Authors: Essam Abdel-Galil.
Background: Sleeve Gastrectomy (resection of 80% of the stomach) and Butterfly gastroplasty (funnel- shaped micropouch constructed below the esophagus limited to the stomach cardia with banded outlet 1.2cm without resection of any gastric part) are purely restrictive gastric procedures to control morbid obesity. This study presents five-years results.
Methods: From March 2014 through March 2019, each procedure was attempted in 500 patients, five years results were collected and compared including early and late complications as well as weight loss maintenance.
Results: Average excess weight loss at one year was 70%, 81% at second year, 85% at third year. 90% at the fourth and fifth years, while in sleeve was 68% in first year, 75% in the second year, then 20% of patients start to gain weight in the third year, then 60% of patients start to gain weight in fourth year and 80% start to gain weight in the fifth year. Reflux was 3% in butterfly and 60% in sleeve. Barrett’s esophagus was 3% in sleeve and 0% in butterfly. Intolerance to solid food was 15% in butterfly and 5% in sleeve. Both techniques has nearly same percentage of hypertension and diabetes resolution.
Conclusion: Butterfly gastroplasty, (micropouch funnel shaped pouch) using the gastric cardia only is an effective way to prevent pouch dilatation and therefore prevent the weight regain occurred in a high percentage of sleeve gastrectomy. Sleeve gastrectomy has a very higher incidence of leakage, stapel – line bleeding, kinking and migration of pouch early weight regain due to rapid dilatation of the pouch beside a very serious pre-malignant Barrett’s esophagus. As well as it is an aggressive and irreversible procedure. We recommend butterfly gastroplasty being safer, easy, low costs, reversible and long term maintained weightloss with no serious complications.
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