Efficacy of sleeve gastrectomy as sole procedure in patients with clinically severe obesity (BMI ≤50 kg/m(2)).

Abstract

BACKGROUND:

Sleeve gastrectomy (SG) is increasingly indicated as a stand-alone procedure for the treatment of clinically severe obesity. Our objective was to present the outcomes of SG in relation to weight loss, resolution of co-morbidities, and procedural morbidity/mortality for ≤5 years postoperatively. The study was conducted at a university hospital, bariatric referral center.

METHODS:

From January 2005 to December 2010, 208 patients underwent SG at our institution. Per standard protocol, SG was the sole surgery indicated for weight reduction in patients with a body mass index of ≤50 kg/m(2) who were not "sweet-eaters" and had no symptoms of gastroesophageal reflux disease. The study endpoints were weight loss, perioperative and late morbidity/mortality, and clinical improvement in co-morbidities and consequential nutritional deficiencies.

RESULTS:

SG was performed laparoscopically in 203 of the patients. The mean age and body mass index was 34.3 ± 10.3 years and 43.2 ± 2.8 kg/m(2), respectively. No deaths were recorded. Early morbidity (≤30 d) was 9.6%, chiefly owing to staple line closure leaks, and late morbidity was 4.8%. A mean excess weight loss of 71.1% was documented in 90 (89.4%) of 106 patients, available for follow-up after 3 years. The excess weight loss slowly declined to 57.6% in 21 (77.7%) of 27 patients at 5 years of follow-up. No major metabolic deficiencies were apparent. Statistically significant improvements in pre-existing hypertension, diabetes mellitus, and dyslipidemia were achieved. After laparoscopic SG, gastroesophageal reflux disease symptoms developed in 9.8% of patients within the first postoperative year but lessened over time to 7.4% at the 5-year mark.

CONCLUSIONS:

SG is a reproducible procedure associated with significant weight reduction, resolution of obesity-related co-morbidities, and minor nutritional deficits at 5 years of follow-up. Laparoscopic SG can thus be safely used as the sole surgical treatment of clinically severe obesity (body mass index ≤50 kg/m(2)). The chief complication of postoperative leakage can be managed nonoperatively in most patients.

• Authors: Ioannis Kehagias, Charalambos Spyropoulos, Stavros Karamanakos, Fotis Kalfarentzos
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2013 May-Jun Vol. 9 Issue 3 Pg. 363-9 ISSN: 1878-7533 [Electronic] United States
• PMID: 22342326 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Female
• Gastrectomy (methods)
• Humans
• Laparoscopy (methods)
• Male
• Metabolic Diseases (etiology)
• Obesity, Morbid (surgery)
• Postoperative Care
• Postoperative Complications (etiology)
• Prospective Studies
• Retrospective Studies
• Weight Loss (physiology)