Importance of pouch size in laparoscopic Roux-en-Y gastric bypass: a cohort study of 14,168 XXXX .

@entity1 @entity10189 @entity353 @entity6 @entity1066 @entity356
BACKGROUND: @entity356 ( @entity356 ) is one of the most common bariatric procedures worldwide, but the importance of gastric pouch size is still under debate. We have studied how pouch size affects risk of marginal @entity1066 and excess body mass index loss (EBMIL%) at 6  weeks and 1  year postoperatively. METHODS: Scandinavian Obesity Surgery Registry included 14,168 @entity356 @entity1 with linear stapled gastrojejunostomies, having complete pre- and postoperative data concerning length of stapler needed to complete the gastric pouch, incidence of @entity10189 and @entity353 . @entity356 technique in Sweden is highly standardized, and total length of stapler was used as a proxy for pouch size. RESULTS: Mean length of stapler used for the pouch was 145  mm. At 1  year, symptomatic @entity10189 were noted in 0.9  % of the @entity1 . The relative risk of marginal @entity1066 increased by 14  % (95  % confidence interval 9-20  %), for each centimeter of stapler used for the pouch. Body mass index (BMI) was reduced from 42.4      5.1 to 36.1  kg/m(2) at 6  weeks and 28.9  kg/m(2) at 1  year. The total length of stapler predicted EBMIL% at 6  weeks but not at 1  year. Female gender, low preoperative BMI, young age and absence of @entity6 predicted better EBMIL% at 1  year. CONCLUSION: A smaller pouch reduces the risk of @entity10189 , but does not predict better @entity353 at 1  year. Additional stapling should be avoided as each extra centimeter increases the relative risk of @entity10189 by 14  %.
