The Effect of Roux Limb Lengths on Outcome after Roux-en-Y Gastric Bypass: A Prospective, Randomized Clinical Trial (original) (raw)

Background:The effect of limb-length on weight loss after Roux-en-Y gastric bypass (RYGBP) is controversial; hence, the optimal limb-lengths have not been determined. This study evaluated the effect of different limb-lengths on weight loss after RYGBP. Methods:The study was a prospective randomized clinical trial in which patients undergoing RYGBP (110 F,24 M; mean age 39.7) were randomized as follows: BMI ≤ 50 (N=69): A-75 cm (N=35) vs B-150 cm alimentary limb (N=34) and C-150 cm (N=33) vs D250 cm alimentary limb (N=31). All other aspects of the operation were identical. Patients were followed at 2 weeks, 6 weeks, 6 months, 12 months, 18 months, 24 months and yearly thereafter. Results: There were no significant differences in age, sex, race, initial BMI, or excess weight between patients assigned to groups A vs B and C vs D. Postoperative nutritional intake was also similar between groups. Within each weight category, there were no differences in mean weight loss, change in BMI, and % excess weight lost (EWL) over time. When the number of patients achieving 50% EWL was evaluated, there was no difference between groups with a BMI ≤ 50 kg/m2; however, among patients with a BMI >50 kg/m2, a significantly greater percentage of those having a 250-cm limb achieved >50% EWL at 18 months postoperatively.This difference was lost at 24 and 36 months, possibly due to the small sample size. Conclusions: In patients with a BMI ≤ 50, there appears to be no advantage to longer limb-lengths. In patients with BMI >50, however, these data suggest that longer alimentary limb-lengths may be associated with a higher percent of patients achieving >50% EWL. Longer follow-up studies of the effects of limb-length on success of RYGBP are indicated.

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Authors and Affiliations

  1. Bariatric Treatment Center of Ohio and The Ohio State University, Columbus, OH
    Patricia S Choban MD FACS
  2. St. Luke's Roosevelt Center for Weight Loss Surgery, New York Obesity Research Center and Columbia University College of Physicians and Surgeons, New York, NY,USA
    Louis Flancbaum MD FACS

Authors

  1. Patricia S Choban MD FACS
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  2. Louis Flancbaum MD FACS
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Choban, P.S., Flancbaum, L. The Effect of Roux Limb Lengths on Outcome after Roux-en-Y Gastric Bypass: A Prospective, Randomized Clinical Trial.OBES SURG 12, 540–545 (2002). https://doi.org/10.1381/096089202762252316

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