Skip to main content

Advertisement

Log in

Mid-term Follow-up after Sleeve Gastrectomy as a Final Approach for Morbid Obesity

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

In previous publications, we demonstrated the safety and short-term efficacy of laparoscopic sleeve gastrectomy (LSG) as a final step in the treatment of morbid obesity (MO). This study aimed to assess the mid-term efficacy of LSG.

Methods

We performed a retrospective review of a prospectively collected database. Between November 2004 and January 2007, 130 consecutive patients underwent LSG as a final procedure to MO. Data including patient demographics, operative time, length of hospital stay, complications, preoperative body mass index (BMI), complications, and weight loss at 3, 6, 12, 18, and 24 months were recorded and analyzed.

Results

The mean age was 45.6 (range: 12–79) years while the mean BMI was 43.2 (range: 30.2–75.4) kg/m2. The mean operative time was 97 (range, 58–180) min and all operations were completed laparoscopically. The mean hospital stay was 3.2 (range, 1–19) days with zero mortality in this series.

One patient (0.7%) had leakage at the stapler line, while four patients (2.8%) developed trocar site infection. Three patients (2.1%) complained of symptoms of gastroesophageal reflux disease (GERD), three patients (2.1 %) developed symptomatic gallstones, and trocar site hernia was present in one (0.7%) patient. The mean weight loss was 21, 31.2, 37.4, 39.5, and 41.7 kg at 3, 6, 12, 18, and 24 months, respectively, while the mean BMI decreased to 36.9, 32.8, 29.5, 28, and 27.1 at 3, 6, 12 18, and 24 months, respectively. Percent of excess weight loss (%EWL) was 33.1, 50.8, 62.2, 64.4, and 67.9 at 3, 6, 12, 18, and 24 months, respectively.

Conclusions

LSG is a safe and effective surgical procedure for the morbidly obese up to 2 years. Excess body weight loss seems to be acceptable at 2 years postoperatively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy, a restrictive procedure. Obes Surg. 2007;17:57–62.

    Article  Google Scholar 

  2. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.

    Article  CAS  Google Scholar 

  3. Ariyasu H, Takaya K, Tagami T, et al. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab. 2001;86:4753–8.

    Article  CAS  Google Scholar 

  4. Roa P, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity. Obes Surg. 2006;16:1323–6.

    Article  Google Scholar 

  5. Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.

    Article  Google Scholar 

  6. Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.

    Article  Google Scholar 

  7. DeMaria EJ, Schauer P, Patterson E, et al. The optimal surgical management of the super-obese patient. Surg Innov. 2005;12:107–21.

    Article  Google Scholar 

  8. Chu CA, Gagner M, Quinn T, et al. Two-stage laparoscopic biliopancreatic diversion with duodenal switch: an alternative approach to super-super morbid obesity. Surg Endosc. 2002;16:S069.

    Google Scholar 

  9. Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861.

    Article  CAS  Google Scholar 

  10. Surgerman HJ, Kellum WB, Engle KM, et al. Gastric bypass for treating severe obesity. Am J Clin Nutr. 1992;55(Suppl):560S–6S.

    Article  Google Scholar 

  11. Gonzalez R, Nelson LG, Gallagher SF. Anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2004;14:1299–307.

    Article  Google Scholar 

  12. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.

    Article  CAS  Google Scholar 

  13. Nakazato M, Murakami N, Date Y, et al. A role for ghrelin in the central regulation of feeding. Nature. 2001;409:194–8.

    Article  CAS  Google Scholar 

  14. Tschop M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents. Nature. 2007;407:908–13.

    Article  Google Scholar 

  15. Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg (England). 2007;17(8):1069–74.

    Article  CAS  Google Scholar 

  16. Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy-volume and pressure assessment. Obes Surg. 2009;19:134.

    Article  Google Scholar 

  17. Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.

    Article  Google Scholar 

  18. Frezza E. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice. Surg Today. 2007;37:275–81.

    Article  Google Scholar 

  19. Khitin L, Roses RE, Birkett DH. Cancer in the gastric remnant after gastric bypass. Curr Surg. 2003;60(5):521–3.

    Article  Google Scholar 

  20. Lord RV, Edwards PD, Coleman MJ. Gastric cancer in the bypassed segment after operation for morbid obesity. Aust N Z J Surg. 1997;67(8):580–2.

    Article  CAS  Google Scholar 

  21. Langer FB, Bohdjalian A, Felberbauer FX, et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16(2):166–71.

    Article  Google Scholar 

  22. Gagner M, Rogula T. Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg. 2003;13:649–54.

    Article  Google Scholar 

  23. Lee CM FJ, Cirangle PT, Jossart GH. Laparoscopic vertical sleeve gastrectomy for morbid obesity in 216 patients: report of two-year results. SAGES 2006 Final Program 2006:88.

  24. Gumbs A, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.

    Article  Google Scholar 

  25. Nesset E, Kendrick M, Houghton S, Mai J, et al. A two-decade spectrum of revisional bariatric surgery at a tertiary referral center. Surg Obes Relat Dis. 2007;3:25–30.

    Article  Google Scholar 

  26. Abu-Abeid S, Keidar A, Gavert N, et al. The clinical spectrum of band erosion following laparoscopic adjustable silicone gastric banding for morbid obesity. Surg Endosc. 2003;17:861–3.

    Article  CAS  Google Scholar 

  27. Nelson LG, Gonzalez R, Haines K, et al. Amelioration of gastroesophageal reflux symptoms following Roux-en-Y gastric bypass for clinically significant obesity. Am Surgeon. 2005;71(11):950–3.

    PubMed  Google Scholar 

  28. Peluso L, Vanek VW. Efficacy of gastric bypass in the treatment of obesity-related comorbidities. Nutr Clin Prac. 2007;22(1):22–8.

    Article  Google Scholar 

  29. Li VKM, Pulido N, Martinez P, et al. Predictor of symptomatic gallstone after bariatric surgery: A multivariate analysis of risk factors comparing gastric bypass, gastric banding and sleeve gastrectomy: abstract for SAGES 2008.

  30. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.

    Article  Google Scholar 

  31. Hamoui N, Anthone GJ, Kaufman HS, et al. Sleevegastrectomy in the high-risk patient. Obes Surg. 2006;16:1445–9.

    Article  Google Scholar 

  32. Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy (LSG): review of a new bariatric procedure and initial results. Surg Technol Int. 2006;15:47–52.

    PubMed  Google Scholar 

  33. Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreaticdiversion with duodenal switch) on comorbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.

    Article  Google Scholar 

  34. Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.

    Article  Google Scholar 

Download references

Conflict of interest

The authors do not have conflict of interest at this time to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raul J. Rosenthal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arias, E., Martínez, P.R., Ka Ming Li, V. et al. Mid-term Follow-up after Sleeve Gastrectomy as a Final Approach for Morbid Obesity. OBES SURG 19, 544–548 (2009). https://doi.org/10.1007/s11695-009-9818-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-009-9818-6

Keywords

Navigation