Ten-Year Results of Laparoscopic Sleeve Gastrectomy: Retrospective Matched Comparison with Laparoscopic Adjustable Gastric Banding—Is There a Significant Difference in Long Term?

Abstract

Background The laparoscopic sleeve gastrectomy (LSG) is the most common bariatric procedure performed worldwide while the laparoscopic adjustable gastric banding (LAGB) has been almost abandoned. Aim of this study was to retrospectively assess 10-year outcomes of LSG through a matched comparison with LAGB. Materials and Methods Retrospective search of prospectively maintained database of our university was carried out to find all patients that underwent LSG before December 2010. Each subject with LSG was matched one-to-one with a patient that had undergone LAGB in the same period with correspondent preoperative age, BMI, and sex. Results A total of 76 patients underwent LSG before 2010 and were all included in this study; a matched group of 76 out of 178 LAGB patients with 10-year follow-up was retrieved from our database. Comparison between the two groups showed better outcomes after LSG at 1 and 5 years but weight loss was comparable with the LAGB group at 10 years (%TWL 22.2 ± 13 vs 21.2 ± 16.1; p = 0.89). No significant difference was found in conversion/removal rate (15.8% vs 18.4%; p = 0.67). Conclusion LSG is an effective stand-alone bariatric procedure with better outcomes than LAGB in medium term, but results are comparable at 10 years. Subjects undergoing LSG should be informed that conversion to RYGB or OAGB may be necessary to achieve further weight loss or to treat reflux. Graphical abstract

Ten-Year Results of Laparoscopic Sleeve Gastrectomy: a Retrospectively Designed Study of a Single Tertiary Center

“…Hauters et al [ 18 ] reported that 41% of patients reached this goal at 10 years after SG. This was further supported by an additional retrospective study reporting 48.6% of patients reaching EWL > 50 [ 19 ]. We agree with conclusions drawn in these studies that SG may be of benefit for selected patients.…”

“…Similarly, Chang et al [ 21 ] reported 39.6% remission of T2D, 78.4% for HTN, and 51.3% for dyslipidemia. On the contrary, Musella et al [ 19 ] showed in their cohort showed 0% remission of T2D and 51.4% remission of HTN. Our results showed 47% remission for T2D, 43.7% remission for HTN, and 48.4% remission for hypercholesterolemia.…”

“…In addition, esophagitis prevalence was significantly higher after SG (31% vs 7%) but no difference was seen in the prevalence of Barret’s esophagus. Musella et al [ 19 ] retrospectively analyzed patients undergoing SG vs gastric band at 10 years and did not show any advantage for SG over the gastric band in terms of weight loss and remission of co-morbidities except for postoperative GERD which was significantly higher in the SG group (25.7% vs 6.5%). We think that additional comparative studies are required to further clarify long term outcomes of SG compared to other MBS.…”

The rising tide of revisional surgery: tracking changes in index cases among bariatric-accredited fellowships

“…Revisions to non-anastomotic operations (i.e., gastric band to sleeve gastrectomy) were not compared, as we restricted our analysis to more complex revisions (revisions to an anastomotic case). In that regard, as the population of sleeve gastrectomy patients continues to increase, we believe revisions to anastomotic cases are likely to increase due to issues related to weight regain and reflux [ 12 ].…”

Lessons from the COVID-19 pandemic: remote coaching in bariatric surgery

“…Surgical technique has been described in detail elsewhere [7], but a brief description is reported below for completeness of the article. For LSG, a five-trocar approach (3 × 12 mm, 2 × 5 mm) was used.…”