Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30–35 kg/m2)

Noun, Roger; Slim, Raoudha; Nasr, Marwan; Chakhtoura, Ghassan; Gharios, Joseph; Antoun, Nayla Abi; Ayoub, Eliane

doi:10.1007/s11695-016-2224-y

Cited by 20 publications

(11 citation statements)

References 25 publications

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“…Noun R et al have published their results of 541 patients with mild obesity in Lebanon with excellent outcomes with a zero-fistula rate. Interestingly, all patients in their study had to self-fund the surgery [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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Purpose Patients with mild obesity especially in absence of associated medical problems (OAMP) are commonly managed by non-surgical approaches. Laparoscopic sleeve gastrectomy (LSG) has proved itself to be effective and it is now the most performed weight loss procedure. We aimed to study the effectiveness and safety of LSG for weight loss in mild obesity. Methods A prospective cohort study. Group A; BMI (30–34.9 kg/m2), and group B; BMI ≥ 40 or BMI ≥ 35 with OAMP. Demographic data, perioperative complications, % excess weight loss (EWL), % total weight loss (TWL), nutritional profile, and evolution of OAMP were recorded and statistically analyzed. Results A total of 250 patients, with 80 patients (32%) in group A, and 170 (68%) in group B. The majority were female. The mean preoperative weight, BMI, and excess weight were 90.1 ± 9.52, 32.7 ± 1.4, and 21.5 ± 4.9 in group A, and 129.88 ± 26.12, 47.8 ± 8.2, and 62.3 ± 23.6 kg in group B respectively. The low BMI group had significantly lower OAMP, with higher pre-LSG non-surgical procedures rate. Overall post-operative morbidity rate was significantly higher in group B. %TWL was significantly lower in low BMI group. Nutritional profile was within the normal range in both groups at 3-year follow-up. Conclusion Laparoscopic sleeve gastrectomy is a safe and effective weight loss solution for mild obesity with better outcome than for higher BMI. Further studies are warranted to reconsider NIH’s statement for medicolegal aspects, and for matching the current changes in bariatric surgery practice, safety evidence, and patients’ demand. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

et al. 2022

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“…In humans, there is increasing interested in using bariatric surgery to treat diabetic patients without obesity. Several clinical studies have clearly indicated that weight-loss follows RYGB and VSG in non-obese or mildly obese subjects (Cohen et al, 2012;Noun et al, 2016;Ferraz et al, 2019). It is also noteworthy that gastrectomy done in non-obese subjects with gastric cancer also results in sustained weight loss, loss of appetite and abdominal discomfort (Adachi et al, 1999;Laffitte et al, 2015).…”

Section: Indiscriminate Weight-loss In the Non-obesementioning

confidence: 99%

The Phantom Satiation Hypothesis of Bariatric Surgery

Gautron

2021

Front. Neurosci.

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The excitation of vagal mechanoreceptors located in the stomach wall directly contributes to satiation. Thus, a loss of gastric innervation would normally be expected to result in abrogated satiation, hyperphagia, and unwanted weight gain. While Roux-en-Y-gastric bypass (RYGB) inevitably results in gastric denervation, paradoxically, bypassed subjects continue to experience satiation. Inspired by the literature in neurology on phantom limbs, I propose a new hypothesis in which damage to the stomach innervation during RYGB, including its vagal supply, leads to large-scale maladaptive changes in viscerosensory nerves and connected brain circuits. As a result, satiation may continue to arise, sometimes at exaggerated levels, even in subjects with a denervated or truncated stomach. The same maladaptive changes may also contribute to dysautonomia, unexplained pain, and new emotional responses to eating. I further revisit the metabolic benefits of bariatric surgery, with an emphasis on RYGB, in the light of this phantom satiation hypothesis.

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“…Data at 12 months showed improvements in BMI from 33.1 kg/m 2 to 24.5 kg/m 2 and %EWL of 107.9%. Noun et al 13 examined 541 Lebanese patients who underwent LSG with a BMI of 30–35 kg/m 2 . Average BMI improved from a preoperative value of 32.59 kg/m 2 to 24.7, 24.9, and 26.4 kg/m 2 at 1, 2, and 5 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…10 Due to the stringent eligibility criteria outlined above, metabolic surgery has been performed on patients with class I obesity primarily outside of the United States. Several large randomized and observational studies examining metabolic surgery in class I obesity have been performed in Chile, 5,11 Brazil, 12 Lebanon, 13 and India. 14 These studies revealed positive results with regard to weight loss and comorbidity resolution.…”

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confidence: 99%

Metabolic Surgery Outcomes in U.S. Patients with Class I Obesity

Baldwin

Sánchez-Johnsen

Bustos

et al. 2021

Bariatric Surgical Practice and Patient Care

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Background: Although numerous studies outside the United States (U.S.) have explored weight loss and comorbidity resolution among patients with class I obesity (body mass index [BMI] 30-34.9 kg/m 2 ) after metabolic surgery, few U.S.-based studies have been conducted. Objective: Our aim was to compare weight loss and comorbidity resolution among U.S. patients with class I obesity, who underwent laparoscopic sleeve gastrectomy (LSG) versus Roux-en-Y gastric bypass (RYGB). Methods: Weight loss and comorbidity data among only patients with class I obesity, who underwent LSG or RYGB, were examined. Between April 2009 and April 2017, 1215 metabolic surgeries were performed with 30 patients meeting the inclusion criteria (17 LSG and 13 RYGB). Results: Percent total weight loss (%TWL) for LSG peaked at 12 months (20.85%), while RYGB %TWL peaked at 18 months (21.65%). Percent excess weight loss (%EWL) peaked at 12 months after LSG (83.59%) and 18 months after RYGB (98.29%). Overall follow-up was 56.3%, 36.7%, and 43.3% at 12, 18, and 24 months. LSG and RYGB were both successful with regard to resolution of medical comorbidities at 12 months. Conclusion: RYGB and LSG appear to have similar, successful outcomes among U.S. patients with class I obesity for weight loss and comorbidity resolution.

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Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30–35 kg/m2)

Abstract: With appropriate surgical expertise, LSG in patients with BMI 30-35 kg/m achieved excellent outcomes with a zero fistula rate.

Cited by 20 publications

References 25 publications

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

Effectiveness and Safety of Laparoscopic Sleeve Gastrectomy for Weight Loss in Mild Obesity: Prospective Cohort Study with 3-Year Follow-up

The Phantom Satiation Hypothesis of Bariatric Surgery

Metabolic Surgery Outcomes in U.S. Patients with Class I Obesity

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