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Open Access 01-12-2014 | Research article

Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study

Authors: Villy Våge, Vetle Aaberge Sande, Gunnar Mellgren, Camilla Laukeland, Jan Behme, John Roger Andersen

Published in: BMC Surgery | Issue 1/2014

Abstract

Background

To evaluate changes in obesity-related diseases and micronutrients after laparoscopic sleeve gastrectomy (LSG).

Methods

We started the procedure in May 2007, and by December 2011, 117 patients could be evaluated for a two year follow-up. Comparisons of preoperative status with 12 and 24 months postoperative status were made for body mass index (BMI), obesity-related diseases and micronutrients.

Results

Major complications included bleeding requiring transfusion at 5.1%, leak at 1.7% and abscess without a visible leak at 0.9%. Mean BMI was reduced from 46.6 (standard deviation (SD) 6.0) kg/m² to 30.6 (SD 5.6) kg/m² at two years, and resolution occurred for 80.7% of patients with type 2 diabetes, 63.9% with hypertension, 75.8% with hyperlipidemia, 93.0% with sleep apnea, 31.4% with musculoskeletal pain, 85.4% with snoring and 73.3% with urinary incontinence. Amenorrhea resolved in all premenopausal females. The proportion of patients with symptomatic gastroesophageal reflux disease increased from 12.8% to 27.4%. The prevalence of patients with low ferritin-levels increased, while 25-hydroxyvitamin D (25(OH)D) deficiency decreased postoperatively.

Conclusions

LSG is an effective procedure for morbid obesity and obesity-related diseases, but the technique should be further explored particularly to avoid gastroesophageal reflux.

Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN: National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011, 377 (9765): 557-567. 10.1016/S0140-6736(10)62037-5.CrossRefPubMedPubMedCentral

Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R: Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009, 373 (9669): 1083-1096. 10.1016/S0140-6736(09)60318-4.CrossRefPubMed

Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, de Ramon RA, Israel G, Dolezal JM: Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995, 222 (3): 339-350. 10.1097/00000658-199509000-00011. discussion 350-332CrossRefPubMedPubMedCentral

Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B: Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007, 357 (8): 741-752. 10.1056/NEJMoa066254.CrossRefPubMed

WHO: Obesity: preventing and managing the global epidemic. 2000, Geneva: Worlds Health Organization

Cottam D, Qureshi FG, Mattar SG, Sharma S, Holover S, Bonanomi G, Ramanathan R, Schauer P: Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surgical Endoscopy. 2006, 20 (6): 859-863. 10.1007/s00464-005-0134-5.CrossRefPubMed

Baltasar A, Serra C, Perez N, Bou R, Bengochea M, Ferri L: Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005, 15 (8): 1124-1128. 10.1381/0960892055002248.CrossRefPubMed

Brethauer SA, Hammel JP, Schauer PR: Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surgery for obesity and related diseases: official Journal of the American Society for Bariatric Surgery. 2009, 5 (4): 469-475. 10.1016/j.soard.2009.05.011.CrossRef

Mognol P, Chosidow D, Marmuse JP: Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obesity Surgery. 2005, 15 (7): 1030-1033. 10.1381/0960892054621242.CrossRefPubMed

10.

Rice RD, Simon TE, Seery JM, Frizzi JD, Husain FA, Choi YU: Laparoscopic sleeve gastrectomy: outcomes at a military training center. The American Surgeon. 2010, 76 (8): 835-840.PubMed

11.

Silecchia G, Boru C, Pecchia A, Rizzello M, Casella G, Leonetti F, Basso N: Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006, 16 (9): 1138-1144. 10.1381/096089206778392275.CrossRefPubMed

12.

Zhang N, Maffei A, Cerabona T, Pahuja A, Omana J, Kaul A: Reduction in obesity-related comorbidities: is gastric bypass better than sleeve gastrectomy?. Surgical Endoscopy. 2013, 27 (4): 1273-1280. 10.1007/s00464-012-2595-7.CrossRefPubMed

13.

Committee ACI: Updated position statement on sleeve gastrectomy as a bariatric procedure. Surgery for obesity and related diseases: official Journal of the American Society for Bariatric Surgery. 2012, 8 (3): e21-26.CrossRef

14.

Shi X, Karmali S, Sharma AM, Birch DW: A review of laparoscopic sleeve gastrectomy for morbid obesity. Obesity Surgery. 2010, 20 (8): 1171-1177. 10.1007/s11695-010-0145-8.CrossRefPubMed

15.

Chiu S, Birch DW, Shi X, Sharma AM, Karmali S: Effect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis. 2011, 7 (4): 510-515. 10.1016/j.soard.2010.09.011.CrossRefPubMed

16.

Melissas J, Daskalakis M, Koukouraki S, Askoxylakis I, Metaxari M, Dimitriadis E, Stathaki M, Papadakis JA: Sleeve gastrectomy-a "food limiting" operation. Obesity Surgery. 2008, 18 (10): 1251-1256. 10.1007/s11695-008-9634-4.CrossRefPubMed

17.

Nocca D, Krawczykowsky D, Bomans B, Noel P, Picot MC, Blanc PM, de Seguin , de Hons C, Millat B, Gagner M, Monnier L: A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity Surgery. 2008, 18 (5): 560-565. 10.1007/s11695-007-9288-7.CrossRefPubMed

18.

Howard DD, Caban AM, Cendan JC, Ben-David K: Gastroesophageal reflux after sleeve gastrectomy in morbidly obese patients. Surg Obes Relat Dis. 2011, 7 (6): 709-713. 10.1016/j.soard.2011.08.003.CrossRefPubMed

19.

Soricelli E, Iossa A, Casella G, Abbatini F, Cali B, Basso N: Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia. Surg Obes Relat Dis. 2013, 9 (3): 356-361. 10.1016/j.soard.2012.06.003.CrossRefPubMed

20.

Daes J, Jimenez ME, Said N, Daza JC, Dennis R: Laparoscopic sleeve gastrectomy: symptoms of gastroesophageal reflux can be reduced by changes in surgical technique. Obes Surg. 2012, 22 (12): 1874-1879. 10.1007/s11695-012-0746-5.CrossRefPubMedPubMedCentral

21.

Snyder-Marlow G, Taylor D, Lenhard MJ: Nutrition care for patients undergoing laparoscopic sleeve gastrectomy for weight loss. Journal of the American Dietetic Association. 2010, 110 (4): 600-607. 10.1016/j.jada.2009.12.022.CrossRefPubMed

22.

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): 1450-1456. 10.1381/096089206778869933.CrossRefPubMed

23.

Kehagias I, Karamanakos SN, Argentou M, Kalfarentzos F: Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obesity surgery. 2011, 21 (11): 1650-1656. 10.1007/s11695-011-0479-x.CrossRefPubMed

24.

Farrell GC, Larter CZ: Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology. 2006, 43 (2 Suppl 1): S99-S112.CrossRefPubMed

25.

Kral JG, Thung SN, Biron S, Hould FS, Lebel S, Marceau S, Simard S, Marceau P: Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis. Surgery. 2004, 135 (1): 48-58. 10.1016/j.surg.2003.10.003.CrossRefPubMed

26.

Deitel M, Gagner M, Erickson AL, Crosby RD: Third international summit: current status of sleeve gastrectomy. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery. 2011, 7 (6): 749-759. 10.1016/j.soard.2011.07.017.CrossRef

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2482/14/8/prepub

Title: Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study
Authors: Villy Våge
Vetle Aaberge Sande
Gunnar Mellgren
Camilla Laukeland
Jan Behme
John Roger Andersen
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2014
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/1471-2482-14-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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