Long-Term Matched Comparison of Primary and Revisional Laparoscopic Sleeve Gastrectomy

• Published in: Obesity surgery Vol. 33; no. 3; pp. 695 - 705
• Main Authors: Sakran, Nasser, Soued, Sharon, Hod, Keren, Buchwald, Jane N., Soifer, Kim, Kessler, Yafit, Adelson, Dana, Biton, Reut, Goitein, David, Raziel, Asnat
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2023; Springer Nature B.V
• Subjects: Adult; Body Mass Index; Diabetes Mellitus, Type 2 - surgery; Female; Gastrectomy - methods; Gastrointestinal surgery; Humans; Laparoscopy; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity, Morbid - surgery; Original Contributions; Patient satisfaction; Reoperation - methods; Retrospective Studies; Surgery; Treatment Outcome; Weight Loss; Obesity; Revision; Bariatric/metabolic surgery; Matched case; Weight regain; Long-term; Sleeve gastrectomy
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-022-06436-8

Background Reports of long-term (> 5–15-year) outcomes assessing the safety and efficacy of primary revisional laparoscopic sleeve gastrectomy (LSG) are few. Methods Retrospective long-term comparisons of primary (pLSG) and revisional (rLSG) procedures were matched for gender, age ± 5 years, and body mass index (BMI) ± 5 kg/m 2 . Weight loss, associated medical condition status, and patient satisfaction were evaluated. Results Between May 1, 2006, and December 31, 2016, 194 matched patients with severe obesity (mean BMI 44.1 ± 6.7 kg/m 2 ; age 44.2 ± 10.0 years, 67.0% female) underwent pLSG ( n  = 97) or rLSG ( n  = 97) and were followed for a mean 12.1 ± 1.5 vs 7.6 ± 2.1 years. Respective mean weight regain from nadir was 15.0 ± 14.4 kg vs 11.9 ± 12.2 kg. Respective percent mean total weight loss and excess weight loss were 20.9 ± 12.7% and 51.8 ± 33.1%, and 18.3 ± 12.8% and 43.4 ± 31.6% at last follow-up, with no significant difference between groups. Resolution of type 2 diabetes (HbA1 C  < 6.5%, off medications) was 23.1% vs 11.1%; hypertension 36.0% vs 16.0%; and hyperlipidemia 37.1% vs 35.3%. Patients in the pLSG group were significantly more satisfied with LSG (59.8% vs 43.3%, p  < 0.05) and more likely to choose the procedure again. Conclusions There were no significant differences in long-term weight loss or associated medical condition outcomes in matched pLSG and rLSG patients. Graphical Abstract