Does gastric resection volume influence sleeve gastrectomy results? a prospective study

Background: Laparoscopic Sleeve Gastrectomy (LSG) is one of the most widespread procedures for the treatment of obesity. The results of LSG could be related to the gastric residual volume. Our aim is to evaluate the outcomes after LSG according to the resected gastric volume (RGV).Methods: 105 patients were divided into three groups according to the RGV: 600-1200 mL (Group A: 34 patients), 1200-1800 mL (Group B: 38 patients), and >1800 mL (Group C: 33 patients). We evaluated the effects of LSG on weight loss (%EWL), gastroesophageal reflux (GERD), hypertension (HTA) and diabetes (DM2) at 3, 6, 12 and 36 months. Data were analyzed for normality of distribution with Shapiro-Wilk test.Results: The overall %EWL at follow up was 34.8%, 42.6%, 53% and 57.7%. Statistically significant difference between group C and group A-B at 6 months was detected, as well as between group B-C and group A at 12 and 36 months. Overall prevalence of GERD was 63.8%, 62.9%, 61% e 43.8%, at 3, 6, 12 and 36 months respectively. An overall increase of GERD (40%) was observed at 12 months; this value decreased at 2.3% after 36 months. The HTA prevalence was 53.3%, 28.6%, 21% and 17.1%, with an overall reduction of 40% and 43.9% at 12 and 36 months. The DM2 prevalence was 28.6%, 18.1%, 12.4% and 9.5% at 3, 6, 12 and 36 months respectively, with an overall reduction of 31.5% at 36 months.Conclusions: RGV influences outcomes of LSG on short-term and mid-term follow up and it predicts the results in terms of %EWL and improvement of DM2 and HTA.