Seven-Year Outcomes of Laproscopic Sleeve Gastectomy in Indian Patients with Different Classes of Obesity

Ismail, Mohamed; Nagaraj, Dileep; Rajagopal, Mahesh; Ansari, Hafiz Md Nasimuddin; Nair, Megha; Hegde, Aparna; Rekha, P. D.

doi:10.1007/s11695-018-3506-3

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…Our results are like other studies which showed safety and effectiveness of LSG in class 1 obesity [ 22 , 35 – 41 ], with better outcomes in the low BMI group. Like cancer surgery, where the best outcome is achieved at earlier stage or with neoadjuvant therapy, we believe that the outcomes of BMS are better when the surgery is offered in the early stages of obesity, and the current guidelines recommend preoperative weight loss with higher obesity stage to minimize the risks.…”

Section: Discussionsupporting

confidence: 89%

“…We believe that the main reason for not lowering the cut-off for surgery was the economic and national regularity conditions rather than the safety of the procedure, as already the action BMI cut points are reduced by 2.5 kg/ m 2 to BMI 27.5, 32.5, and 37.5 kg/m 2 for Asian populations due to ethnic liability for obesity-associated medical problems [15]. In addition, many studies in the literature have proved the safety and effectiveness of metabolic surgery in patients with mild obesity especially in patients with T2DM [16][17][18][19][20][21][22][23][24]. A recent meta-analysis by Ji et al showed the safety of BMS in general in Asian patients with type 2 diabetes and BMI < 30 kg/m 2 [25], while Wang L concluded the same effect with laparoscopic sleeve gastrectomy on type 2 diabetes mellitus in patients with a body mass index (BMI) less than 30 kg/m 2 [26].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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Purpose Patients with mild obesity especially in absence of associated medical problems (OAMP) are commonly managed by non-surgical approaches. Laparoscopic sleeve gastrectomy (LSG) has proved itself to be effective and it is now the most performed weight loss procedure. We aimed to study the effectiveness and safety of LSG for weight loss in mild obesity. Methods A prospective cohort study. Group A; BMI (30–34.9 kg/m2), and group B; BMI ≥ 40 or BMI ≥ 35 with OAMP. Demographic data, perioperative complications, % excess weight loss (EWL), % total weight loss (TWL), nutritional profile, and evolution of OAMP were recorded and statistically analyzed. Results A total of 250 patients, with 80 patients (32%) in group A, and 170 (68%) in group B. The majority were female. The mean preoperative weight, BMI, and excess weight were 90.1 ± 9.52, 32.7 ± 1.4, and 21.5 ± 4.9 in group A, and 129.88 ± 26.12, 47.8 ± 8.2, and 62.3 ± 23.6 kg in group B respectively. The low BMI group had significantly lower OAMP, with higher pre-LSG non-surgical procedures rate. Overall post-operative morbidity rate was significantly higher in group B. %TWL was significantly lower in low BMI group. Nutritional profile was within the normal range in both groups at 3-year follow-up. Conclusion Laparoscopic sleeve gastrectomy is a safe and effective weight loss solution for mild obesity with better outcome than for higher BMI. Further studies are warranted to reconsider NIH’s statement for medicolegal aspects, and for matching the current changes in bariatric surgery practice, safety evidence, and patients’ demand. Graphical abstract

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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“…As regarding the analysis of efficacy, the statistical analysis was conducted considering only groups of patients with a mean baseline BMI between 30 and 40 kg/m² who had completed 12 months follow-up after the procedure. Two Studies [33,40] stratified their patient sample for classes of BMI; only class 1 (BMI between 30 kg/m² and 35 kg/m²) and class 2 (BMI between 35 kg/m² and 40 kg/m²) were included in our study sample. Relative to the analysis of safety, the statistical analysis was con-ducted considering all patients involved in the 16 studies included.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…With reference to the Clavien-Dindo classification [15], which deals with the stratification of peri-procedural complications, two studies did not report the rate of minor complications [33,39]. Despite not being analyzed, further complications may occasionally have occurred.…”

Section: Risk Of Bias Study Quality and Heterogeneitymentioning

confidence: 99%

Laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty: a systematic review and meta-analysis

et al. 2021

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Background and study aims Laparoscopic sleeve gastrectomy (LSG) is the current standard for bariatric surgery, but it is affected by several postoperative complications. Endoscopic sleeve gastroplasty (ESG) was created as a less invasive alternative to LSG. However, its efficacy and safety compared with LSG is unclear. Materials and methods Relevant publications were identified in MEDLINE/Cochrane/EMBASE/OVID/ PROSPERO and NIH up to January 2020. Studies were selected that included obese patients with a baseline body mass index (BMI) between 30 and 40 kg/m² with a minimum of 12 months of follow-up and with reported incidence of complications. The mean difference in percentage of excess weight loss (%EWL) at 12 months between LSG and ESG represented the primary endpoint. We also assessed the difference in pooled rate of adverse events. The quality of the studies and heterogeneity among them was analyzed. Results Sixteen studies were selected for a total of 2188 patients (LSG: 1429; ESG: 759) with a mean BMI 34.34 and 34.72 kg/m² for LSG and ESG, respectively. Mean %EWL was 80.32 % (± 12.20; 95 % CI; P = 0.001; I² = 98.88) and 62.20 % (± 4.38; 95 % CI; P = 0.005; I² = 65.52) for the LSG and ESG groups, respectively, corresponding to an absolute difference of 18.12 % (± 0.89; 95 % CI, P = 0.0001). The difference in terms of mean rate of adverse events was 0.19 % (± 0.37; 95 %CI; χ 2 = 1.602; P = 0.2056). Conclusions Our analysis showed a moderate superiority of LSG versus ESG. No difference in terms of safety was shown between the two groups. ESG is a less-invasive, repeatable and reversable and acceptable option for mild-moderate obese patients.

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“…Further, a decrease of 1 kg of weight has been associated with an approximate 1 mmHg decline in systolic blood pressure [12]. In the Asian population, individuals with Class I obesity who have undergone LSG have shown a greater %EBMIL than other treatment modalities [13]. In our study, the LSG group had a more rapid change in %EBMIL at 6,12, and 18 months and reached nearly 100%, in comparison to the WCP group, where the trend of %EBMIL was very gradual and only reached 25% by the end of 18 months.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Sleeve Gastrectomy versus Lifestyle Modification in Class I Obesity in Pakistani Population: A Prospective Cohort Study

Amin

Siddiq

Haider

et al. 2019

Cureus

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Introduction The American Society of Metabolic and Bariatric Surgery has stated that bariatric surgery is indicated in Class I obesity patients with one or more comorbidities. However, other weight loss options, such as diet plus exercise, are available to patients with a body mass index (BMI) ranging from 30 to 35 kg/m 2. This study aimed to prospectively compare the results of Class I obesity patients undergoing laparoscopic sleeve gastrectomy (LSG) or using a weight control program (WCP). Methods A prospective analysis was conducted of patients with Class I obesity and comorbid diabetes and hypertension, with follow-ups at 6, 12, and 18 months. Subjects were divided into two groups: the LSG group of patients who had undergone LSG, and the WCP group who adhered to a WCP. The percentage of excess BMI loss (%EBMIL) and comorbidity remission (diabetes mellitus and hypertension) were tracked with measurements of hemoglobin A1C (HBA1C) levels and systolic blood pressure. Self-esteem was also tracked using the Rosenberg Self-Esteem Scale (SES) at 0 and 18 months. The overall patient satisfaction score was calculated using a visual analogue scale. Results Of the 150 patients enrolled in the study, 106 were included in the LSG group, and 103 were included in the WCP group. The reduction in HBA1C was more pronounced in the LSG group, and the differences between the two were statistically significant after 6, 12, and 18 months (LSG 5.6 ± 0.47 vs. WCP 6.5 ± 0.64, CI 1.04-0.73, P < 0.05). At 12 and 18 months, there were statistically significant reductions in systolic blood pressure after LSG (LSG 134.2 ± 7.16 vs. WCP 145.63 ± 5.94, CI 13.2-9.6, P < 0.05). Self-esteem levels measured by the Rosenberg SES increased for all participants, while patient satisfaction score was higher in the LSG group than that in the WCP group (P < 0.05). The %EBMIL at 6 months in the LSG group was 35.48%, compared to the WCP group at only 7.23%. At 12 months, the %EBMIL had increased twofold in the LSG group, at 68.19%, compared to 14.53% in the WCP group. At the final 18-month followup, the %EBMIL in the LSG group was 99.60% but was only 25.70% in the WCP group (P < 0.05). Conclusion Open Access Original Article

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Seven-Year Outcomes of Laproscopic Sleeve Gastectomy in Indian Patients with Different Classes of Obesity

Cited by 11 publications

References 21 publications

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

Laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty: a systematic review and meta-analysis

Laparoscopic Sleeve Gastrectomy versus Lifestyle Modification in Class I Obesity in Pakistani Population: A Prospective Cohort Study

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