Clinical Science
Laparoscopic sleeve gastrectomy for morbid obesity: 5-year results

https://doi.org/10.1016/j.amjsurg.2014.04.006Get rights and content

Abstract

Background

Data concerning the long-term efficacy of laparoscopic sleeve gastrectomy in the treatment of morbid obesity remain scarce. In this retrospective, the authors present 5-year follow-up of 30 patients having undergone laparoscopic sleeve gastrectomy.

Methods

Since 2004, 30 patients underwent laparoscopic sleeve gastrectomy and completed 5 years of follow-up. Five patients were subsequently subjected to laparoscopic Roux-en-Y gastric bypass and were excluded from further analysis. The remaining 25 patients comprised the study population.

Results

Mean excess weight loss was 65.2 ± 6.1%, 64.7 ± 5.6%, 62 ± 4.9%, 58.2 ± 5.5%, and 56.4 ± 5.8% for the first 5 years, respectively. There were no deaths, nor any major morbidity. Remission of comorbidities was observed in 40% to 80.9% of cases.

Conclusions

Laparoscopic sleeve gastrectomy is a safe and effective means of treatment of morbid obesity both in the short and in the long term. More research is needed to better predict which patient will benefit most from this operation.

Section snippets

Materials and Methods

From January 2004 to July 2008, a total of 30 morbidly obese patients underwent laparoscopic sleeve gastrectomy at our department. The operations were performed either as the first part of a planned 2-stage weight reduction operative strategy for morbid obesity or as a stand-alone option for the definitive treatment of morbid obesity.

According to our protocol, patients underwent an extensive preoperative workup including blood tests, chest radiograph, abdominal ultrasound, echocardiography,

Results

Until July 2013, a total of 150 laparoscopic sleeve gastrectomy procedures have been performed. A total of 30 patients have completed 5 years of follow-up. Five patients have been excluded from the data analysis because they underwent a second-stage laparoscopic Roux-en-Y gastric bypass at various time points after the initial laparoscopic sleeve gastrectomy because of inadequate weight loss.

Patients' demographics and comorbidities are listed in Table 1. Sixty percent of the patients (15/25)

Comments

Sleeve gastrectomy was initially described in 1999 by Hess and Hess16 as part of biliopancreatic diversion with duodenal switch. In 2000, Regan et al17 reported its use as a first-stage operation for super obese patients before Roux-en-Y gastric bypass establishing the 2-stage approach for bariatric patients. In 2004, Almogy et al18 announced results for patients who underwent only laparoscopic sleeve gastrectomy with favorable results. This observation led to an exponential rise in the use of

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    The authors declare no conflicts of interest.

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