Long-term effects of laparoscopic sleeve gastrectomy: What are the results beyond 10 years?

Abstract

Abstract Objective Sleeve gastrectomy (SG) has become the most commonly performed bariatric procedure worldwide. Newer studies providing long-term follow-up are showing high incidence of weight regain and high incidence of de novo reflux or worsening of preexisting GERD leading to conversion to different bariatric procedure. The objective of our study was to present 5 to 15-year follow-up results in terms of weight loss, remission of comorbidities and reoperation rate. Methods This is a retrospective analysis of prospectively collected data. The minimal follow-up time was 5 years. Patients who underwent SG between August 2004 and December 2014 were included. In case of reoperation patients were converted to Roux-en-Y gastric bypass or biliopancreatic diversion type duodenal-switch with or without hiatal hernia repair. Results A total of 307 patients underwent SG either as primary bariatric procedure (n = 262) or as redo operation after failed laparoscopic gastric banding (n = 45). Mean body mass index at time of primary SG was 46.4 ± 8.0 kg/m2. Mean age at operation was 43.7 ± 12.4 years with 68% females. Follow-up was 84% and 70% at 5 and 10 years respectively. The mean EBMIL for primary SG was 62.8 ± 23.1% after 5 years, 53.6 ± 24.6% after 10 years and 51.2 ± 20.3% after 13 years. Reoperation after SG was necessary in almost every fifth SG patient: 24 patients (7.8%) were reoperated due to insufficient weight loss, 12 patients (3.9 %) due to reflux, while 23 patients (7.5%) needed conversion due to both, insufficient weight loss and reflux. Comorbidities improved considerably while the incidence of new onset reflux was 29.7%. Conclusion SG provides a long-term EBMIL from 51 to 54% beyond 10 years and a significant improvement of comorbidities. On the other hand, a high incidence of both weight loss failure and de novo reflux was observed leading to conversion.