Abstract
Background
Laparoscopic sleeve gastrectomy (LSG) is gaining popularity, but studies reporting
long-term results are still rare. The objective of this study was to present the 5-year
outcome concerning weight loss, modification of co-morbidities, and late complications.
Methods
This is a retrospective analysis of a prospective cohort with a minimal follow-up
of 5 years. A total of 68 patients underwent LSG either as primary bariatric procedure
(n = 41) or as redo operation after failed laparoscopic gastric banding (n = 27) between
August 2004 and December 2007. At the time of LSG, the mean body mass index (BMI)
was 43.0±8.0 kg/m2, the mean age 43.1±10.1 years, and 78% were female. The follow-up rate was 100% at
1 year postoperatively, 97% after 2 years, and 91% after 5 years; the mean follow-up
time was 5.9±0.8 years.
Results
The average excessive BMI loss was 61.5%±23.4% after 1 year, 61.1%±23.4% after 2 years,
and 57.4%±24.7% after 5 years. Co-morbidities improved considerably; a remission of
type 2 diabetes could be reached at 85%. The following complications were observed:
1 leak (1.5%), 2 incisional hernias (2.9%), and new-onset gastroesophageal reflux
in 11 patients (16.2%). Reoperation due to insufficient weight loss was necessary
in 8 patients (11.8%).
Conclusions
LSG was effective 5.9 years postoperatively with an excessive BMI loss of almost 60%
and a considerable improvement or even remission of co-morbidities.
Keywords
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References
- Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient.Obes Surg. 2003; 13: 861-864
- Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers.Obes Surg. 2008; 18: 814-818
- Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study.Ann Surg. 2008; 247: 401-407
- Sleeve gastrectomy—a "food limiting" operation.Obes Surg. 2008; 18: 1251-1256
- Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels.Obes Surg. 2005; 15: 1024-1029
- Midterm results of primary vs. secondary laparoscopic sleeve gastrectomy (LSG) as an isolated operation.Obes Surg. 2009; 19: 401-406
- Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial.Obes Surg. 2012; 22: 740-748
- Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial.Surg Obes Relat Dis. 2011; 7: 561-568
- Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure.Obes Surg. 2010; 20: 271-275
- Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery.Obes Surg. 2012; 22: 330-334
- International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of>12,000 cases.Surg Obes Relat Dis. 2012; 8: 8-19
- Prospective study of a two-stage operative concept in the treatment of morbid obesity: primary lap-band followed if needed by sleeve gastrectomy with duodenal switch.Obes Surg. 2007; 17: 334-340
- Early results of the swiss multicentre bypass or sleeve study (SM-BOSS): A prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-Y-gastric bypass.Ann Surg. Accepted for publication. May 2, 2013;
- Third International Summit: Current status of sleeve gastrectomy.Surg Obes Relat Dis. 2011; 7: 749-759
- Long-term results of laparoscopic sleeve gastrectomy for obesity.Ann Surg. 2010; 252: 319-324
- Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin.Obes Surg. 2010; 20: 535-540
- Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss.Surg Endosc. 2011; 25: 2498-2504
- Sleeve Gastrectomy: 5-year outcomes of a single institution.Surg Obes Relat Dis. 2012;
- Failure of laparoscopic sleeve gastrectomy—further procedure?.Obes Facts. 2011; 4: 42-46
- Sleeve gastrectomy: a restrictive procedure?.Obes Surg. 2007; 17: 57-62
- Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results.Obes Surg. 2007; 17: 1442-1450
- Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects.Ann Surg. 2012; 256: 1023-1029
- Bariatric surgery versus intensive medical therapy in obese patients with diabetes.N Engl J Med. 2012; 366: 1567-1576
- Type 2 diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects.Obes Surg. 2008; 18: 1077-1082
- Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)-a prospective study.Obes Surg. 2010; 20: 447-453
- New data on quality assurance in bariatric surgery in Germany [in German].Zentralbl Chir. 2013; 138: 180-188
- Previous gastric banding increases morbidity and gastric leaks after laparoscopic sleeve gastrectomy for obesity.J Visc Surg. 2011; 148: e205-e209
Article info
Publication history
Published online: July 12, 2013
Accepted:
June 4,
2013
Received:
March 22,
2013
Identification
Copyright
© 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
