Efficiency of Laparoscopic sleeve gastrectomy at patients with obesity

Abstract

Introduction. Laparoscopic Sleeve Gastrectomy (SG) is a relatively new bariatric operation popularity of which is increasing yearly. However many questions regarding this operation are still unclear. Aim of this study is an assessment of efficacy of SG in the patients of different BMI-groups, evaluation of early and late postoperative complications and possible side effects. Materials and methods. From 2004 г. to August 2014 primary laparoscopic SG in CELT-clinic (Moscow) was performed in 263 patients aged 39,1 ± 10,7 yrs, male/female rate - 55:208, initial weight -113,9± 21,34 kg, mean BMI - 40,1± 6,1 kg/m2. Results. There was no mortality, early complications rate was 4,2%. 92,7 % of pts were follow-uped one year and more after surgery. In the entire group maximal excess weight loss (EWL) was 75,8% at 12 months and 63,7% at 60 months postoperatively. EWL depended on initial BMI. In patients with BMI 35 ( n=39) EWL was 94,1 % at 9 months and remained at level of 90 % to 4 year while in the super-obese patients (BMI50, n=10), maximal mean EWL didn’t exceed 40 % at 2 years. Late complications were: reflux- oesophagitis - 5,7 %, cholelithiasis - 2,7 %, iron-deficiency anemia - 16,3%. 4 (1,5%)of ptsunderwent second-step Duodenal Switch in the late period, but actually more patients need second-step surgery due to insufficient effect of SG. Conclusion. SG is prospective, safe and effective operation and may be considered as stand-alone operation as well as first step of more complex operations. Further evaluation of late (5 years) results is necessary as well as a comparison of results with other bariatric operations.

The treatment of metabolic syndrome in patients with morbid obesity

“…Assessing the rapid growth in the number of obese patients, as well as a significant increase in the economic costs of their treatment, many authors justify the need to use a powerful resource of various surgical methods to correct pathological changes inherent in obesity [4]. Lifestyle modification, including vigorous exercise and a diet low in fat and calories, is fundamental to treating obese patients [5][6][7]. The use of surgical treatment methods is the most effective way to combat morbid obesity (MO), especially against the background of complications of the disease, which requires a special approach, both in preoperative preparation and intra-and postoperative management, which is associated with the presence of concomitant pathology of vital organs that is invariably detected in them and body systems [8][9][10].…”

Ghrelin concentration before and after bariatric surgery

“…Most researchers now recognise that conservative treatment of extreme degrees of obesity is an extremely difficult task and for 90-95% of patients is not feasible [5,6]. Many authors, assessing the rapid growth in the number of obese patients and the significant increase in the costs of their treatment, justify the need to use a powerful resource of various surgical methods to correct the pathological changes inherent in obesity [7,8,9].…”