Long-Term Outcome of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Japanese Patients

Seki, Yosuke; Kasama, Kazunori; Hashimoto, Kenkichi

doi:10.1007/s11695-015-1728-1

Cited by 59 publications

(37 citation statements)

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“…Primary restrictive procedures such as Vertical Banded Gastroplasty (VBG), Laparoscopic Adjustable Gastric Banding (LAGB) or Laparoscopic Sleeve Gastrectomy (LSG), although the latter is considered to be a metabolic procedure, seem to be a safe and effective strategy for weight reduction in short and mid-term follow-up. However, patients who underwent these procedures are at risk of having insufficient weight loss and weight regain [4][5][6][7][8]. These complications can be an indication for revisional surgery [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…However, patients who underwent these procedures are at risk of having insufficient weight loss and weight regain [4][5][6][7][8]. These complications can be an indication for revisional surgery [8,9]. Cumulative failure rates in patients who received LSG and LAGB have been reported up to 30 and 60%, respectively [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

et al. 2020

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Background Failure occurs in up to 60% of the patients that were treated with primary restrictive bariatric operations such as Laparoscopic Adjustable Gastric Banding (LAGB), or restrictive/metabolic operations like Laparoscopic Sleeve Gastrectomy (LSG). Insufficient weight loss and weight regain are the most commonly reported reasons of failure. The aim of this retrospective multicenter study was to compare One Anastomosis Gastric Bypass (OAGB) to Roux-en-Y Gastric Bypass (RYGB) as a revisional procedure in terms of weight loss, procedure time, complication rate and morbidity. Methods 491 patients operated on between 2012 and 2017 for failed restrictive surgery were included in this study (OAGB (n=185) or RYGB (n=306)). Failure was defined as total weight loss (TWL) less than 25%, excess weight loss (EWL) less than 50% and/or a remaining body mass index (BMI) larger than 40 kg/m2 at two years of follow up. Primary outcome measures were %TWL and % excess BMI loss (EBMIL) at 12, 24 and 36 months of follow-up. Secondary outcomes were procedure time, reduction of comorbidity, early and late complication rate, and mortality. Results %TWL was significantly larger in the OAGB group at 12 months (mean 24.1±9.8 vs. 21.9±9.7, p = 0.023) and 24 months (mean 23.9±11.7 vs. 20.5±11.2, p = 0.023) of follow-up. %EBMIL was significantly larger in the OAGB group at 12 months (mean 69.0±44.6 vs. 60.0±30.1, p = 0.014) and 24 months (mean 68.6±51.6 vs. 56.4±35.4, p = 0.025) of follow-up. Intraabdominal complications (leakage, bleeding, intra-abdominal abscess and perforation) occurred less frequently after revisional OAGB (1.1% vs. 4.9%, p = 0.025). Surgical intervention for biliary reflux (5.4% vs. 0.3%, p < 0.001) was more prevalent in the OAGB group. Surgical intervention for internal herniation (0.0% vs. 4.9%, p = 0.002) was more prevalent in the RYGB group. Conclusions This study suggests that OAGB is superior to RYGB as a remedy for insufficient weight loss and weight regain after failed restrictive surgery with more weight loss and a lower early complication rate. To substantiate these findings, further research from prospective randomized controlled trials is needed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

et al. 2020

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“…Техническими аспектами процедуры, влияющими на отдаленный исход, являются ширина создаваемой желудочной трубки, расстояние от начала резекции до привратника и др. [18,21].…”

Section: продольна я резекция же лудк аunclassified

“…Применение бужа размером 36 Fr позволяет добиться потери 78,3 % избыточной массы тела через пять лет после операции, в то время как при использовании зонда 45 Fr -только 42,7 %. Примечательно, что данная деталь влияет именно на долгосрочную эффективность, не отражаясь на ранних результатах [18,21].…”

Section: продольна я резекция же лудк аunclassified

“…Напротив, при расстоянии менее 4 см от пилоруса избыточная масса тела снижается на 75,5 %. Удаление всего антрального отдела желудка позволяет добиться редукции 81,5 ± 22,9 % избыточной массы тела с минимальной частотой рецидива ожирения (до 5 %) [17,21].…”

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Revision procedures in bariatric surgery

et al. 2019

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Searching the optimal options for reoperations in overweight patients has the same lengthy and difficult history as all bariatric surgery. The key issues of this aspect of obesity surgery are inefficiency (inadequate weight reduction or it regain) and the unavoidable complications of conservative methods and the negative effects of primary surgery. Weight regain after bariatric surgery is a multicomponent problem. The main reason for the unsatisfactory results of surgical (and conservative) treatment of obesity in some patients is the nature of obesity – the lifelong chronic recurrent disease. A certain role in the return of excess weight is played by the imperfection of the currently existing surgical procedures for the correction of overweight, as well as the wrong choice of options for surgical interventions and technical errors in their implementation. Increase the number of worldwide operations for obesity and its associated diseases translates the problem of revision bariatric surgery from the category of narrow questions in this field of medicine into a serious problem. The article describes modern approaches to the surgical treatment of re-gaining weight after bariatric operations. It considered options for audit procedures, depending on the previously performed surgery. Original techniques of repeated operations for effective correction of the relapse of overweight are described in article.

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Background characteristics and postoperative outcomes of insufficient weight loss after laparoscopic sleeve gastrectomy in Japanese patients

Saiki

Yamaguchi

Tanaka

et al. 2019

Annals of Gastroent Surgery

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AimLaparoscopic sleeve gastrectomy (LSG) is becoming popular in Japan, but insufficient weight loss is often observed in patients after LSG. We investigated the effect of LSG on obesity‐related comorbidities and identified the background characteristics of Japanese patients with insufficient weight loss after LSG.MethodsIn this multi‐institutional retrospective study at 10 certified bariatric institutions, 322 Japanese patients who underwent LSG with a follow‐up period of more than 2 years were analyzed. Anthropometry, obesity‐related comorbidities and psychosocial background data were collected. Weight loss was expressed as 2‐year percent total weight loss (%TWL).ResultsMean age, body weight, body mass index (BMI) and glycated hemoglobin were 46.9 years, 119.2 kg, 43.7 kg/m2 and 7.1%, respectively. Prevalence of mental disorders was 26.3%. Mean BMI declined to 30.3 kg/m2 at 2 years and %TWL was 29.9%. Improvements in the markers and prevalence of obesity‐related comorbidities were observed. Remission rates of diabetes, dyslipidemia and hypertension were 75.6%, 59.7% and 41.8%, respectively. %TWL at the respective cut‐off level of diabetes remission was 20.8%. Lower remission rates of diabetes in patients with %TWL <20%, and less calorie restriction and higher prevalence of mental disorders (46.9%) in patients with %TWL <15% were observed. Frequencies of %TWL <15% and <20% were 6.5% and 18.5%, respectively.Conclusion%TWL 20% was a candidate cut‐off point of insufficient weight loss for diabetes remission after LSG, and mental disorders might be relevant to intractable obesity in Japanese patients.

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Long-Term Outcome of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Japanese Patients

Abstract: LSG for Japanese morbidly obese patients is safe, effective, and acceptably durable up to 5 years although some complications unique to the procedure such as leakage from the staple line and intractable GERD occur. For super morbidly obese patients, other surgical options may be required.

Cited by 59 publications

References 20 publications

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

Revision procedures in bariatric surgery

Background characteristics and postoperative outcomes of insufficient weight loss after laparoscopic sleeve gastrectomy in Japanese patients

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