Reply:Gastric bypass-A combined restrictive and malabsorbtive procedure or a malabsorbtive procedure alone?

摘要

We appreciate the comments from Dr. O'Dea regarding our research on the influence of pouch and stoma size on weight loss outcomes after gastric bypass surgery [1]. The Roux-en-Y gastric bypass has long been considered a combined restrictive and malabsorptive procedure [2]. The restrictive component is not only attributable to the size of the gastrojejunostomy (GJ); the creation of a 20- to 30-cc gastric pouch contributes significantly to the restrictive component of this procedure. Our use of 20 mm as the upper size limit of a normal stoma has been used previously by our group and others as the upper limit of normal for this anastomosis [3]. Additionally, a commonly used definition of a GJ anastomotic stricture is a stoma size of < 10 mm (equivalent to the inability to pass a 10-mm endoscope through the stoma).