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Obesity Surgery

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01-06-2018 | Original Contributions

Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy on Morbidly Obese, Super-Obese, and Super-Super Obese Patients for the Treatment of Morbid Obesity

Authors: Ilhan Ece, Huseyin Yilmaz, Husnu Alptekin, Serdar Yormaz, Bayram Colak, Farise Yilmaz, Mustafa Sahin

Published in: Obesity Surgery | Issue 6/2018

Abstract

Backgrounds

The management of super-super obese patients is challenging for bariatric surgeons. Laparoscopic sleeve gastrectomy (LSG) is feasible as two-stage treatment for high-risk patients. However, its efficacy as a stand-alone procedure in super-super obese (SSO) patients is controversial. The study objective was to demonstrate the safety and efficacy of LSG in super-obese (SO) and SSO patients.

Methods

A retrospective analysis was performed of consecutive patients undergoing LSG. The patients were classified into three groups: morbidly obese (MO), SO, and SSO. The patients’ data, including each patient’s characteristics, body mass index (BMI), preoperative comorbidities, postoperative complications, the resolution of comorbidities, percentage of excess weight loss (%EWL), and total weight loss (%TWL) were compared between groups.

Results

Of the 186 patients, 163 (87.6%) were followed up for 41.2 ± 7.3 months (range 33–54 months). The mean BMI was 52.6 kg/m². Eighty-three patients (50.9%) were MO, 52 (31.9%) were SO, and 28 (17.2%) were SSO. The groups were similar in terms of preoperative characteristics and postoperative complications. The mean %TWL were lower for the SSO group with no significant difference. The mean %TWL at 12, 24, 36, and 41.2 months postoperatively was 34.7, 34.4, 31.4, and 29.6% in SSO group, respectively. Also, the %EWL for the SSO group was significantly lower (48.3%) at the end of the follow-up period. However, the rate of significant improvement or complete resolution of comorbidities was similar in all groups.

Conclusion

Although %EWL was lower in the SSO group, LSG was a feasible and safe stand-alone bariatric surgical procedure for the resolution of comorbidities in MO, SO, and SSO patients.

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Title: Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy on Morbidly Obese, Super-Obese, and Super-Super Obese Patients for the Treatment of Morbid Obesity
Authors: Ilhan Ece
Huseyin Yilmaz
Husnu Alptekin
Serdar Yormaz
Bayram Colak
Farise Yilmaz
Mustafa Sahin
Publication date: 01-06-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 6/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3053-3

At a glance: The STEP trials

Springer Medicine

Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy on Morbidly Obese, Super-Obese, and Super-Super Obese Patients for the Treatment of Morbid Obesity

Abstract

Backgrounds

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Backgrounds

Methods

Results

Conclusion

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