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

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.

• Authors: Ilhan Ece, Huseyin Yilmaz, Husnu Alptekin, Serdar Yormaz, Bayram Colak, Farise Yilmaz, Mustafa Sahin
• Journal: Obesity surgery (Obes Surg) Vol. 28 Issue 6 Pg. 1484-1491 (06 2018) ISSN: 1708-0428 [Electronic] United States
• PMID: 29235011 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Topics

• Adult
• Bariatric Surgery (adverse effects, methods, statistics & numerical data)
• Body Mass Index
• Comorbidity
• Female
• Gastrectomy (adverse effects, methods, statistics & numerical data)
• Humans
• Laparoscopy (adverse effects, methods, statistics & numerical data)
• Male
• Middle Aged
• Obesity, Morbid (epidemiology, pathology, surgery)
• Postoperative Complications (epidemiology, etiology)
• Postoperative Period
• Retrospective Studies
• Treatment Outcome
• Weight Loss (physiology)
• Young Adult