Skip to main content
Top
Published in: Surgical Endoscopy 8/2011

01-08-2011

Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss

Authors: Mathieu D’Hondt, Sofie Vanneste, Hans Pottel, Dirk Devriendt, Frank Van Rooy, Franky Vansteenkiste

Published in: Surgical Endoscopy | Issue 8/2011

Login to get access

Abstract

Background

This retrospective study evaluated long-term weight loss, resolution of comorbidities, quality of life (QoL), and food tolerance after laparoscopic sleeve gastrectomy (LSG).

Methods

Between January 2003 and July 2008, 102 patients underwent LSG as a sole bariatric operation. A retrospective review of a prospectively collected database was performed. Demographics, complications, and percentage of excess weight loss (%EWL) were determined. Quality of life was measured using Medical Outcomes Survey Short Form 36 (SF-36) and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaires, which were sent to all patients. The food tolerance score (FTS) was determined and compared with that of nonobese subjects.

Results

A total of 83 patients (81.4%) were eligible for follow-up evaluation. Their mean initial body mass index (BMI) was 39.3 kg/m2. No major complications occurred. At a median follow-up point of 49 months (range, 17–80 months), the mean %EWL was 72.3% ± 29.3%. For the 23 patients who reached the 6-year follow-up point, the mean %EWL was 55.9% ± 25.55%. The mean BAROS score was 6.5 ± 2.1, and a “good” to “excellent” score was observed for 75 patients (90.4%). In the comparison of patients with a %EWL greater than 50% and those with a %EWL of 50% or less, the SF-36 scores were statistically different only for “physical functioning” and “general health perception.” The mean FTS was 23.8, and 95.2% of the patients described their food tolerance as acceptable to excellent.

Conclusion

Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure, although a tendency for weight regain is noted after 5 years of follow-up evaluation. Resolution of comorbidity is comparable with that reported in the literature. The LSG procedure results in good to excellent health-related QoL. Food tolerance is lower for patients after LSG than for nonobese patients who had no surgery, but 95.2% described food tolerance as acceptable to excellent.
Literature
1.
go back to reference Ren CJ, Patterson E, Gagner M (2000) Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 10:514–523PubMedCrossRef Ren CJ, Patterson E, Gagner M (2000) Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 10:514–523PubMedCrossRef
2.
go back to reference Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super-obese patient. Obes Surg 13:861–864PubMedCrossRef Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super-obese patient. Obes Surg 13:861–864PubMedCrossRef
3.
go back to reference Himpens J, Dapri D, Cadière GB (2006) A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 16:1450–1456PubMedCrossRef Himpens J, Dapri D, Cadière GB (2006) A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 16:1450–1456PubMedCrossRef
4.
go back to reference Moon Han S, Kim WW, Oh JH (2005) Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg 15:1469–1475PubMedCrossRef Moon Han S, Kim WW, Oh JH (2005) Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg 15:1469–1475PubMedCrossRef
5.
go back to reference Till H, Blücher W, Kiess W (2008) Efficacy of laparoscopic sleeve gastrectomy (LSG) as a stand-alone technique for children with morbid obesity. Obes Surg 18:1047–1049PubMedCrossRef Till H, Blücher W, Kiess W (2008) Efficacy of laparoscopic sleeve gastrectomy (LSG) as a stand-alone technique for children with morbid obesity. Obes Surg 18:1047–1049PubMedCrossRef
6.
go back to reference Roa P, Kaidar-Person O, Pinto D, Cho M, Szomstein S, Rosenthal RJ (2006) Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg 16:1323–1326PubMedCrossRef Roa P, Kaidar-Person O, Pinto D, Cho M, Szomstein S, Rosenthal RJ (2006) Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg 16:1323–1326PubMedCrossRef
7.
go back to reference Arias E, Martinez PR, Ka Ming Li V, Szomstein S, Rosenthal R (2009) Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg 19:544–548PubMedCrossRef Arias E, Martinez PR, Ka Ming Li V, Szomstein S, Rosenthal R (2009) Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg 19:544–548PubMedCrossRef
8.
go back to reference Larsen JK, Geenen R, van Ramhorst B, Brand N, de Wit P, Stroebe W, van Doornen LJ (2003) Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study. Obes Surg 13:629–636PubMedCrossRef Larsen JK, Geenen R, van Ramhorst B, Brand N, de Wit P, Stroebe W, van Doornen LJ (2003) Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study. Obes Surg 13:629–636PubMedCrossRef
9.
go back to reference Favricatore AN, Wadden TA, Sarwer DB, Faith MS (2005) Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg 15:304–309CrossRef Favricatore AN, Wadden TA, Sarwer DB, Faith MS (2005) Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg 15:304–309CrossRef
10.
go back to reference Sarwer DB, Wadden TA, Fabricatore AN (2005) Psychosocial and behavioral aspects of bariatric surgery. Obes Res 13:639–648PubMedCrossRef Sarwer DB, Wadden TA, Fabricatore AN (2005) Psychosocial and behavioral aspects of bariatric surgery. Obes Res 13:639–648PubMedCrossRef
11.
go back to reference Dymek MP, Le Grange D, Neven K, Alverdy J (2001) Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg 11:32–39PubMedCrossRef Dymek MP, Le Grange D, Neven K, Alverdy J (2001) Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg 11:32–39PubMedCrossRef
12.
go back to reference Oria HE, Moorehead MK (2009) Updated bariatric analysis and reporting outcome system (BAROS). Surg Obes Relat Dis 5:60–66PubMedCrossRef Oria HE, Moorehead MK (2009) Updated bariatric analysis and reporting outcome system (BAROS). Surg Obes Relat Dis 5:60–66PubMedCrossRef
13.
go back to reference Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validation of the SF-36 health survey questionnaire: new outcome measure for primary care. Br Med J 27:1812–1816 Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validation of the SF-36 health survey questionnaire: new outcome measure for primary care. Br Med J 27:1812–1816
14.
go back to reference Suter M, Calmes JM, Paroz A, Giusti V (2007) A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg 17:2–8PubMedCrossRef Suter M, Calmes JM, Paroz A, Giusti V (2007) A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg 17:2–8PubMedCrossRef
15.
go back to reference Benjaminov O, Beglaibter N, Gindy L, Spivak H, Singer P, Wienberg M, Stark A, Rubin M (2007) The effect of low-carbohydrate diet on the nonalcoholic fatty liver in morbidly obese patients prior to bariatric surgery. Surg Endosc 21:1423–1427PubMedCrossRef Benjaminov O, Beglaibter N, Gindy L, Spivak H, Singer P, Wienberg M, Stark A, Rubin M (2007) The effect of low-carbohydrate diet on the nonalcoholic fatty liver in morbidly obese patients prior to bariatric surgery. Surg Endosc 21:1423–1427PubMedCrossRef
16.
go back to reference Milone L, Strong V, Gagner M (2005) Laparoscopic sleeve gastrectomy is superior to intragastric balloon as a first-stage procedure for super-obese patients (BMI ≥ 50 kg/m²). Obes Surg 15:612–617PubMedCrossRef Milone L, Strong V, Gagner M (2005) Laparoscopic sleeve gastrectomy is superior to intragastric balloon as a first-stage procedure for super-obese patients (BMI ≥ 50 kg/m²). Obes Surg 15:612–617PubMedCrossRef
17.
go back to reference Sánchez-Santos R, Masdevall C, Baltasar A, Martínez-Blázquez C, Ruiz García, de Gordejuela A, Ponsi E, Sánchez-Pernaute A, Vesperinas G, Del Castillo D, Bombuy E, Durán-Escribano C, Ortega L, Ruiz de Adana JC, Baltar J, Maruri I, García-Blázquez E, Torres A (2009) Short- and midterm outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg 19:1203–1210. Epub 2 July 2009PubMedCrossRef Sánchez-Santos R, Masdevall C, Baltasar A, Martínez-Blázquez C, Ruiz García, de Gordejuela A, Ponsi E, Sánchez-Pernaute A, Vesperinas G, Del Castillo D, Bombuy E, Durán-Escribano C, Ortega L, Ruiz de Adana JC, Baltar J, Maruri I, García-Blázquez E, Torres A (2009) Short- and midterm outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg 19:1203–1210. Epub 2 July 2009PubMedCrossRef
18.
go back to reference Cottam D, Qureshi FG, Mattar SG, Sharma S, Holover S, Bonanomi G, Ramanathan R, Schauer P (2006) Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 20:859–863PubMedCrossRef Cottam D, Qureshi FG, Mattar SG, Sharma S, Holover S, Bonanomi G, Ramanathan R, Schauer P (2006) Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 20:859–863PubMedCrossRef
19.
go back to reference Clinical Issues Committee of American Society for Metabolic, Bariatric Surgery (2007) Sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis 3:573–576CrossRef Clinical Issues Committee of American Society for Metabolic, Bariatric Surgery (2007) Sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis 3:573–576CrossRef
20.
go back to reference Givon-Madhala O, Spector R, Wasserberg N, Beglaibter N, Lustigman H, Stein M, Arar N, Rubin M (2007) Technical aspects of laparoscopic sleeve gastrectomy in 25 morbidly obese patients. Obes Surg 17:722–727PubMedCrossRef Givon-Madhala O, Spector R, Wasserberg N, Beglaibter N, Lustigman H, Stein M, Arar N, Rubin M (2007) Technical aspects of laparoscopic sleeve gastrectomy in 25 morbidly obese patients. Obes Surg 17:722–727PubMedCrossRef
21.
go back to reference Langer FB, Bohdjalian A, Felberbauer FX, Fleischmann E, Reza Hoda MA, Ludvik B, Zacherl J, Jakesz R, Prager G (2006) Does gastric dilation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg 16:166–171PubMedCrossRef Langer FB, Bohdjalian A, Felberbauer FX, Fleischmann E, Reza Hoda MA, Ludvik B, Zacherl J, Jakesz R, Prager G (2006) Does gastric dilation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg 16:166–171PubMedCrossRef
22.
go back to reference Weiner RA, Weiner S, Pomhoff I, Makarewicz W, Weigand G (2007) Laparoscopic sleeve gastrectomy: influence of sleeve size and resected gastric volume. Obes Surg 17:1297–1305PubMedCrossRef Weiner RA, Weiner S, Pomhoff I, Makarewicz W, Weigand G (2007) Laparoscopic sleeve gastrectomy: influence of sleeve size and resected gastric volume. Obes Surg 17:1297–1305PubMedCrossRef
23.
go back to reference Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis (review). JAMA 292:1724–1737PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis (review). JAMA 292:1724–1737PubMedCrossRef
24.
go back to reference Frezza EE, Chiriva-Internati M, Wachtel MS (2008) Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today 38:481–483PubMedCrossRef Frezza EE, Chiriva-Internati M, Wachtel MS (2008) Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today 38:481–483PubMedCrossRef
25.
go back to reference Akkary E, Duffy A, Bell R (2008) Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg 18:1323–1329PubMedCrossRef Akkary E, Duffy A, Bell R (2008) Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg 18:1323–1329PubMedCrossRef
26.
go back to reference Gumbs AA, Gagner M, Dakin G, Pomp A (2007) Sleeve gastrectomy for morbid obesity. Obes Surg 17:962–969PubMedCrossRef Gumbs AA, Gagner M, Dakin G, Pomp A (2007) Sleeve gastrectomy for morbid obesity. Obes Surg 17:962–969PubMedCrossRef
27.
go back to reference Freys SM, Tigges H, Heimbucher J, Fuchs KH, Fein M, Thiede A (2001) Quality of Life following laparoscopic gastric banding in patients with morbid obesity. J Gastrointest Surg 5:401–407PubMedCrossRef Freys SM, Tigges H, Heimbucher J, Fuchs KH, Fein M, Thiede A (2001) Quality of Life following laparoscopic gastric banding in patients with morbid obesity. J Gastrointest Surg 5:401–407PubMedCrossRef
28.
go back to reference Dixon JB, Dixon ME, O’Brein PE (2001) Quality of life after Lap-Band placement: influence of time, weight loss, and comorbidities. Obes Res 9:713–721PubMedCrossRef Dixon JB, Dixon ME, O’Brein PE (2001) Quality of life after Lap-Band placement: influence of time, weight loss, and comorbidities. Obes Res 9:713–721PubMedCrossRef
29.
go back to reference Dixon JB, O’Brein PE (2002) Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg 184:51S–54SPubMedCrossRef Dixon JB, O’Brein PE (2002) Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg 184:51S–54SPubMedCrossRef
30.
go back to reference Tolonen P, Victorzon M, Mäkelä J (2004) Impact of laparoscopic adjustable gastric banding for morbid obesity on disease specific and health-related quality of life. Obes Surg 14:788–795PubMedCrossRef Tolonen P, Victorzon M, Mäkelä J (2004) Impact of laparoscopic adjustable gastric banding for morbid obesity on disease specific and health-related quality of life. Obes Surg 14:788–795PubMedCrossRef
Metadata
Title
Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss
Authors
Mathieu D’Hondt
Sofie Vanneste
Hans Pottel
Dirk Devriendt
Frank Van Rooy
Franky Vansteenkiste
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-1572-x

Other articles of this Issue 8/2011

Surgical Endoscopy 8/2011 Go to the issue