Long-term outcomes of laparoscopic sleeve gastrectomy - a single-center prospective observational study.

Abstract

Introduction Laparoscopic sleeve gastrectomy (LSG) is an established bariatric procedure. Aim We present our long-term results regarding weight loss and comorbidities during 9 years. Material and methods We calculated the percent excess weight loss (%EWL) and changes in body mass index (ΔBMI). We evaluated arterial hypertension (AHT), type 2 diabetes (T2DM) and obstructive sleep apnea syndrome (OSAS). Results One hundred seventy-nine patients were included (136 female/43 male), mean age of 40.47 ±11.08 years, median preoperative body mass index (BMI) of 42.93 kg/m 2 . Median follow-up period was 72 months (36–84 months). The %EWL during follow-up was 41.8 (n = 179 patients, at 3-month follow-up), 64.1 (n = 163), 75.33 (n = 134), 77.1 (n = 103), 76,03 (n = 99), 73.78 (n = 64), 71.58 (n = 37), 63.83 (n = 22) and 64.1 (n = 14) at 6, 12, 18, 24, 36, 48, 60 and 72 months, respectively. We noted a negative correlation between %EWL and both the age and initial weight and BMI of the patient; a negative correlation between gender (male patients) and %EWL was also found. After LSG, 68.2% of patients with AHT presented resolution (no medication) or significant improvement (doses reduced) of the disease. As regards T2DM, 65.8% described resolution or significant improvement after surgery. Furthermore, 31 (70.4%) patients with preoperative OSAS reported resolution/improvement within a year from surgery. Conclusions Laparoscopic sleeve gastrectomy is a safe and effective procedure, with good results in the short and medium term. Long-term follow-up reveals a tendency to weight regain after approximately 2 years from primary surgery, with the need for revisional surgery in some cases.

Type 2 Diabetes Remission 5 Years After Laparoscopic Sleeve Gastrectomy: Multicenter Cohort Study

“…Metabolic changes come hand in hand with weight loss, and hence, the resolution of metabolic disorders such as diabetes is possible. Knowledge of factors promoting diabetes remission together with recognition of both short-and mid-term outcomes of different procedures is crucial to enable conscious decision-making [15][16][17][18][19]. The topic of mid-term remissions after LRYGB has already been extensively studied [20,21].…”

Laparoscopic Gastric Plication vs Laparoscopic Sleeve Gastrectomy - A Single Center, Prospective and Case-Control Study

“…The LSG procedure was performed under general anesthesia, following a procedure we have described in our previous work (6,7).…”

Biomechanical Investigation of the Stomach Following Different Bariatric Surgery Approaches

“… Identification of the weaknesses of traditional and current bariatric surgery (BS) techniques, with particular regard to unsatisfactory weight loss and/or weight regain ( a ), side effects and/or postsurgical complications ( b ), and mortality ( c ) [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. …”

“…The most controversial issue for LSG is gastroesophageal reflux disease due to both the increase of esophagogastric junction angle and the strong reduction of the stomach [ 14 ]. In general, unsatisfactory weight loss or weight gain is a possible postsurgical complication, and altered food approaches affect up to 25% of bariatric patients [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ] ( Figure 1 ), leading to the need for improvements in BS.…”