 Dec;22(12):1874-9
references.pmid: 22915063
references.citation: Surg Obes Relat Dis. 2009 Jul-Aug;5(4):469-75
references.pmid: 19632646
references.citation: Obes Surg. 2012 Jan;22(1):182-7
references.pmid: 21861236
references.citation: Obes Surg. 2005 Sep;15(8):1124-8
references.pmid: 16197783
references.citation: Obes Surg. 2010 May;20(5):535-40
references.pmid: 20094819
references.citation: Obes Surg. 2011 Feb;21(2):146-50
references.pmid: 21132397
references.citation: Obes Surg. 2010 Mar;20(3):357-62
references.pmid: 20013071
references.citation: N Engl J Med. 2004 Dec 23;351(26):2683-93
references.pmid: 15616203
references.citation: Ann Surg. 2004 Aug;240(2):205-13
references.pmid: 15273542
references.citation: Obes Surg. 2006 Nov;16(11):1445-9
references.pmid: 17132409
references.citation: Obes Surg. 2013 Oct;23(10):1551-7
references.pmid: 23636996
references.citation: Am J Surg. 2008 Nov;196(5):e56-9
references.pmid: 18954593
references.citation: Surg Endosc. 2006 Jun;20(6):859-63
references.pmid: 16738970
references.citation: Obes Surg. 2010 Aug;20(8):1171-7
references.pmid: 20379795
references.citation: Obes Surg. 2010 Sep;20(9):1306-11
references.pmid: 20574787
references.citation: Obes Surg. 2007 Jan;17(1):57-62
references.pmid: 17355769
references.citation: Br J Anaesth. 2012 May;108(5):768-75
references.pmid: 22401881
references.citation: Obes Surg. 2011 Aug;21(8):1225-31
references.pmid: 21533881
references.citation: Ann Surg. 2010 Aug;252(2):319-24
references.pmid: 20622654
references.citation: Obes Surg. 2008 May;18(5):560-5
references.pmid: 18317859
references.citation: Obes Surg. 2010 Jan;20(1):1-6
references.pmid: 19802646
references.citation: Ann Surg. 2013 Feb;257(2):231-7
references.pmid: 23023201
references.citation: Obes Surg. 2005 Aug;15(7):1030-3
references.pmid: 16105402
references.citation: Obes Surg. 2012 May;22(5):721-31
references.pmid: 22411568
references.citation: Obes Surg. 2009 Sep;19(9):1203-10
references.pmid: 19572113
references.citation: Obes Surg. 2012 Mar;22(3):507-14
references.pmid: 22246395
references.citation: Surg Endosc. 2013 Oct;27(10):3937
references.pmid: 23708727
references.citation: Obes Surg. 2011 Jul;21(7):858-63
references.pmid: 20730606
references.citation: World J Gastroenterol. 2008 Feb 14;14(6):821-7
references.pmid: 18240338
references.citation: Obes Surg. 2012 Jan;22(1):42-6
references.pmid: 21533880
references.citation: Ann Surg. 2012 Aug;256(2):262-5
references.pmid: 22791102
references.citation: Obes Surg. 2006 Sep;16(9):1138-44
references.pmid: 16989696
references.citation: Obes Surg. 2007 Jun;17(6):722-7
references.pmid: 17879568