To investigate the effect of the distance between gastric antrum margin and pylorus in laparoscopic sleeve gastrectomy (LSG) on postoperative gastroesophageal reflux disease (GERD) and weight loss.

A single-center prospective randomized controlled study was used. 45 patients who received LSG during March 2018 to March 2019 were included. Patients were equally divided into 3 groups according to the distance between antral margin and pylorus by computerized random grouping method: G1 (2 cm), G2 (4 cm), and G3 (6 cm). Data were collected and analyzed before and 1 month, 3 months, 6 months and 1 year after LSG.

There were statistically significant differences in the postoperative BMI decrease and %TWL between the groups (P<0.05). The postoperative symptoms of 2 patients with GERD before surgery were improved. There have 6 patients were new-onset of the GERD after 1 year of follow-up. In the GERD-HRQL score, the total score and heartburn score at 1 month after surgery were significantly higher among all groups compared with those before surgery (P<0.05). Compared with G2 and G3 groups, the average postoperative BMI decreased and the average %TWL increased more significantly in G1 group, with statistically significant differences (P<0.05).

This study found that postoperative GERD-HRQL scores have generally increase. Yet, there was no significant correlation between different antral margin distances and the occurrence of postoperative GERD. Compared with 4 cm and 6 cm, 2 cm between antral margin and pylorus may be a safe distance to achieve better weight loss after LSG.