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Obesity Surgery

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01-12-2016 | Original Contributions

Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30–35 kg/m²)

Authors: Roger Noun, Rita Slim, Marwan Nasr, Ghassan Chakhtoura, Joseph Gharios, Nayla Abi Antoun, Eliane Ayoub

Published in: Obesity Surgery | Issue 12/2016

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is currently the leading bariatric procedure and targets, among other obesity classes, patients with BMI 30–35 kg/m², which are reaching alarming proportions.

Methods

Between February 2010 and August 2015, data on 541 consecutive patients with BMI 30–35 kg/m² undergoing LSG were prospectively collected and analyzed.

Results

Mean age was 32 ± 8 years (13–65) and 419 (77.4 %) were women. Preoperative weight was 92.0 ± 8.8 kg (65–121) and BMI was 32.6 ± 1.5 kg/m² (30–35). Comorbidities were detected in 210 (39 %) patients. Operative time was 74 ± 12 min (40–110) and postoperative stay was 1.7 ± 0.22 days (1–3). There were no deaths, leaks, abscesses or strictures and the rate of hemorrhage was 1.2 %. At 1 year, 98 % were followed and BMI decreased to 24.7 ± 1.6, the percentage of total weight loss (% TWL) was 24.1 ± 4.7 while the percentage of excess BMI loss (%EBMIL) reached 106.1 ± 24.1. At 5 years, 76 % of followed patients achieved a ≥50 % EBMIL.

Conclusion

With appropriate surgical expertise, LSG in patients with BMI 30–35 kg/m² achieved excellent outcomes with a zero fistula rate.

Sroka G, Milevski D, Shteinberg D, et al. Minimizing hemorrhagic complications in laparoscopic sleeve gastrectomy—a randomized controlled trial. Obes Surg. 2015;25(9):1577–83.CrossRefPubMed

Gagner M, Deitel M, Erickson AL, et al. Survey on laparoscopic sleeve gastrectomy at the fourth international consensus summit on sleeve. Obes Surg. 2013;23(12):2013–7.CrossRefPubMed

Clinical Issues Committee A. Bariatric surgery in class I obesity (body mass index 30–35 kg/m(2)). Surg Obes Relat Dis. 2013;9(1):e1–10.CrossRef

Busetto L, Dixon J, De Luca M, et al. Bariatric surgery in class I obesity. Obes Surg. 2014;24(4):487–519.CrossRefPubMed

Cerci M, Bellini MI, Russo F, et al. Bariatric surgery in moderately obese patients: a prospective study. Gastroenterol Res Pract. 2013;2013:276183.CrossRefPubMedPubMedCentral

Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010;316(2):104–8.CrossRefPubMed

Flegal KM, Kit BK, Orpana H, et al. Association of all cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71–82.CrossRefPubMedPubMedCentral

Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78.CrossRefPubMed

Keating CL, Peeters A, Swinburn BA, et al. Utility-based quality of life associated with overweight and obesity: the Australian diabetes, obesity, and lifestyle study. Obesity (Silver Spring). 2013;21(3):652–5.CrossRef

10.

Noun R, Chakhtoura G, Nasr M, et al. Laparoscopic sleeve gastrectomy for mildly obese patients (body mass index 30–35 kg/m²). Operative and short-term results. J Obes. 2012;2012:813650.CrossRefPubMedPubMedCentral

11.

Park JY, Kim YJ. Efficacy of laparoscopic sleeve gastrectomy in mildly obese patients with body mass index of 30–35 kg/m². Obes Surg. 2015;25(8):1351–7.CrossRefPubMed

12.

Márquez MF, Ayza MF, Lozano RB, et al. Gastric leak after laparoscopic sleeve gastrectomy. Obes Surg. 2010;20(9):1306–11.CrossRefPubMed

13.

Chouillard E, Chahine E, Schoucair N, et al. Roux-En-Y Fistulo-Jejunostomy as a salvage procedure in patients with post-sleeve gastrectomy fistula. Surg Endosc. 2014;28(6):1954–60.CrossRefPubMed

14.

National Institute for Health and Care Excellence. Identification, assessment, and management of overweight and obesity. Clinical Guidelines 189. BMJ 2014. 2014;349:g6608.

15.

Dixon JB, Zimmet P, Alberti KG. Bariatric surgery: an IDF statement for obese type 2 diabetes. Surg Obes Relat Dis. 2011;7(4):433–47.CrossRefPubMed

16.

Livingston EH. Inadequacy of BMI as an indicator for bariatric surgery. JAMA. 2012;307(1):88–9.CrossRefPubMed

17.

Boza C, Salinas J, Salgado N, et al. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22(6):866–71.CrossRefPubMed

18.

Hong J-S, Kim W-W, Han S-M. Five years results of laparoscopic sleeve gastrectomy in Korean patients with lower body mass index (30–35 kg/m²). Obes Surg. 2015;25(5):824–9.CrossRefPubMed

19.

Maiz C, Alvarado J, Quezada N, et al. Bariatric surgery in 1119 patients with preoperative body mass index <35 (kg/m2) : results at 1 year. Surg Obes Relat Dis. 2015;11(5):1127–32.CrossRefPubMed

20.

Berrington de Gonzalez A, Hartge P, Cerhan JR, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363(23):2211–9.CrossRefPubMed

21.

Sakran N, Raziel A, Goitein O, et al. Laparoscopic sleeve gastrectomy for morbid obesity in 3003 patients: results at a high-volume bariatric center. Obes Surg. 2016.

22.

Slim R, Smayra T, Chakhtoura G, et al. Endoscopic stenting of gastric staple line leak following sleeve gastrectomy. Obes Surg. 2013;23(11):1942–5.CrossRefPubMed

23.

Aminian A, Brethauer SA, Sharafkhah M, et al. Development of a sleeve gastectomy risk calculator. Surg Obes Relat Dis. 2015;11(4):758–64.CrossRefPubMed

24.

Rebibo L, Dhahri A, Badaoui R, et al. Laparoscopic sleeve gastrectomy as day-case surgery. Surg Obes Relat Dis. 2015;11(2):335–42.CrossRefPubMed

Title: Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30–35 kg/m2)
Authors: Roger Noun
Rita Slim
Marwan Nasr
Ghassan Chakhtoura
Joseph Gharios
Nayla Abi Antoun
Eliane Ayoub
Publication date: 01-12-2016
Publisher: Springer US
Published in: Obesity Surgery / Issue 12/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-016-2224-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30–35 kg/m²)

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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