Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy

Arman, Gustavo A.; Himpens, Jacques; Dhaenens, Jeroen; Ballet, T; Vilallonga, Ramón; Leman, Guido

doi:10.1016/j.soard.2016.01.013

Cited by 223 publications

(112 citation statements)

References 24 publications

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“…Our observation revealed that the weight reduction after both procedures is similar (12). In our study percent of EBMIL after LSG, measured 6 months after surgery, was 59.90% (46.75-69.28%) and it was comparable to others authors (13,14). In opposition to LRYGB, mechanisms of diabetes remission after LSG are not well-defined.…”

Section: Discussionsupporting

confidence: 83%

Laparoscopic sleeve gastrectomy for the treatment of diabetes mellitus type 2 patients—single center early experience

et al. 2016

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Background: In recent years, laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly used primary bariatric procedures for morbid obesity. While laparoscopic Roux-en-Y gastric bypass (LRYGB) has well documented positive clinical influence on type 2 diabetes, the role of LSG in diabetes treatment is debatable. The main aim of this study is to present our early experience in LSG as a method of bariatric treatment in patients with type 2 diabetes or abnormalities in glucose homeostasis.Methods: Prospectively collected data of patients operated for morbid obesity at the 2nd Department of Surgery. The study was designed to assess the influence of LSG on type 2 diabetes and glucose homeostasis.The primary endpoint was the diabetes type 2 remission. Secondary endpoint was the change of glucose metabolism parameters after LSG. Patients were assessed preoperatively and allocated to two groups: group 1-with any preoperative abnormalities in glucose homeostasis (prediabetes, diabetes) and group 2-with non-elevated fasting glucose level. During follow-up (6 months after surgery) all glucose homeostasis parameters were analyzed again. One hundred and thirty-six patients after LSG were enrolled in the study (90 females, 46 males; mean age 40.5±9.9 years). Preoperative abnormalities in glucose homeostasis were confirmed in 64 (47%) patients. Twenty (15%) patients in this group had diabetes. Results:We observed significant reduction of body mass index (BMI) after surgery. Mean percent of EBMIL for all groups after 6 months from surgery was 59.90% (46.75-69.28%). There were no full remissions after surgery in patients with preoperative diabetes. We found significant improvement in biochemical markers of glucose homeostasis. We observed significant reduction of HbA1c% after surgery in both groups. The level of postoperative HbA1c% was related to BMI loss after surgery.Conclusions: LSG leads to significant improvement in biochemical glucose homeostasis and can be considered as a method of treatment in morbidly obese patients with glucose metabolism abnormalities. LSG as a method of treatment for patients with clinical type 2 diabetes still needs some further observation.

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Section: Discussionsupporting

confidence: 83%

Laparoscopic sleeve gastrectomy for the treatment of diabetes mellitus type 2 patients—single center early experience

et al. 2016

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“…Total weight loss of approximately 25‐30% and excess weight loss of 60‐70% for up to 10 years can be achieved 30, 31. However, a significant drawback of this procedure is the development of reflux esophagitis.…”

Section: New Procedures With Better Outcomesmentioning

confidence: 99%

“…However, a significant drawback of this procedure is the development of reflux esophagitis. Up to 30% of LSG patients may require revision surgery for reflux esophagitis or weight regain 29, 30, 31, 32. Table 1 shows long‐term weight loss (>10 years) in different bariatric procedures.…”

Section: New Procedures With Better Outcomesmentioning

confidence: 99%

“…However, our experience in Asian patients disclosed that although LAGB was successful in weight loss and in resolution of comorbidities in morbidly obese patients, the gastrointestinal quality of life index (GIQLI) did not improve and the long‐term revision rate was high 63. Long‐term (>10 years) weight loss after LAGB was reported to be around 15% total weight loss and 40‐45% EWL 31, 40, 41, 62. However, up to 50% of LAGB patients may require revision surgery to another procedure for inadequate weight loss 39, 41, 62, 63…”

Section: New Procedures With Better Outcomesmentioning

confidence: 99%

“…Recent advancements in clinical research and understanding of the mechanism in bariatric/metabolic surgery has paved the way for precision medicine in this field, a personalized treatment of bariatric/metabolic surgery. For example, LSG may be the first choice of bariatric procedure but should be avoided in patients with reflux disease 30, 31. RYGB is a better choice for morbidly obese patients with significant reflux disease.…”

Section: Personalized Treatmentmentioning

confidence: 99%

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Recent advancements in bariatric/metabolic surgery

Lee

Almalki

2017

Annals of Gastroent Surgery

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Obesity and type 2 diabetes mellitus (T2DM) are currently two pan‐endemic health problems worldwide and are associated with considerable increase in morbidity and mortality. Both diseases are closely related and very difficult to control by current medical treatment, including diet, drug therapy and behavioral modification. Bariatric surgery has proven successful in treating not just obesity but also in significantly decreasing overall obesity‐associated morbidities as well as improving quality of life in severely obese patients (body mass index [BMI] >35 kg/m2). A rapid increase in bariatric surgery started in the 2000s when the laparoscopic surgical technique was introduced into this field. Many new procedures had been developed and changed the face of modern bariatric surgery. Recently, bariatric surgery played as gastrointestinal metabolic surgery has been proposed as a new treatment modality for obesity‐related T2DM for patients with BMI >35 kg/m2. Strong evidence has demonstrated that bariatric/metabolic surgery is an effective and durable treatment for obese T2DM patients. Bariatric/metabolic surgery is now becoming an important surgical division. The present article examines and discusses recent advancements in bariatric/metabolic surgery and covers four major fields: (i) the rapid increase in numbers and better safety; (ii) new procedures with better outcomes; (iii) from bariatric to metabolic surgery; and (iv) understanding the mechanisms and personalized treatment.

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Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity

Salminen

Helmiö

Ovaska

et al. 2018

JAMA

809

569

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Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy

Cited by 223 publications

References 24 publications

Laparoscopic sleeve gastrectomy for the treatment of diabetes mellitus type 2 patients—single center early experience

Laparoscopic sleeve gastrectomy for the treatment of diabetes mellitus type 2 patients—single center early experience

Recent advancements in bariatric/metabolic surgery

Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity

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