Journal de thérapie contre l'obésité et la perte de poids

Abstrait

Effect of Bougie Size and Level of Gastric Resection on Weight Loss Post Laparoscopic Sleeve Gastrectomy

Saleh M Aldaqal* and Munaser S Al-Amoodi

Objectives: To study the effect of bougie size and level of gastric resection on the outcome of laparoscopic sleeve gastrectomy (LSG) in morbid obese patients. Methods: A prospective randomized trial on 90 patients with morbid obesity who underwent LSG between February 2010 and April 2012. The Patients were prospectively randomized into two groups, the first group in which a bougie size of 34 French was used and resection of the stomach was performed 4 cm from pylorus. In the second group, a bougie size of 36 French was used, and resection of the stomach was performed 6 cm from the pylorus. A comparison between the two groups was carried out by assessing percentage of excess weight loss (%EWL), mean body mass index changes (mean BMI) at 6 months and one year post-operative, and complications of surgery . Results: Out of 45 patients in first group, 15 were males (33.3%) and 30 were females (66.7%), mean age was 31.3 years and mean BMI 46.1 kg/m2 (range 40-55.6). out of 45 patients in second group, 14 were males (31.2%) and 31were females (68.8%) with mean age of 32.3 years and mean BMI 45.4 kg/m2 (range 40-56). Six months after LSG, the %EWL in first group was 79% while in second group was 68% (P-value=0.011), and the mean BMI change was 10.1 kg/m2 (range 5-11) and 8.3 kg/m2 (range 4-9) respectively (P-value=0.009). One year after LSG, the %EWL in first group was 84% while in second group was 76 % (P-value=0.015), and the mean BMI change was 14.3 kg/m2 (range 7-15) and 11.2 kg/m2 (range 5-13) respectively (P-value=0.012). In both groups, the duration of operative time, bleeding, gastric leak, Intensive care unit admission, and hospital stay were similar in which statistically insignificant (p-value>0.05). Conclusion: Using bougie size 34fr and gastric resection at 4cm from the pylorus is safe and results in greater weight loss and higher change in BMI.