Laparoscopic Sleeve Gastrectomy — Influence of Sleeve Size and Resected Gastric Volume

Weiner, Rudolf A.; Weiner, Sylvia; Pomhoff, Ingmar; Jacobi, C. A.; Makarewicz, Wojciech; Weigand, Gerhard

doi:10.1007/s11695-007-9232-x

Cited by 396 publications

(250 citation statements)

References 18 publications

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“…Also, they showed a reduction in the operative risk (ASA score) after LSG. They proved that LSG effec-tively downstages patients to a lower-risk group as Cottam et al [41] and Weiner et al [47] also reported, and effectively resolved or improved co-morbidities as many other teams have also demonstrated ( Table 1).…”

Section: Discussionmentioning

confidence: 82%

“…LSG has demonstrated weight-loss results comparable to LRYGB and LBPD-DS but with a lower morbidity profile, associated with improvement of health status and resolution of co-morbidities such as diabetes, hypertension, OSA and dyslipidemia [16,18,38,41,44,45,47,48]. Silecchia et al [44] showed that in 41 super-obese patients (9 patients with BMI > 60 kg/m ) following LSG, 60% of major comorbidities were resolved and 24% improved, 57.8% of patients were co-morbidity-free and 31.5% had only one major co-morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…This is not a concern limited to the short-term but to the midand long-term. However, laparoscopic re-sleeve gastrectomy (LRSG) can be performed in the context of a gastric tube dilatation, inadequate original gastric volume reduction or in case of poor weight loss after independent LSG or LBPD-DS [47,56,57]. Furthermore, LSG can also be converted to LRYGB or LBPD-DS in case of weight regain.…”

Section: Discussionmentioning

confidence: 99%

“…Weiner et al [47] suggest in a prospective but nonrandomized study that the volume of the gastric sleeve is an important factor for later dilatation and consequently weight regain. The non-calibrated sleeves showed satisfactory shortterm weight loss comparable to the calibrated sleeves, but over time patients regain weight.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Weiner et al [47] reported the results of 120 patients who underwent LSG, which were performed without calibration or using a 32-Fr or a 44-Fr bougie. All three groups were comparable for age, gender and co-morbidities.…”

Section: Weight-loss Outcomesmentioning

confidence: 99%

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Updated Review of Sleeve Gastrectomy

Trelles¹,

Gautier²

2008

TOGASJ

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There is a bariatric explosion worldwide to deal with the rising prevalence of morbid obesity. In 1988, Hess and Hess first added the sleeve gastrectomy (SG) and the duodenal switch (DS) as a modification to the biliopancreatic diversion (BPD) to improve clinical outcomes. But the increased morbidity and mortality observed in super-super-obese patients (BMI > 60 kg/m ) who underwent BPD with DS (BPD-DS) made Gagner and co-workers propose SG as a bridge to gastric bypass or BPD-DS to reduce complications and mortality. The excellent short-term weight-loss outcomes after SG have increased the enthusiasm among surgeons to use it as a definitive treatment for morbidly obese and super-obese patients (BMI > 50 kg/m ). Neurohormonal and gastric emptying changes may account for its superiority over other restrictive procedures. Recent reports on mid-term weight-loss outcomes make this procedure a viable option for bariatric surgeons; nonetheless, long-term studies are still required.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Weight-loss Outcomesmentioning

confidence: 99%

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Updated Review of Sleeve Gastrectomy

Trelles¹,

Gautier²

2008

TOGASJ

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Long-term Follow-up After Bariatric Surgery

Puzziferri

Roshek

Mayo

et al. 2014

JAMA

735

418

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IMPORTANCE Bariatric surgery is an accepted treatment for obesity. Despite extensive literature, few studies report long-term follow-up in cohorts with adequate retention rates. OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss, type 2 diabetes, hypertension, and hyperlipidemia in severely obese adults. EVIDENCE REVIEW MEDLINE and Cochrane databases were searched from 1946 through May 15, 2014. Search terms included bariatric surgery, individual bariatric procedures, and obesity. Studies were included if they described outcomes for gastric bypass, gastric band, or sleeve gastrectomy performed on patients with a body mass index of 35 or greater, had more than 2 years of outcome information, and had follow-up measures for at least 80% of the initial cohort. Two investigators reviewed each study and a third resolved study inclusion disagreements. FINDINGS Of 7371 clinical studies reviewed, 29 studies (0.4%, 7971 patients) met inclusion criteria. All gastric bypass studies (6 prospective cohorts, 5 retrospective cohorts) and sleeve gastrectomy studies (2 retrospective cohorts) had 95% confidence intervals for the reported mean, median, or both exceeding 50% excess weight loss. This amount of excess weight loss occurred in 31% of gastric band studies (9 prospective cohorts, 5 retrospective cohorts). The mean sample-size–weighted percentage of excess weight loss for gastric bypass was 65.7% (n = 3544) vs 45.0% (n = 4109) for gastric band. Nine studies measured comorbidity improvement. For type 2 diabetes (glycated hemoglobin <6.5% without medication), sample-size–weighted remission rates were 66.7% for gastric bypass (n = 428) and 28.6% for gastric band (n = 96). For hypertension (blood pressure <140/90 mm Hg without medication), remission rates were 38.2% for gastric bypass (n = 808) and 17.4% for gastric band (n = 247). For hyperlipidemia (cholesterol <200 mg/dL, high-density lipoprotein >40 mg/dL, low-density lipoprotein <160 mg/dL, and triglycerides <200 mg/dL), remission rates were 60.4% for gastric bypass (n = 477) and 22.7% for gastric band (n = 97). CONCLUSIONS AND RELEVANCE Very few bariatric surgery studies report long-term results with sufficient patient follow-up to minimize biased results. Gastric bypass has better outcomes than gastric band procedures for long-term weight loss, type 2 diabetes control and remission, hypertension, and hyperlipidemia. Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections.

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Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: Cosponsored by american association of clinical endocrinologists, The obesity society, and american society for metabolic & bariatric surgery*

Mechanick

Youdim

Jones

et al. 2013

Obesity

1,082

372

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The development of these updated guidelines was commissioned by the AACE, TOS, and ASMBS Board of Directors and adheres to the AACE 2010 protocol for standardized production of clinical practice guidelines (CPG). Each recommendation was re-evaluated and updated based on the evidence and subjective factors per protocol. Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type-2 diabetes, bariatric surgery for patients with mild obesity, copper deficiency, informed consent, and behavioral issues. There are 74 recommendations (of which 56 are revised and 2 are new) in this 2013 update, compared with 164 original recommendations in 2008. There are 403 citations, of which 33 (8.2%) are EL 1, 131 (32.5%) are EL 2, 170 (42.2%) are EL 3, and 69 (17.1%) are EL 4. There is a relatively high proportion (40.4%) of strong (EL 1 and 2) studies, compared with only 16.5% in the 2008 AACE-TOS-ASMBS CPG. These updated guidelines reflect recent additions to the evidence base. Bariatric surgery remains a safe and effective intervention for select patients with obesity. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues.

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Laparoscopic Sleeve Gastrectomy — Influence of Sleeve Size and Resected Gastric Volume

Cited by 396 publications

References 18 publications

Updated Review of Sleeve Gastrectomy

Updated Review of Sleeve Gastrectomy

Long-term Follow-up After Bariatric Surgery

Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: Cosponsored by american association of clinical endocrinologists, The obesity society, and american society for metabolic & bariatric surgery*

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