Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy.

Abstract

Long-term laparoscopic sleeve gastrectomy (LSG) outcomes in patients with obesity are scarce. We aimed to examine the outcomes and subjective experience of patients who underwent primary LSG with long-term follow-up. The study is a retrospective observational analysis of patients who underwent primary LSG in a single center with 5-15years of follow-up. Patients' hospital chart data supplemented by a detailed follow-up online questionnaire and telephone interview were evaluated. The study sample included 578 patients (67.0% female) with 8.8 ± 2.5years of mean follow-up, with a response rate to the survey of 82.8%. Mean baseline age and body mass index (BMI) were 41.9 ± 10.6years and 42.5 ± 5.5kg/m2, respectively. BMI at nadir was 27.5 ± 4.9kg/m2, corresponding to a mean excess weight loss (EWL) of 86.9 ± 22.8%. Proportion of patients with weight regain, defined as nadir ≥ 50.0% EWL, but at follow-up < 50.0% EWL, was 34.6% (n = 200) and the mean weight regain from nadir was 13.3 ± 11.1kg. BMI and EWL at follow-up were 32.6 ± 6.4kg/m2 and 58.9 ± 30.1%, respectively. The main reasons for weight regain given by patients included "not following guidelines," "lack of exercise," "subjective impression of being able to ingest larger quantities of food in a meal," and "not meeting with the dietitian." Resolution of obesity-related conditions at follow-up was reported for hypertension (51.7%), dyslipidemia (58.1%) and type 2 diabetes (72.2%). The majority of patients (62.3%) reported satisfaction with LSG. In the long term, primary LSG was associated with satisfactory weight and health outcomes. However, weight regain was notable.