Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure

• Published in: Surgery for obesity and related diseases Vol. 10; no. 6; pp. 1129 - 1133
• Main Authors: Boza, Camilo, M.D, Daroch, David, M.D, Barros, Diego, M.D, León, Felipe, M.D, Funke, Ricardo, M.D, Crovari, Fernando, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2014
• Subjects: Adolescent; Adult; Aged; Bariatric surgery; Bariatric Surgery - methods; Body Mass Index; Chi-Square Distribution; Chile; Cohort Studies; Confidence Intervals; Female; Follow-Up Studies; Gastrectomy - adverse effects; Gastrectomy - methods; Gastroenterology and Hepatology; Humans; Laparoscopic sleeve gastrectomy; Laparoscopy - adverse effects; Laparoscopy - methods; Length of Stay; Long-term results; Male; Middle Aged; Minimally Invasive Surgical Procedures - adverse effects; Minimally Invasive Surgical Procedures - methods; Obesity, Morbid - diagnosis; Obesity, Morbid - surgery; Operative Time; Postoperative Complications - physiopathology; Postoperative Complications - surgery; Reoperation - methods; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; Surgery; Time Factors; Treatment Outcome; Weight Loss; Young Adult; Chile; Long-term results; Laparoscopic sleeve gastrectomy; Bariatric surgery
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2014.03.024

Abstract Background Laparoscopic 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. Methods Retrospective 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. Results A 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. Conclusion LSG 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.