Stomach Volume and BMI
dilated LSGs, weight gain, weight loss, weight loss failure
DILATION
In our study, the preoperative stomach volume was increased after undergoing primary LSG, which might have contributed to weight regain in these patients. This was confirmed by Weiner et al. [Moreover, Brachetto et al. reported that the mean capacity of the stomach increased from 108±25 on the third operative day to 250± 85 ml in the follow-up period (Thus, we may assume that an average postoperative volume of 108 mL with a two-fold increase after 24–36 months does not cause any weight to regain [We aim to find solutions and test this scientifically to create the best possible option for the patients: (1) In the solution for weight loss and reduction of associated medical problems (primary and revision surgery in general) and (2) the solution is to prevent weight regain (placement of a band, adherence to lifestyle changes, behavior and eating treatment, and assessment of psychological factors) and try to stabilize the patient’s health over time.So, when patients have postoperative weight regain after LSG, an MDCT test can help determine whether dilation of the stomach has occurred in combination with weight regain. Therefore, attention to eating habits, psychological factors, and hormonal status is essential in assessing weight loss failure despite the absence of a significant increase in stomach volume. In our study, it was difficult to correlate the reasons for weight regain since the preoperative stomach volume from the first LSG operation was unknown.A possible explanation for weight gain in patients who underwent primary LSG that those with dilated LSGs may have had a smaller total gastric volume at baseline. This could result in more significant changes in sleeve dilatation when the sleeve what was created was too narrow [After two years, there was a significant reduction in stomach volume and BMI in the BLSG and NBLSG groups. Furthermore, after two years, the extra BMI loss was in the BLSG group with a smaller stomach volume. The literature shows equal initial weight loss between the LBSG and the NBLSG or better weight loss in the BLSG [A study by Filip et al., who followed up patients for three years, also reported a reduction in stomach volume and BMI after re-LSG [Furthermore, this RCT showed that the %EWL and %TWL in the NBLSG slightly decreased, and weight increased in 80% of the NBLSG patients (24% in the BLSG) after two years of follow-up with significant differences between both groups on the weight increase. Thus, band placement may help reduce stomach volume and prevents weight increase after two years for better postoperatively results. Longer follow-up must prove the related effects of the band in the years to come on the clinical implication after revisional BMS with and without a band placement.Our study focused on only the increased volume of the stomach within patients who were stable and compliant in lifestyle and behavior instead of other causes of weight regain of insufficient weight loss. We used a strict inclusion criterion for this study, that in an MDT, every patient was screened and discussed. All had a pre-diet plan, assessment by a psychiatrist, and checked on lifestyle factors. So, we had a clear sample with low bias or confounding factors.