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Food Tolerance After Laparoscopic Sleeve Gastrectomy with Total Antral Resection

Authors
  • Khalifa, Ibrahim G.1
  • Tobar, Wael L.1
  • Hegazy, Tarek O.1
  • Balamoun, Hany A.1
  • Mikhail, Sameh1
  • Salman, Mohammed Abdalla1
  • Elsayed, Elsayed A.1
  • 1 Cairo University, Department of General Surgery, Faculty of Medicine, Cairo, 11562, Egypt , Cairo (Egypt)
Type
Published Article
Journal
Obesity Surgery
Publisher
Springer-Verlag
Publication Date
Mar 21, 2019
Volume
29
Issue
7
Pages
2263–2269
Identifiers
DOI: 10.1007/s11695-019-03840-5
Source
Springer Nature
Keywords
License
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Abstract

BackgroundAmong the controversial points in laparoscopic sleeve gastrectomy (LSG) is how much of the antrum to be resected. This study aimed to evaluate food tolerance after preservation or resection of the antrum during LSG.MethodsProspective randomized study included 50 patients scheduled for LSG. Participants were randomly allocated into one of two groups. In antral resection (AR-LSG) group (n = 25), resection started 2 cm from the pylorus. In antral sparing (AS-LSG) group (n = 25), it started 6 cm from the pylorus. Percentage of excess weight loss (%EWL) and percentage of excess BMI loss (%EBL) were evaluated after 3 and 6 months. Quality of life (QOL) was evaluated by using the Bariatric Analysis and Reporting Outcome System (BAROS). Food tolerance was assessed using the Quality of Alimentation questionnaire. Primary outcome measure was food tolerance and %EWL.ResultsFood tolerance was significantly better in the antral sparing group compared to the antral resection group after 3 and 6 months. The two groups were comparable in %EWL and BMI change after 3 and 6 months. Six months after surgery, the majority of patients had a very good quality of life, with no significant difference between the two groups (p = 0.877). There was no significant difference between the two groups in operative time, intraoperative blood loss, and hospital stay.ConclusionsPreservation of the pyloric antrum during LSG is associated with significantly better food tolerance and comparable effect of weight loss up to 6 months postoperatively when compared with total antral resection.

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