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Published in: Obesity Surgery 1/2017

01-01-2017 | Original Contributions

Long-Term Results of Laparoscopic Sleeve Gastrectomy for Morbid Obesity: 5 to 8-Year Results

Authors: Ralph P. M. Gadiot, L. Ulas Biter, Stefanie van Mil, Hans F. Zengerink, J. Apers, Guido H. H. Mannaerts

Published in: Obesity Surgery | Issue 1/2017

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Abstract

Introduction

Although long-term results of sleeve gastrectomy (LSG) remain scarce in the literature, its popularity as a stand-alone procedure has accounted for a global increase in LSG performance. In this retrospective study, the authors present 5 to 8-year follow-up results in terms of weight loss, failure/revision rate, and comorbidity resolution from a single center.

Materials and Methods

A prospectively maintained database was reviewed for patients who underwent LSG between 2007 and 2010. Data analysis on weight loss, comorbid conditions, revision surgery, and mortality was conducted.

Results

Median percentage excess BMI loss (%EBMIL) was 59.0, and 53.9 %, and median percentage total weight loss (%TWL) was 25.1, and 22.9 % at 5 and 8 years, respectively. Revision to gastric bypass due to insufficient weight loss or gastroesophageal reflux disease (GERD) was performed in 42 patients (15.2 %). Resolution of comorbid condition was achieved in 91 % of patients with obstructive sleep apnea syndrome (OSAS), 68 % of patients with type 2 diabetes (T2DM), 53 % of patients with hypertension, and 25 % of patients with dyslipedemia. Loss to follow-up rate was 45 % at 5 years, 28 % at 6 years, 23 % at 7 years, and 13 % at 8 years.

Conclusion

This study adds to the currently available data confirming the LSG to be a safe and effective procedure at long term. Data from high-volume studies are needed to establish the definite role of the LSG in the spectrum of bariatric procedures.
Literature
1.
go back to reference Marceau P, Biron S, St Georges R, et al. Biliopancreatic diversion with gastrectomy as surgical treatment of morbid obesity. Obes Surg. 1991;1(4):381–7.CrossRefPubMed Marceau P, Biron S, St Georges R, et al. Biliopancreatic diversion with gastrectomy as surgical treatment of morbid obesity. Obes Surg. 1991;1(4):381–7.CrossRefPubMed
2.
go back to reference Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10(6):514–23. discussion 524.CrossRefPubMed Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10(6):514–23. discussion 524.CrossRefPubMed
3.
go back to reference Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18(5):487–96.CrossRefPubMed Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18(5):487–96.CrossRefPubMed
4.
go back to reference Gagner M, Deitel M, Kalberer TL, et al. The second international consensus summit for sleeve gastrectomy, March 19–21, 2009. Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2009;5(4):476–85.CrossRef Gagner M, Deitel M, Kalberer TL, et al. The second international consensus summit for sleeve gastrectomy, March 19–21, 2009. Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2009;5(4):476–85.CrossRef
5.
go back to reference Deitel M, Gagner M, Erickson AL, et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2011;7(6):749–59.CrossRef Deitel M, Gagner M, Erickson AL, et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2011;7(6):749–59.CrossRef
6.
go back to reference Braghetto I, Csendes A, Lanzarini E, et al. Is laparoscopic sleeve gastrectomy an acceptable primary bariatric procedure in obese patients? Early and 5-year postoperative results. Surg Laparosc, Endosc Percutaneous Tech. 2012;22(6):479–86.CrossRef Braghetto I, Csendes A, Lanzarini E, et al. Is laparoscopic sleeve gastrectomy an acceptable primary bariatric procedure in obese patients? Early and 5-year postoperative results. Surg Laparosc, Endosc Percutaneous Tech. 2012;22(6):479–86.CrossRef
7.
go back to reference D’Hondt M, Vanneste S, Pottel H, et al. 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. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed D’Hondt M, Vanneste S, Pottel H, et al. 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. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed
8.
go back to reference Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2013;9(1):21–5.CrossRef Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2013;9(1):21–5.CrossRef
9.
go back to reference Strain GW, Saif T, Gagner M, et al. Cross-sectional review of effects of laparoscopic sleeve gastrectomy at 1, 3, and 5 years. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2011;7(6):714–9.CrossRef Strain GW, Saif T, Gagner M, et al. Cross-sectional review of effects of laparoscopic sleeve gastrectomy at 1, 3, and 5 years. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2011;7(6):714–9.CrossRef
10.
go back to reference Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297–305.CrossRefPubMed Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297–305.CrossRefPubMed
11.
go back to reference Bohdjalian A, Langer FB, Shakeri-Leidenmuhler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefPubMed Bohdjalian A, Langer FB, Shakeri-Leidenmuhler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefPubMed
12.
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.CrossRefPubMed Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.CrossRefPubMed
13.
go back to reference Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256(2):262–5.CrossRefPubMed Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256(2):262–5.CrossRefPubMed
14.
go back to reference Sarela AI, Dexter SP, O’Kane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2012;8(6):679–84.CrossRef Sarela AI, Dexter SP, O’Kane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2012;8(6):679–84.CrossRef
15.
go back to reference Gastrointestinal surgery for severe obesity. Consensus statement/NIH Consensus Development Conference National Institutes of Health Consensus Development Conference 1991, 9(1):1–20. Gastrointestinal surgery for severe obesity. Consensus statement/NIH Consensus Development Conference National Institutes of Health Consensus Development Conference 1991, 9(1):1–20.
16.
go back to reference Gadiot RP, Biter LU, Zengerink HJ, et al. Laparoscopic sleeve gastrectomy with an extensive posterior mobilization: technique and preliminary results. Obes Surg. 2012;22(2):320–9.CrossRefPubMed Gadiot RP, Biter LU, Zengerink HJ, et al. Laparoscopic sleeve gastrectomy with an extensive posterior mobilization: technique and preliminary results. Obes Surg. 2012;22(2):320–9.CrossRefPubMed
17.
go back to reference Reinhold RB. Critical analysis of long term weight loss following gastric bypass. Surg, Gynecol Obstet. 1982;155(3):385–94. Reinhold RB. Critical analysis of long term weight loss following gastric bypass. Surg, Gynecol Obstet. 1982;155(3):385–94.
18.
go back to reference Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefPubMedPubMedCentral Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefPubMedPubMedCentral
19.
go back to reference Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg: Off J Soc Surg Aliment Tract. 2008;12(4):662–7.CrossRef Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg: Off J Soc Surg Aliment Tract. 2008;12(4):662–7.CrossRef
20.
go back to reference Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.CrossRefPubMed Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.CrossRefPubMed
21.
go back to reference Fridman A, Moon R, Cozacov Y, et al. Procedure-related morbidity in bariatric surgery: a retrospective short- and mid-term follow-up of a single institution of the American College of Surgeons Bariatric Surgery Centers of Excellence. J Am Coll Surg. 2013;217(4):614–20.CrossRefPubMed Fridman A, Moon R, Cozacov Y, et al. Procedure-related morbidity in bariatric surgery: a retrospective short- and mid-term follow-up of a single institution of the American College of Surgeons Bariatric Surgery Centers of Excellence. J Am Coll Surg. 2013;217(4):614–20.CrossRefPubMed
22.
go back to reference Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). Obes Surg. 2005;15(5):612–7.CrossRefPubMed Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). Obes Surg. 2005;15(5):612–7.CrossRefPubMed
23.
24.
go back to reference Alvarenga ES, Lo Menzo E, Szomstein S, Rosenthal RJ: Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surgical endoscopy 2015. Alvarenga ES, Lo Menzo E, Szomstein S, Rosenthal RJ: Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surgical endoscopy 2015.
25.
go back to reference Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2014;10(1):177–83.CrossRef Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2014;10(1):177–83.CrossRef
26.
go back to reference Mannaerts GH, van Mil SR, Stepaniak PS, et al. Results of implementing an enhanced recovery after bariatric surgery (ERABS) protocol. Obes Surg. 2016;26(2):303–12.CrossRefPubMed Mannaerts GH, van Mil SR, Stepaniak PS, et al. Results of implementing an enhanced recovery after bariatric surgery (ERABS) protocol. Obes Surg. 2016;26(2):303–12.CrossRefPubMed
27.
go back to reference Mahawar KK, Graham Y, Carr WR, et al. Revisional Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review of comparative outcomes with respective primary procedures. Obes Surg. 2015;25(7):1271–80.CrossRefPubMed Mahawar KK, Graham Y, Carr WR, et al. Revisional Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review of comparative outcomes with respective primary procedures. Obes Surg. 2015;25(7):1271–80.CrossRefPubMed
Metadata
Title
Long-Term Results of Laparoscopic Sleeve Gastrectomy for Morbid Obesity: 5 to 8-Year Results
Authors
Ralph P. M. Gadiot
L. Ulas Biter
Stefanie van Mil
Hans F. Zengerink
J. Apers
Guido H. H. Mannaerts
Publication date
01-01-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2235-8

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