Our Summary

This research paper reviews and compares two types of weight loss surgery: laparoscopic greater curvature plication (LGP) and laparoscopic sleeve gastrectomy (SG). LGP is a newer type of surgery that doesn’t involve removing any part of the stomach, which could potentially make it safer and cause fewer complications.

The researchers looked at various studies from different databases on these two types of surgery. They compared factors like how long the surgery and hospital stay were, how much the feeling of hunger decreased, how much weight patients lost, any complications or symptoms after surgery, and whether any existing health conditions like diabetes improved or remitted.

Their review of over 17,000 studies led them to select eight for a detailed analysis. The results showed that there wasn’t a big difference in surgery time, hospital stay, or complications between the two procedures. However, patients who had the SG surgery felt less hungry afterwards, lost more weight in the first two years, and showed better improvement in diabetes.

In contrast, those who underwent LGP experienced more salivation. However, in terms of long-term weight loss (over 24 to 36 months), both surgeries showed similar results. In conclusion, the study found that the SG surgery had better short-term results in terms of weight loss, reduced hunger, fewer post-surgery symptoms, and improvement in diabetes.

FAQs

  1. What are the two types of weight loss surgeries compared in this research paper?
  2. What differences were found between the laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy in terms of patient outcomes?
  3. Did the study find any significant differences in long-term weight loss between the two types of surgeries?

Doctor’s Tip

A doctor might tell a patient who is considering gastrectomy surgery that laparoscopic sleeve gastrectomy (SG) may be a better option for short-term weight loss, reduced hunger, and improvement in diabetes compared to laparoscopic greater curvature plication (LGP). However, both surgeries have similar long-term weight loss results. It is important for the patient to discuss their individual health conditions and goals with their doctor to determine the best option for them. Additionally, it is important for the patient to follow post-surgery guidelines for diet, exercise, and follow-up appointments to ensure successful outcomes.

Suitable For

Patients who are typically recommended gastrectomy are those who have severe obesity with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. These patients have usually tried other weight loss methods such as diet and exercise without success, and are in need of a more drastic intervention to improve their health and quality of life.

In addition, patients who have been diagnosed with certain stomach conditions such as stomach cancer, severe ulcers, or Barrett’s esophagus may also be recommended for gastrectomy to remove the affected part of the stomach and prevent further complications.

Overall, the decision to recommend gastrectomy for a patient is made on a case-by-case basis by a team of healthcare professionals including surgeons, dietitians, psychologists, and other specialists. It is important for patients to discuss the potential risks and benefits of the procedure with their healthcare provider and make an informed decision based on their individual health needs and goals.

Timeline

Before gastrectomy:

  • Patient undergoes pre-operative assessments and tests to determine eligibility for surgery
  • Patient meets with healthcare team to discuss risks, benefits, and expectations of surgery
  • Patient may be required to follow a specific diet and exercise regimen to prepare for surgery
  • Surgery is scheduled and patient is admitted to the hospital for the procedure

After gastrectomy:

  • Patient undergoes surgery, which typically lasts 1-4 hours depending on the type of gastrectomy
  • Patient stays in the hospital for 2-7 days post-surgery to recover and be monitored for any complications
  • Patient will gradually transition from a liquid diet to solid foods over several weeks
  • Patient will have follow-up appointments with their healthcare team to monitor progress and address any concerns
  • Patient may experience weight loss, changes in appetite, and improvements in certain health conditions like diabetes
  • Long-term follow-up is necessary to monitor weight loss maintenance and overall health post-gastrectomy.

What to Ask Your Doctor

Questions a patient should ask their doctor about gastrectomy include:

  1. What are the potential risks and complications associated with gastrectomy surgery?
  2. How long will the surgery take, and how long can I expect to stay in the hospital?
  3. Will I need to make any changes to my diet or lifestyle after the surgery?
  4. How much weight can I expect to lose after the surgery, and how quickly?
  5. Will the surgery improve or resolve any existing health conditions I have, such as diabetes?
  6. What can I expect in terms of hunger and appetite after the surgery?
  7. How long will it take for me to recover fully from the surgery?
  8. Are there any long-term effects or complications I should be aware of?
  9. Will I need any follow-up appointments or ongoing care after the surgery?
  10. Are there any alternative weight loss treatments or procedures that I should consider before deciding on gastrectomy?

Reference

Authors: Barrichello S, Minata MK, García Ruiz de Gordejuela A, Bernardo WM, de Souza TF, Galvão Neto M, Hourneaux de Moura DT, Santo MA, Hourneaux de Moura EG. Journal: Obes Surg. 2018 Oct;28(10):3199-3212. doi: 10.1007/s11695-018-3330-9. PMID: 29951784