Imperial College London
Dr Ajay K Gupta

Dr Ajay K Gupta

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 3437a.k.gupta Website

 
 
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Location

 

ICCH59/61 North Wharf RoadSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{McGlone:2018:10.1016/j.soard.2018.02.021,
author = {McGlone, ER and Gupta, AK and Reddy, M and Khan, OA},
doi = {10.1016/j.soard.2018.02.021},
journal = {Surgery for Obesity and Related Diseases},
pages = {857--864},
title = {Antral resection versus antral preservation during laparoscopic sleeve gastrectomy for severe obesity: Systematic review and meta-analysis},
url = {http://dx.doi.org/10.1016/j.soard.2018.02.021},
volume = {14},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Although laparoscopic sleeve gastrectomy is an established operation for severe obesity, there is controversy regarding the extent to which the antrum is excised. The objective of this systematic review was to investigate the effect on perioperative complications and medium-term outcomes of antral resecting versus antral preserving sleeve gastrectomy. MEDLINE, EMBASE, and Cochrane databases were searched from 1946 to April 2017. Eligible studies compared antral resection (staple line commencing 2-3 cm from pylorus) with antral preservation (>5 cm from pylorus) in patients undergoing primary sleeve gastrectomy for obesity. Meta-analyses were performed with a random-effects model, and risk of bias within and across studies was assessed using validated scoring systems. Eight studies (619 participants) were included: 6 randomized controlled trials and 2 cohort studies. Overall follow-up was 94% for the specified outcomes of each study. Mean percentage excess weight loss was 62% at 12 months (7 studies; 574 patients) and 67% at 24 months (4 studies; 412 patients). Antral resection was associated with significant improvement in percentage excess weight loss at 24-month follow-up (mean 70% versus 61%; standardized mean difference .95; confidence interval .35-1.58, P<.005), an effect that remained significant when cohort studies were excluded. There was no difference in incidence of perioperative bleeding, leak, or de novo gastroesophageal reflux disease. According to the available evidence, antral resection is associated with better medium-term weight loss compared with antral preservation, without increased risk of surgical complications. Further randomized clinical trials are indicated to confirm this finding.
AU  - McGlone,ER
AU  - Gupta,AK
AU  - Reddy,M
AU  - Khan,OA
DO  - 10.1016/j.soard.2018.02.021
EP  - 864
PY  - 2018///
SN  - 1550-7289
SP  - 857
TI  - Antral resection versus antral preservation during laparoscopic sleeve gastrectomy for severe obesity: Systematic review and meta-analysis
T2  - Surgery for Obesity and Related Diseases
UR  - http://dx.doi.org/10.1016/j.soard.2018.02.021
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29602713
UR  - http://hdl.handle.net/10044/1/58531
VL  - 14
ER  -
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