Comparison of the mid-term outcomes of banded and non-banded sleeve gastrectomy: safety, food tolerance, and weight regain.

BACKGROUND: Long-term weight regain (WR) after sleeve gastrectomy (SG) is a major challenge. Laparoscopic banded SG (BSG) was introduced to overcome pouch dilation and, consequently, WR; however, its mid-and long-term outcomes have not been sufficiently demonstrated. OBJECTIVE: This study retrospectively evaluated the mid-term weight loss efficacy and morbidity over at least a 4-year follow-up after laparoscopic banded SG using a MiniMizer Gastric Ring® and laparoscopic non-banded SG. METHOD: The data of 1586 bariatric surgeries were retrospectively evaluated. To ensure homogeneity in our study cohort, propensity score matching (PSM) was performed. RESULTS: The final cohort comprised 1392 patients: the non-banded SG (n = 1260) and BSG (n = 132) groups. In our matched cohort (SG, n = 655 and BSG, n = 132), WR was noted in 4 (3.0%) and 71 (10.8%) patients in the BSG and SG groups, respectively. Gastric band erosion or slippage was not noted in the BSG cohort. The levels of cholesterol and triglyceride were similar in the two groups. Postoperative glycemic control was significantly reduced in the BSG group. CONCLUSION: Although the percentage of weight loss achieved in the BSG group was low in the first year postoperatively, the mid-term (sustained) weight loss associated with BSG was superior to that associated with non-banded SG. BSG is a safe procedure with no significant mid-term band-related morbidity; its impact on the resolution of comorbidities is equivalent and perhaps superior to SG.

A Successful Central Gastrectomy and Gastro-Gastric Anastomosis for a Large Gastric GIST.

PURPOSE: Partial gastrectomy is always the preferred technique for GIST resection. Central gastrectomy is a practical technique that can be employed in many situations during the resection of both subepithelial stromal tumors and gastric tumors. CASE PRESENTATION: A 53-year-old Egyptian female patient with a 15 × 19 cm large fungating gastric GIST managed by central gastrectomy. Central gastrectomy and gastro-gastric anastomosis were performed with negative resection margins, and the patient received post-operative imatinib, achieving disease control throughout an 8-month post-operative follow-up. CONCLUSION: Central gastrectomy is an effective method of partial gastrectomy that can be considered in GIST resection; however, more studies are needed to evaluate the efficiency of central gastrectomy in terms of long-term follow-up and terms of R0 respectability in gastric cancer.