Advertisement

What are the long-term results 8 years after sleeve gastrectomy?

      Abstract

      Background

      Laparoscopic sleeve gastrectomy (LSG) became the most frequent bariatric procedure performed in France (2011) and in the United States (2013), but studies reporting long-term results are still rare.

      Setting

      Private hospital, France.

      Methods

      This is a retrospective analysis of a prospective cohort of 168 patients who underwent LSG between 2005 and 2008. The objective of this study was to present the 8-year outcome concerning weight loss, modification of co-morbidities, and to report the revisional surgery after sleeve.

      Results

      The preoperative mean body mass index was 42.8 kg/m2 (31.1–77.9), 35 patients were super obese, and 64 patients had a previous gastric band. For LSG as a definitive bariatric procedure, 8 years of follow-up data were available for 116 patients (follow-up: 69%). Of the remainder, 23 patients underwent revisional surgery and 29 were lost to follow-up. For the entire cohort, the mean excess weight loss (EWL) was 76% (0–149) at 5 years and 67% (4–135) at 8 years, respectively. Of the 116 patients with 8 years of follow-up, 82 patients had>50% EWL at 8 years (70.7%). Percentages of co-morbidities resolved were hypertension, 59.4%; type 2 diabetes, 43.4%; and obstructive sleep apnea, 72.4%. Twenty-three patients had revisional surgery for weight regain (n = 14) or for severe reflux (n = 9) at a mean period of 50 months (9–96). Twelve patients underwent resleeve gastrectomy, 6 patients underwent conversion to a bypass, and 5 patients to duodenal switch (1 single anastomosis duodeno-ileostomy). A total of 31% of patients reported gastroesophageal reflux symptoms at 8 years.

      Conclusions

      At 8 years postoperatively, the LSG as a definitive bariatric procedure remained effective for 59% of cases. The results appear to be more favorable especially for the non-super-obese patients and primary procedures. LSG is a well-tolerated bariatric procedure with low long-term complication rates.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery for Obesity and Related Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Lazzati A.
        • Guy-Lachuer R.
        • Delaunay V.
        • Szwarcensztein K.
        • Azoulay D.
        Bariatric surgery trends in France: 2005-2011.
        Surg Obes Relat Dis. 2014; 10: 328-334
        • Ponce J.
        • DeMaria E.J.
        • Nguyen N.T.
        • Hutter M.
        • Sudan R.
        • Morton J.M.
        American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States.
        Surg Obes Relat Dis. 2016; 12: 1637-1639
        • Fezzi M.
        • Kolotkin R.L.
        • Nedelcu M.
        • et al.
        Improvement in quality of life after laparoscopic sleeve gastrectomy.
        Obes Surg. 2011; 21: 1161-1167
        • Arman G.A.
        • Himpens J.
        • Dhaenens J.
        • Ballet T.
        • Vilallonga R.
        • Leman G.
        Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy.
        Surg Obes Relat Dis. 2016; 12: 1778-1786
        • D׳Hondt M.
        • Vanneste S.
        • Pottel H.
        • Devriendt D.
        • Van Rooy F.
        • Vansteenkiste F.
        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
        • Sarela A.I.
        • Dexter S.P.
        • O׳Kane M.
        • Menon A.
        • McMahon M.J.
        Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results.
        Surg Obes Relat Dis. 2012; 8: 679-684
        • Rawlins L.
        • Rawlins M.P.
        • Brown C.C.
        • Schumacher D.L.
        Sleeve gastrectomy: 5-year outcomes of a single institution.
        Surg Obes Relat Dis. 2013; 9: 21-25
        • Eid G.M.
        • Brethauer S.
        • Mattar S.G.
        • Titchner R.L.
        • Gourash W.
        • Schauer P.R.
        Laparoscopic sleeve gastrectomy for superobese patients: forty- eight percent excess weight loss after 6 to 8 years with 93% follow-up.
        Ann Surg. 2012; 256: 262-265
        • Braghetto I.
        • Csendes A.
        • Lanzarini E.
        • Papapietro K.
        • Cárcamo C.
        • Molina J.C.
        Is laparoscopic sleeve gastrectomy an acceptable primary bariatric procedure in obese patients? Early and 5-year postoperative results.
        Surg Laparosc Endosc Percutan Tech. 2012; 22: 479-486
        • Catheline J.M.
        • Fysekidis M.
        • Bachner I.
        • et al.
        Five-year results of sleeve gastrectomy.
        J Visc Surg. 2013; 150: 307-312
        • Brethauer S.A.
        • Aminian A.
        • Romero-Talamás H.
        • et al.
        Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus.
        Ann Surg. 2013; 258: 628-637
        • Sieber P.
        • Gass M.
        • Kern B.
        • Peters T.
        • Slawik M.
        • Peterli R.
        Five-year results of laparoscopic sleeve gastrectomy.
        Surg Obes Relat Dis. 2014; 10: 243-249
        • Boza C.
        • Daroch D.
        • Barros D.
        • León F.
        • Funke R.
        • Crovari F.
        Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure.
        Surg Obes Relat Dis. 2014; 10: 1129-1133
        • Dakour Aridi H.
        • Alami R.
        • Tamim H.
        • Shamseddine G.
        • Fouani T.
        • Safadi B.
        Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience.
        Surg Obes Relat Dis. 2016; 12: 1689-1696
        • Casella G.
        • Soricelli E.
        • Giannotti D.
        • et al.
        Long-term results after laparoscopic sleeve gastrectomy in a large monocentric series.
        Surg Obes Relat Dis. 2016; 12: 757-762
        • Hirth D.A.
        • Jones E.L.
        • Rothchild K.B.
        • Mitchell B.C.
        • Schoen J.A.
        Laparoscopic sleeve gastrectomy: long-term weight loss outcomes.
        Surg Obes Relat Dis. 2015; 11: 1004-1007
        • Lemanu D.P.
        • Singh P.P.
        • Rahman H.
        • Hill A.G.
        • Babor R.
        • MacCormick A.D.
        Five-year results after laparoscopic sleeve gastrectomy: a prospective study.
        Surg Obes Relat Dis. 2015; 11: 518-524
        • Ruiz-Tovar J.
        • Martínez R.
        • Bonete J.M.
        • et al.
        Long-term weight and metabolic effects of laparoscopic sleeve gastrectomy calibrated with a 50-Fr Bougie.
        Obes Surg. 2016; 26: 32-37
        • Noel P.
        • Nedelcu M.
        • Gagner M.
        Impact of the surgical experience on leak rate after laparoscopic sleeve gastrectomy.
        Obes Surg. 2016; 26: 1782-1787
        • Nedelcu M.
        • Eddbali I.
        • Noel P.
        Three-port sleeve gastrectomy: complete posterior approach.
        Surg Obes Relat Dis. 2016; 12: 925-927
        • Halverson J.D.
        • Koehler R.E.
        Gastric bypass: analysis of weight loss and factors determining success.
        Surgery. 1981; 90: 446-455
        • Peterli R.
        • Borbély Y.
        • Kern B.
        • et al.
        Early results of the Swiss Multi-centre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass.
        Ann Surg. 2013; 258: 690-694
        • Nedelcu M.
        • Noel P.
        • Iannelli A.
        • Gagner M.
        Revised sleeve gastrectomy (re-sleeve).
        Surg Obes Relat Dis. 2015; 11: 1282-1288
        • Sánchez-Pernaute A.
        • Rubio M.Á.
        • Conde M.
        • Arrue E.
        • Pérez-Aguirre E.
        • Torres A.
        Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy.
        Surg Obes Relat Dis Epub. 2015; 11: 351-355
        • Desart K.
        • Rossidis G.
        • Michel M.
        • Lux T.
        • Ben-David K.
        Gastroesophageal reflux management with the LINX® system for gastroesophageal reflux disease following laparoscopic sleeve gastrectomy.
        J Gastrointest Surg. 2015; 19: 1782-1786
        • Marceau P.
        • Biron S.
        • Marceau S.
        • et al.
        Long-term metabolic outcomes 5 to 20 years after biliopancreatic diversion.
        Obes Surg. 2015; 25: 1584-1593
        • Mehaffey J.H.
        • LaPar D.J.
        • Clement K.C.
        • et al.
        10-year outcomes after Roux-en-Y gastric bypass.
        Ann Surg. 2016; 264: 121-126
        • Nedelcu M.
        • Khwaja H.A.
        • Rogula T.G.
        Weight regain after bariatric surgery-how should it be defined?.
        Surg Obes Relat Dis. 2016; 12: 1129-1130
        • Langer F.B.
        • Bohdjalian A.
        • Shakeri-Leidenmuhler S.
        • Schoppmann S.F.
        • Zacherl J.
        • Prager G.
        Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass—indications and outcome.
        Obes Surg. 2010; 20: 835-840
        • Obeidat F.
        • Shanti H.
        • Mismar A.
        • Albsoul N.
        • Al-Qudah M.
        The magnitude of antral resection in laparoscopic sleeve gastrectomy and its relationship to excess weight loss.
        Obes Surg. 2015; 25: 1928-1932
        • Bohdjalian A.
        • Langer F.B.
        • Shakeri-Leiden Muhler S.
        • et al.
        Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin.
        Obes Surg. 2010; 20: 535-540
        • Abdallah E.
        • El Nakeeb A.
        • Yousef T.
        • et al.
        Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study).
        Obes Surg. 2014; 24: 1587-1594
        • Carmeli I.
        • Golomb I.
        • Sadot E.
        • Kashtan H.
        • Keidar A.
        Laparoscopic conversion of sleeve gastrectomy to a biliopancreatic diversion with duodenal switch or a Roux-en-Y gastric bypass due to weight loss failure: our algorithm.
        Surg Obes Relat Dis. 2015; 11: 79-85
        • Jimenez A.
        • Casamitjana R.
        • Flores L.
        • et al.
        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
        • Beitner M.M.
        • Ren-Fielding C.J.
        • Kurian M.S.
        • et al.
        Sustained weight loss after gastric banding revision for pouch-related problems.
        Ann Surg. 2014; 260: 81-86
        • Carlsson L.M.
        • Peltonen M.
        • Ahlin S.
        • et al.
        Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects.
        N Engl J Med. 2012; 367: 695-704
        • Karmali S.
        • Brar B.
        • Shi X.
        • Sharma A.M.
        • de Gara C.
        • Birch D.W.
        Weight recidivism post-bariatric surgery: a systematic review.
        Obes Surg. 2013; 23: 1922-1933
        • Deguines J.B.
        • Verhaeghe P.
        • Yzet T.
        • Robert B.
        • Cosse C.
        • Regimbeau J.M.
        Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure?.
        Surg Obes Relat Dis. 2013; 9: 660-666
        • Braghetto I.
        • Cortes C.
        • Herquinigo D.
        • et al.
        Evaluation of the radiological gastric capacity and evolution of the BMI 2-3 years after sleeve gastrectomy.
        Obes Surg. 2009; 19: 1262-1269
        • Langer F.B.
        • Bohdjalian A.
        • Felberbauer F.X.
        • et al.
        Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity?.
        Obes Surg. 2006; 16: 166-171