Correlation of Gastric Volume and Weight Loss 5 Years Following Sleeve Gastrectomy
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ORIGINAL CONTRIBUTIONS
Correlation of Gastric Volume and Weight Loss 5 Years Following Sleeve Gastrectomy Clara Pañella 1,2 & Marcos Busto 3 & Alba González 1 & Carme Serra 1 & Alberto Goday 4,5,2,6 & Luís Grande 1,7,2 & Manuel Pera 1,7,2 & José M Ramón 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction The volume of the gastric reservoir (VGR) after sleeve gastrectomy influences weight loss in the short-term, but long-term results are scarce. The aim was to analyze the correlation between the VGR and weight loss at 5 years of follow-up. Methods It is a prospective observational study of 50 patients undergoing sleeve gastrectomy (SG) from February 2009 to December 2013. An upper gastrointestinal series was performed at 1 month and at 1 and 5 years after surgery. A composite formula was used for VGR estimation. Weight loss-related data included the following: body mass index (BMI), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL) at 1 month and at 1 and 5 years. Uni- and multivariate analyses were carried out to determine other factors that might influence long-term weight loss results. Results The %EWL at 1 year was 74.5(63.8–86) vs. 55.5(47–74.3) at 5 years (p < 0.001). The VGR 1 month after surgery was 114.9 (90.5–168.3) mL. The VGR increased from 216.7 (155.1–278.6) to 367.5 (273–560.3) mL (p < 0.001) at 1 and 5 years. Although a significant inverse correlation was observed between VGR and BMI, %EWL, and %EBMIL at 1 year, it disappeared at 5 years. In the multivariate analysis, the main factor to predict worse weight results at 5 years was a pre-surgical BMI ≥ 50 kg/m2. Conclusion The VGR increased progressively during the study period. Although an inverse relationship between VGR and weight was found at 1 year, this correlation did not remain at 5 years. A preoperative BMI ≥ 50 kg/m2 is the main predictive factor of poor weight outcomes. Keywords Sleeve gastrectomy . gastric volume . Excess weight loss . long-term results.
Introduction
* Clara Pañella [email protected] 1
Bariatric and Metabolic Surgery Unit, Section of Gastrointestinal Surgery, Hospital del Mar, Barcelona, Spain
2
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
3
Department of Radiology, Hospital del Mar, Barcelona, Spain
4
Department of Endocrinology, Hospital del Mar, Barcelona, Spain
5
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
6
CiberOBN, Instituto de Salud Carlos III, Madrid, Spain
7
Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain
Sleeve gastrectomy (SG) has shown to be a straightforward stand-alone primary bariatric technique due to its feasibility and acceptable short-term weight loss outcomes (1, 2). In the global survey performed by the International Federation for the Surgery of Obesity and Metabolic Diseases (IFSO) in 2016, SG was the procedure most frequently performed worldwide (53.6%) followed by Roux-en-Y gastric bypass (RYGB) (30.1%) (3, 4). SG involve
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