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Published in: Obesity Surgery 3/2012

01-03-2012 | Other

An Analysis of 1–3-Year Follow-up Results of Laparoscopic Sleeve Gastrectomy: an Indian Perspective

Authors: Parmanand Prasad, Om Tantia, Nirmal Patle, Shashi Khanna, Bimalendu Sen

Published in: Obesity Surgery | Issue 3/2012

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) has become very popular nowadays among bariatric surgeons because of its surgical simplicity and good postoperative results. We present our experience on LSG as a single stage primary bariatric procedure for morbid obesity and its 1–3-year follow-up results.

Methods

Between March 2008 and March 2011, a total of 110 patients underwent laparoscopic sleeve gastrectomy. Two patients were excluded from the study and thus the prospectively maintained data of 108 patients were retrospectively reviewed and outcomes were recorded.

Results

The mean patient age was 39.3 ± 11.1 years, mean body mass index was 44.5 ± 6.8, mean excess body weight was 54.1 ± 16.3 kg, and the mean American Society of Anesthesiologists score was 3.1 ± 0.57. The mean operative time for the LSG procedure was 64.8 ± 10.6 min. The minimum follow-up duration was 6 months and maximum of 36 months. The mean postoperative percent excess body weight loss achieved was 67.5 ± 13.0 at 1 year, 71.1 ± 13.8 at 2 years, and 66.09 ± 14.3 at 3 years. At the end of 3 years, there was 83.3% resolution in diabetes, 85.7% resolution in hypertension, and 85.71% resolution in dyslipidemia. There were no reports of postoperative hemorrhage, gastric leak, deep venous thrombosis, pulmonary embolism, delayed gastric tube stricture, and operative mortality.

Conclusions

LSG is a safe and effective bariatric procedure with low perioperative complications. Before it is considered as a single stage primary procedure, a long-term prospective comparative study with other bariatric procedures is required.
Literature
1.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef
2.
go back to reference Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMed Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMed
3.
go back to reference Sjostrom L, Narbro K, Karason K, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef Sjostrom L, Narbro K, Karason K, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef
4.
go back to reference Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef
5.
go back to reference Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14(4):492–7.PubMedCrossRef Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14(4):492–7.PubMedCrossRef
6.
go back to reference Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.PubMedCrossRef Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.PubMedCrossRef
7.
go back to reference Sammour T, Hill AG, Singh P, et al. Laparoscopic sleeve gastrectomy as a single stage bariatric procedure. Obes Surg. 2010;20:271–5.PubMedCrossRef Sammour T, Hill AG, Singh P, et al. Laparoscopic sleeve gastrectomy as a single stage bariatric procedure. Obes Surg. 2010;20:271–5.PubMedCrossRef
8.
go back to reference Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15:1030–3.PubMedCrossRef Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15:1030–3.PubMedCrossRef
9.
go back to reference Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.PubMedCrossRef Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.PubMedCrossRef
10.
go back to reference Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–9.PubMedCrossRef Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–9.PubMedCrossRef
11.
go back to reference Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.PubMedCrossRef Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.PubMedCrossRef
12.
go back to reference Abbatini F, Rizzello M, Casella G, et al. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass and adjustable gastric banding on type 2 diabetes. Surg Endosc. 2010;24:1005–10.PubMedCrossRef Abbatini F, Rizzello M, Casella G, et al. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass and adjustable gastric banding on type 2 diabetes. Surg Endosc. 2010;24:1005–10.PubMedCrossRef
13.
go back to reference Misra A, Chowbey P, Makkar BM, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. JAPI. 2009;57:163–70.PubMed Misra A, Chowbey P, Makkar BM, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. JAPI. 2009;57:163–70.PubMed
14.
go back to reference Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2:CD003641.PubMed Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2:CD003641.PubMed
15.
go back to reference Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37(4):275–81.PubMedCrossRef Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37(4):275–81.PubMedCrossRef
16.
go back to reference Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.PubMedCrossRef Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.PubMedCrossRef
17.
18.
go back to reference Marceau P, Hould FS, Simard S, et al. Bilio-pancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.PubMedCrossRef Marceau P, Hould FS, Simard S, et al. Bilio-pancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.PubMedCrossRef
19.
go back to reference Gagner M, Patterson E. Laparoscopic biliopancreatic diversion with duodenal switch. Dig Surg. 2000;17:547–66.CrossRef Gagner M, Patterson E. Laparoscopic biliopancreatic diversion with duodenal switch. Dig Surg. 2000;17:547–66.CrossRef
20.
go back to reference Arias E, Martinez PR, Ka Ming Li V, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19:544–8.PubMedCrossRef Arias E, Martinez PR, Ka Ming Li V, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19:544–8.PubMedCrossRef
21.
go back to reference Menenakos E, Stamou KM, Albanopoulos K, et al. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year. Obes Surg. 2010;20(3):276–82.PubMedCrossRef Menenakos E, Stamou KM, Albanopoulos K, et al. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year. Obes Surg. 2010;20(3):276–82.PubMedCrossRef
22.
go back to reference Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.PubMedCrossRef Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.PubMedCrossRef
23.
go back to reference Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today. 2008;38:481–3.PubMedCrossRef Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today. 2008;38:481–3.PubMedCrossRef
24.
go back to reference Brethauer SA, Hamsmel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.PubMedCrossRef Brethauer SA, Hamsmel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.PubMedCrossRef
25.
go back to reference Trelles N, Gagner M. Updated review of sleeve gastrectomy. The open Gastroenterol J. 2008;2:41–9.CrossRef Trelles N, Gagner M. Updated review of sleeve gastrectomy. The open Gastroenterol J. 2008;2:41–9.CrossRef
26.
go back to reference Chowbey PK, Dhawan K, Khullar R, et al. Laparoscopic sleeve gastrectomy: an Indian experience—surgical technique and early result. Obes Surg. 2010;20:1340–7.PubMedCrossRef Chowbey PK, Dhawan K, Khullar R, et al. Laparoscopic sleeve gastrectomy: an Indian experience—surgical technique and early result. Obes Surg. 2010;20:1340–7.PubMedCrossRef
27.
go back to reference Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the result of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.PubMedCrossRef Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the result of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.PubMedCrossRef
28.
go back to reference Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.PubMedCrossRef Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.PubMedCrossRef
29.
go back to reference Han SM, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRef Han SM, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRef
30.
go back to reference Chen B, Kiriakopoulos A, Tsakayannis D, et al. Reinforcement does not necessarily reduce the rate of staple line leaks after sleeve gastrectomy. A review of the literature and clinical experiences. Obes Surg. 2009;19:166–72.PubMedCrossRef Chen B, Kiriakopoulos A, Tsakayannis D, et al. Reinforcement does not necessarily reduce the rate of staple line leaks after sleeve gastrectomy. A review of the literature and clinical experiences. Obes Surg. 2009;19:166–72.PubMedCrossRef
31.
go back to reference Rubin M, Yehoshua RT, Stein M, et al. Laparoscopic sleeve gastrectomy with minimal morbidity. Early results in 120 morbidly obese patients. Obes Surg. 2008;18(12):1567–70.PubMedCrossRef Rubin M, Yehoshua RT, Stein M, et al. Laparoscopic sleeve gastrectomy with minimal morbidity. Early results in 120 morbidly obese patients. Obes Surg. 2008;18(12):1567–70.PubMedCrossRef
32.
33.
go back to reference Consten EC, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14:1360–6.PubMedCrossRef Consten EC, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14:1360–6.PubMedCrossRef
34.
go back to reference Dapri G, Cadiere GB, Himpens J. Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing three different techniques. Obes Surg. 2010;20:462–7.PubMedCrossRef Dapri G, Cadiere GB, Himpens J. Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing three different techniques. Obes Surg. 2010;20:462–7.PubMedCrossRef
35.
go back to reference Cuenca-Abente F, Parra JD, Oelschlager BK. Laparoscopic sleeve gastrectomy: an alternative for recurrent paraesophageal hernias in obese patients. JSLS. 2006;10(1):86–9.PubMed Cuenca-Abente F, Parra JD, Oelschlager BK. Laparoscopic sleeve gastrectomy: an alternative for recurrent paraesophageal hernias in obese patients. JSLS. 2006;10(1):86–9.PubMed
36.
go back to reference Jacobs M, Bisland W, Gomez E, et al. Laparoscopic sleeve gastrectomy: a retrospective review of 1 and 2 years results. Surg Endosc. 2010;24:781–5.PubMedCrossRef Jacobs M, Bisland W, Gomez E, et al. Laparoscopic sleeve gastrectomy: a retrospective review of 1 and 2 years results. Surg Endosc. 2010;24:781–5.PubMedCrossRef
37.
go back to reference Himpens J, Dobbeleir J, Peeters G. Long term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.PubMedCrossRef Himpens J, Dobbeleir J, Peeters G. Long term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.PubMedCrossRef
38.
go back to reference Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196(5):e56–9.PubMedCrossRef Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196(5):e56–9.PubMedCrossRef
39.
go back to reference Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy morbid obesity. World J Gastroenterol. 2008;14(6):821–7.PubMedCrossRef Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy morbid obesity. World J Gastroenterol. 2008;14(6):821–7.PubMedCrossRef
40.
go back to reference Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci. 1994;39(2):315–20.PubMedCrossRef Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci. 1994;39(2):315–20.PubMedCrossRef
41.
go back to reference Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg. 2010;20(4):447–53.PubMedCrossRef Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg. 2010;20(4):447–53.PubMedCrossRef
42.
go back to reference Acarturk TO, Wachtman G, Heil B, et al. Panniculectomy as an adjuvant to bariatric surgery. Ann Plast Surg. 2004;53:360–6.PubMedCrossRef Acarturk TO, Wachtman G, Heil B, et al. Panniculectomy as an adjuvant to bariatric surgery. Ann Plast Surg. 2004;53:360–6.PubMedCrossRef
43.
go back to reference Nemerofsky RB, Oliak DA, Capella JF. Body lift: an account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg. 2006;117(2):414–30.PubMedCrossRef Nemerofsky RB, Oliak DA, Capella JF. Body lift: an account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg. 2006;117(2):414–30.PubMedCrossRef
44.
go back to reference Chandawarkar RY. Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med. 2006;27:61–72.PubMedCrossRef Chandawarkar RY. Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med. 2006;27:61–72.PubMedCrossRef
Metadata
Title
An Analysis of 1–3-Year Follow-up Results of Laparoscopic Sleeve Gastrectomy: an Indian Perspective
Authors
Parmanand Prasad
Om Tantia
Nirmal Patle
Shashi Khanna
Bimalendu Sen
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 3/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0599-y

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