Long-Term Outcomes of Laparoscopic Sleeve Gastrectomy—a Single-Center, Retrospective Study

Abstract

IntroductionSleeve gastrectomy (LSG) is one of the most popular bariatric procedures. We present our long-term results regarding weight loss, comorbidities, and gastric reflux disease.Material and MethodsWe identified patients who underwent LSG in our institution between 2006 and 2009. We revised the data, and the patients with outdated contact details were tracked with the national health insurance database and social media (facebook). Each of the identified patients was asked to complete an online or telephone survey covering, among others, their weight and comorbidities. On that basis, we calculated the percent total weight loss (%TWL) and percent excess weight loss (%EWL), along with changes in body mass index (ΔBMI). Satisfactory weight loss was set at >50% EWL (for BMI = 25 kg/m2). We evaluated type 2 diabetes (T2DM) and arterial hypertension (AHT) based on the pharmacological therapy. GERD presence was evaluated by the typical symptoms and/or proton pump inhibitor (PPI) therapy.ResultsOne hundred twenty-seven patients underwent LSG between 2006 and 2009. One hundred twenty patients were qualified for this study. Follow-up data was available for 100 participants (47 female, 53 male). Median follow-up period reached 8.0 years (from 7.1 to 10.7). Median BMI upon qualification for LSG was 51.6 kg/m2. Sixteen percent of patients required revisional surgery over the years (RS group), mainly because of insufficient weight loss (14 Roux-Y gastric bypass—LRYGB; one mini gastric bypass, one gastric banding). For the LSG (LSG group n = 84), the mean %EWL was 51.1% (±22.3), median %TWL was 23.5% (IQR 17.7–33.3%), and median ΔBMI was 12.1 kg/m2 (IQR 8.2–17.2). Fifty percent (n = 42) of patients achieved the satisfactory %EWL of 50%. For RS group, the mean %EWL was 57.8% (±18.2%) and median %TWL reached 33% (IQR 27.7–37.9%). Sixty-two percent (n = 10) achieved the satisfactory weight loss. Fifty-nine percent of patients reported improvement in AHT therapy, 58% in T2DM. After LSG, 60% (n = 60) of patients reported recurring GERD symptoms and 44% were treated with proton pomp inhibitors (PPI). In 93% of these cases, GERD has developed de novo.ConclusionsIsolated LSG provides fairly good effects in a long-term follow-up with mean %EWL at 51.1%. Sixteen percent of patients require additional surgery due to insufficient weight loss. More than half of the subjects observe improvement in AHT and T2DM. Over half of the patients complain of GERD symptoms, which in most of the cases is a de novo complaint.

Laparoscopic sleeve gastrectomy: a study of efficiency in treatment of metabolic syndrome components, comorbidities and influence on certain biochemical markers.

“…Demographic and clinical data were gathered prospectively at the follow-up visits, along with repeat measurements of selected laboratory parameters (on the day of the operation, 1 month, 3 months, 6 months, 12 months after LSG). 107 males and 104 females (51%/49%) with the average age of 51 (47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57) years were analyzed during the follow-up, with a total of 211 patients subjected to LSG operation technique. Median length of hospital stay was 3 (2-3) days.…”

“…The contemporary medical knowledge base already provides viable information on bariatric treatment long-term efficiency in aspects of obesity, metabolic syndrome and comorbidities treatment, but many authors claim that the data in this issue are still insufficient. Analysis of 3-and 5-year long follow-ups confirms efficient weight loss and a major improvement in obesity-related comorbidities, but some also report significant weight regain followed by an NIDDM remission rate decrease [47][48][49]. Positive changes in lipid profile after undergoing the LSG operation appear to be statistically significant only in short-term observations, but seem to remain at desirable levels over time [50].…”

Consecuencias clínicas posgastrectomía vertical tubular: enfermedad por reflujo gastroesofágico

“…La aparición de síntomas de ERGE y esofagitis es muy variable 2,6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] . Incluyendo los datos más recientes sobre este punto, la mayoría de los estudios informaron un aumento en los síntomas de ERGE.…”

“…La Tabla 4 describe los datos reportados por la literatura internacional. La mayoría de las publicaciones han mostrado síntomas después de la cirugía [11][12][13][14][15][16][17][18][20][21][22][23][24][25] . Genco 13 también demostró una mayor incidencia de síntomas de ERGE (42% de sus pacientes) en un promedio de 58 meses de seguimiento, y nosotros hemos observado esofagitis 9 años después de la operación.…”

“…En la actualidad, a los 5-9 años de seguimiento, el esófago de Barrett aumenta a 4,8%. Muchos autores de los ya antes citados han señalado lo mismo [12][13][14][15][16][17][20][21][22][23][24][25][26][27][28] . De acuerdo con estas experiencias, hemos observado esofagitis endoscópica muy severa (Grado C) después de la GVT (Tabla 3).…”