Outcomes of laparoscopic sleeve gastrectomy at a bariatric unit in South Africa

Abstract

BackgroundLaparoscopic sleeve gastrectomy (LSG) has gained popularity over the years as a standalone procedure. In 2014, it was the most rapidly growing bariatric procedure. The aim of this study was to describe the outcomes of LSG at a single bariatric unit in Johannesburg, South Africa, using the Bariatric Analysis and Reporting Outcome System (BAROS) standardised scoring.MethodsA retrospective record review and analysis was carried out using data collected from patients who had LSGs. The information obtained included patient demographics, comorbidities, preoperative weight and height, operative technique, time and complications, postoperative gastrografin swallow results, hospital stay, and weight at 6 months postoperatively. The percentage of excess body mass index (BMI) loss (%EBMIL) was calculated at 6 months, and included in the BAROS questionnaire completed by the patients at the 6-month follow-up visit. Statistical significance was set at p < 0.05.ResultsA total of 103 patients were included in the study; of these, 85.4% were female and 14.6% were male. The mean preoperative BMI was 42.1 kg/m2; additionally, 77.7% of the patients in the study had comorbidities prior to the procedure. The mean operative time was 104.3 min, with a mean hospital stay of 2.5 days. No mortalities occurred, and a complication rate of 7.7% was encountered. At the 6-month follow-up, the mean %EBMIL was 65%. When followed up at 6 months, all 103 patients demonstrated no failures according to the BAROS assessment. It was found that 96.1% had good, very good or excellent outcomes. In total, 9.7% of the patients had an excellent outcome.ConclusionsLSG was shown to produce an adequate %EBMIL loss at 6 months, resulting in a significant improvement in the quality of life (QoL), coupled with good BAROS outcomes. The results of this research are comparable to other studies of LSGs, and the low complication rate supports the use of the procedure and accounts for no observed mortality.

Metabolic surgery in South Africa: an initial academic hospital experience

“…17 Our major and minor morbidity rate of 5.3% and 8.8% respectively also compares well to the limited national numbers available. [9][10][11] In the current series, where postoperative endoscopy is performed on indication in symptomatic patients only, no marginal ulceration was noted at follow-up. Due to initial reports of marginal ulceration in up to 16% of patients undergoing RYGB, and due to a paucity in studies regarding ideal duration of treatment at the time, we placed all patients on lifelong PPI therapy.…”

“…This report, with short-term follow-up (79% < 3 years), confirms that RYGB can be performed safely in a government hospital setting in South Africa, with mortality (0%) and morbidity (14%) rates comparable to international outcomes. The predominantly middle aged female patient cohort, with a mean BMI of 59 kg/m 2 and 42.1% of patients known with T2D, is comparable to both national and international patient populations undergoing MS. [9][10][11] The mean BMI of our initial experience leans towards the higher end of the scale when compared to most series, and this is likely reflected in the reported operating time of 185 minutes. When at the beginning of the learning curve, it is prudent to select patients with a lower BMI in order to minimise perioperative risk.…”

“…8 MS has been performed in the private sector in South Africa with excellent outcomes, but there are limited reports representing public hospitals, none of which report on the performance of RYGB. [9][10][11] With an increasingly obese and undernourished public patient population, studies on outcomes after MS in government hospitals are lacking. Since…”

Quality of life after laparoscopic sleeve gastrectomy – review of literature

“…The BAROS questionnaire was used in 5 studies, twice it was paired with the SF-36 [20,26,27,[30][31]. In 2 studies the authors used the updated version of BAROS [14,20,27].…”

“…The BAROS questionnaire was completed by patients in Sofianos et al study with good to excellent outcomes achieved in 96.1% of patients at the 6-month follow-up and the mean BAROS score was 5.1 (range 1.9-8.7, max. possible score = 9) [31]. Rebibo et al checked QoL after 6 months of follow-up using previous version of BAROS.…”