title: Impact of sleeve gastrectomy volumes on weight loss results: a prospective study.
abstract: BACKGROUND
  Causes of weight loss failure after sleeve gastrectomy (SG) are still controversial. The impact of the size of the sleeve continues to be debated.
  
  
  OBJECTIVE
  The aim of our study was to determine the impact of sleeve volumes assessed at 3 months using gastric computed tomography (CT) on weight loss at 18 months.
  
  
  METHODS
  University Hospital, France.
  
  
  METHODS
  Sixty-seven obese patients eligible for SG were prospectively evaluated. Sleeve volumes were assessed postsurgery using 3-dimensional gastric CT with gas at 3 months and weight loss outcomes recorded up to 18 months. The population was divided into 2 groups: the first tertile (n = 22) with the smallest gastric volume was defined as the "small sleeve" group (SSG) and the rest of the population (n = 45) was defined as the "without small sleeve" group (WSSG).
  
  
  RESULTS
  No patients were lost to follow-up. In the SSG, overall gastric volume was 133±7 mL versus 264±11 mL for the WSSG (P<.0001). Percentage excess body mass index loss (%EBMIL) during the first postoperative 18 months was significantly greater in the SSG compared with the WSSG (P = .04). Although the volume of the gastric tube was not correlated with weight loss (r =-.04, P = .78), there was a negative linear correlation between the volume of the antrum and the %EBMIL at 18 months (r =-.39, P = .005). A narrow gastric tube was also associated with a high digestive intolerance and reflux.
  
  
  CONCLUSIONS
  Our data suggest that performing the sleeve with a not-too-small bougie size and a radical antrectomy could improve weight loss and digestive tolerance.
authors.affiliation: Department of Digestive and Bariatric Surgery, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, Lyon, France. Electronic address: maud.robert@chu-lyon.fr.
authors.forename: Maud
authors.initials: M
authors.lastname: Robert
authors.affiliation: Department of Digestive and Bariatric Surgery, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pasquer
authors.affiliation: Department of Digestive and Bariatric Surgery, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Elise
authors.initials: E
authors.lastname: Pelascini
authors.affiliation: Claude Bernard Lyon 1 University, Lyon, France; Department of Radiology, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Valette
authors.affiliation: Department of Digestive and Bariatric Surgery, E. Herriot University Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Gouillat
authors.affiliation: Claude Bernard Lyon 1 University, Lyon, France; Department of Endocrinology, Lyon Sud University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Disse
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008297:Male; D009765:Obesity / Q000473:pathology / Q000601:surgery*; D009929:Organ Size; D011446:Prospective Studies; D013270:Stomach / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D015431:Weight Loss / Q000502:physiology*
keywords: Gastric computed tomography; Obesity; Sleeve gastrectomy; Volumetry; Weight loss