LAPAROSCOPIC VERTICAL GASTRECTOMY AT 2 VS 5 CM FROM THE PYLORUS: A PROSPECTIVE AND COMPARATIVE STUDY WITH 5 YEARS OF FOLLOW-UP.

Abstract

Bariatric surgery, particularly laparoscopic sleeve gastrectomy (LSG), has proven to be an effective alternative for sustained weight loss in patients with morbid obesity. Objective: To compare the efficacy of sleeve gastrectomy with resection at 5 cm and 2 cm from the pylorus in terms of weight loss. Methods: This was a prospective, non-randomized comparative study with a sample of 76 patients who underwent laparoscopic sleeve gastrectomy with resection at 5 cm (group A) or 2 cm (group B) from the pylorus, performed at Dr. Miguel Pérez Carreño Hospital and Santa Sofía Clinic between 2017 and 2022, with a minimum follow-up of five years. Results: The average age did not show relevant variations between the groups (40.94 ± 11.52 years vs. 36.07 ± 9.52 years, p=0.31906). The gender distribution indicated a female prevalence of 84.21%. The initial body mass index (BMI) was similar in both groups (35.94 ± 5.53 kg/m² vs. 36.10 ± 5.32 kg/m², p=0.84025). A statistically significant difference was found in the percentage of excess weight loss between the two groups, with a mean at 5 years of 65.74% ± 19.66 for group A and 80.04% ± 23.14 for group B (p=0.02079). The mean BMI at 5 years was 26.91 ± 4.07 kg/m² for group A and 24.91 ± 4.56 kg/m² for group B, with no significant difference (p=0.57568). Conclusion: The results obtained suggest that sleeve gastrectomy with antral resection may be associated with greater weight loss.