Sleeve Gastrectomy Outcomes in Patients with BMI Between 30 and 35–3 Years of Follow-Up

Berry, Marcos; Urrutia, Lionel; Lamoza, Patricio; Molina, Alfredo; Luna, Eduardo; Rivilla, Fernando; Domínguez, M. J.; Alonso, Rodrigo

doi:10.1007/s11695-017-2897-x

Cited by 50 publications

(36 citation statements)

References 35 publications

(29 reference statements)

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“…Two studies were excluded due to too small sample size 25 26 . Many that met our inclusion criteria did not provide data on 12 months follow up EWL%, so their authors were contacted to get more detailed information; for some of them, we were kindly given a comprehensive answer 27 28 29 30 …”

Section: Resultsmentioning

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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Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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“…To date, the only study evaluating NAFLD remission after metabolic surgery including patients with class I obesity was the one conducted by Berry et al [ 170 ]. This retrospective cohort study included 252 patients with BMI 30–35 kg/m 2 and at least one associated comorbidity, such as NAFLD (n = 69) and/or T2D (n = 10).…”

Section: Nafld Treatmentmentioning

confidence: 99%

“…This retrospective cohort study included 252 patients with BMI 30–35 kg/m 2 and at least one associated comorbidity, such as NAFLD (n = 69) and/or T2D (n = 10). Over 3 years of postoperative follow-up, NAFLD (assessed by US) remitted in 84.6%, and T2D remitted in 60% and improved in 40% [ 170 ]. It was not clear, however, how many patients had both conditions at baseline.…”

Section: Nafld Treatmentmentioning

confidence: 99%

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Godoy-Matos

Júnior

Valério

2020

Diabetol Metab Syndr

362

287

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Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing rapidly. It is nowadays recognized as the most frequent liver disease, affecting a quarter of global population and regularly coexisting with metabolic disorders such as type 2 diabetes, hypertension, obesity, and cardiovascular disease. In a more simplistic view, NAFLD could be defined as an increase in liver fat content, in the absence of secondary cause of steatosis. In fact, the clinical onset of the disease is a much more complex process, closely related to insulin resistance, limited expandability and dysfunctionality of adipose tissue. A fatty liver is a main driver for a new recognized liver-pancreatic α-cell axis and increased glucagon, contributing to diabetes pathophysiology. Main text: This review will focus on the clinical and pathophysiological connections between NAFLD, insulin resistance and type 2 diabetes. We reviewed non-invasive methods and several scoring systems for estimative of steatosis and fibrosis, proposing a multistep process for NAFLD evaluation. We will also discuss treatment options with a more comprehensive view, focusing on the current available therapies for obesity and/or type 2 diabetes that impact each stage of NAFLD. Conclusion: The proper understanding of NAFLD spectrum-as a continuum from obesity to metabolic syndrome and diabetes-may contribute to the early identification and for establishment of targeted treatment.

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“…SG is largely considered as a refluxogenic procedure although controversies exist because improvement of GERD after SG has been observed in some studies ( 32 , 64 – 66 ). With the use of a gold standard diagnostic test for GERD, our meta-analysis demonstrated conclusively an increased AET after surgery, which confirmed the above-mentioned statement ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Esophageal Pathophysiologic Changes and Adenocarcinoma After Bariatric Surgery: A Systematic Review and Meta-Analysis

Jaruvongvanich

Matar

Ravi

et al. 2020

Clinical and Translational Gastroenterology

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INTRODUCTION: To assess the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on acid reflux and esophageal motor function and to evaluate the observation of esophageal adenocarcinoma (EAC) after bariatric surgery. METHODS: We searched 5 databases for adults who underwent SG or RYGB and had esophageal pH test and/or esophageal manometry before and after surgery. A separate systemic search of observational studies and a retrospective review at 3 institutions of adults who developed EAC after these surgeries were conducted. Outcomes were changes in manometric and pH parameters and EAC cases after SG and RYGB. RESULTS: A total of 27 nonrandomized studies (SG: 612 patients; RYGB: 470 patients) were included. After SG, lower esophageal sphincter pressure and esophageal body amplitude were decreased and the risk of ineffective esophageal motility was increased. Total and recumbent acid exposure times were increased. After RYGB, an increased risk of ineffective esophageal motility was observed. Total, upright, and recumbent acid exposure times were decreased. The total reflux episodes remained unchanged but with increased nonacid reflux and decreased acid reflux events. Including our largest series, 31 EAC cases have been reported to date after SG and RYGB. DISCUSSION: This systematic review demonstrates increased acid reflux after SG and decreased acid reflux after RYGB. An observed increased nonacid reflux after RYGB might contribute to failure of gastroesophageal reflux disease improvement. This refluxate might be noxious to the esophagus, warranting further studies. RYGB might not entirely preserve esophageal function as previously believed.

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Sleeve Gastrectomy Outcomes in Patients with BMI Between 30 and 35–3 Years of Follow-Up

Cited by 50 publications

References 35 publications

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

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

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Esophageal Pathophysiologic Changes and Adenocarcinoma After Bariatric Surgery: A Systematic Review and Meta-Analysis

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