Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure |
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| Affiliation: | 1. Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden;2. Department of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden;3. Department of Morbid Obesity and Bariatric Surgery, Oslo University Hospital Aker, Norway;4. Department of Plastic surgery, Sahlgrenska University Hospital, Gothenburg, Sweden;5. Department of Neurophysiology and rehabilitation, Sahlgrenska University Hospital, Gothenburg, Sweden;1. Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt;2. Hepatobiliary Surgical Department, National Liver Institute, Menoufiya University, Egypt;3. Department of Digestive Surgery, TBRI, Cairo, Egypt;4. Department of Surgery, Jahra Hospital, Kuwait;1. Department of Surgery, Monklands District General Hospital, Airdrie, North Lanarkshire, UK;2. Department of Anaesthetics and Intensive Care, Cardiff University, Cardiff, UK;1. University of Pittsburgh Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, Pennsylvania;2. University of Pittsburgh School of Medicine, Department of Pathology, Pittsburgh, Pennsylvania;3. SUNY Downstate, Department of Pathology, Brooklyn, New York;4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota, USA;1. Group Health Research Institute, Seattle, Washington;2. Kaiser Permanente Center for Health Research, Portland, Oregon;3. Kaiser Permanente Georgia Center for Health Research Southeast, Atlanta, Georgia;4. The Permanente Medical Group, Kaiser Permanente Northern California, San Francisco, California;5. Kaiser Permanente Colorado Institute for Health Research, Denver, Colorado;6. University of Colorado School of Medicine, Aurora, Colorado |
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| Abstract: | BackgroundLaparoscopic sleeve gastrectomy (LSG) has been established as a reliable bariatric procedure, but questions have emerged regarding its long-term results. Our aim is to report the long-term outcomes of LSG as a primary bariatric procedure.MethodsRetrospective analysis of patients submitted to LSG between 2005 and 2007 in our institution. Long-term outcomes at 5 years were analyzed in terms of body mass index (BMI), excess weight loss (EWL) and co-morbidities resolution. Surgical success was defined as %EWL>50%. Also, we compared long-term results according to preoperative BMI, using Mann-Whitney test.ResultsA total of 161 LSG were analyzed, and 114 patients (70.8%) were women. The median age was 36 years old (range 16–65), median preoperative BMI was 34.9 kg/m2 (interquartile range [IQR], 33.3–37.5). A total of 112 patients (70%) completed 5 years of follow-up. At the fifth year, median BMI and %EWL was 28.5 kg/m2 (IQR: 25.8–31.9) and 62.9% (IQR: 45.3–89.6), respectively, with a surgical success of 73.2% of followed patients. According to preoperative BMI, surgical success was achieved in 80% of patients with BMI<35 kg/m2, 75% of BMI 35–40 kg/m2, and 52.6% of BMI>40 kg/m2, with significant lower %EWL in patients with BMI>40 kg/m2 (P = .001 and .004). Dyslipidemia and insulin resistance resolution was 80.7% and 84.7%, respectively. A total of 26.7% of patients reported new-onset gastroesophageal reflux symptoms at 5 years.ConclusionLSG as a primary procedure is a reliable surgery. We observed positive long-term outcomes of %EWL and co-morbidities resolution. In our series, best results are seen in patients with preoperative BMI<40 kg/m2. |
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| Keywords: | Laparoscopic sleeve gastrectomy Bariatric surgery Long-term results |
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