Highlights
- •Sleeve gastrectomy long term outcomes are scarce and generally do not exceed 5 years.
- •Baseline BMI significantly and linearly predicts the %EWL at 10 years.
- •Sustained weight loss and resolution of comorbidities are observed up to 10 years.
- •Weight regain does not impact negatively on comorbidity remission/improvement rates.
Abstract
Background
Sleeve gastrectomy (SG) has grown into the most popular bariatric operation. Nevertheless,
a scarcity of long-term outcomes are available.
Objectives
This study aims at evaluating the long-term percent weight loss (%WL), excess weight
loss (%EWL), weight regain (WR), and co-morbidity resolution rates in a single-center
cohort undergoing SG as a primary procedure, with a minimum 10-year follow-up.
Setting
University hospital, Italy.
Methods
One hundred eighty-two morbidly obese patients with body mass index (BMI) 46.6 ± 7.3
kg/m2 underwent SG. Obesity-related co-morbidities (type 2 diabetes, hypertension, sleep
apnea, gastroesophageal reflux disease) were investigated. Predictors of dichotomous
dependent-variable diabetes remission were computed using a binomial logistic regression.
Results
Patient retention rate was 77%. Mean %WL was 30.9, %EWL was 52.5%, and WR (≥25% maximum
WL) occurred in 10.4%. Baseline BMI significantly (P = .001) and linearly predicted %EWL (10 yr %EWL = 18.951 + initial BMI × .74); the super-obese subgroup generated substantially greater WL compared with those
with BMI <50 kg/m2 (%EWL 48.0 ± 18.5 versus 61.5 ± 23.2; P < .001). Type 2 diabetes remission occurred in 64.7%; 42.9% patients developed de
novo gastroesophageal reflux disease symptoms postoperatively (P < .0001).
Conclusions
SG generates sustained WL and co-morbidity resolution up to 10 years postoperatively.
Although a notable portion of patients experience WR, mean %WL persists to exceed
30%, translating in adequate WL also in the long term. Additionally, WR does not seem
to impact negatively on co-morbidity resolution. SG represents a safe and effective
bariatric operation, which easily grants the possibility to proceed to revisional
bariatric surgery in patients with WR or failure to WL.
Key words
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Article info
Publication history
Published online: July 02, 2018
Accepted:
June 26,
2018
Received in revised form:
June 18,
2018
Received:
April 28,
2018
Identification
Copyright
© 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
