Long-term results after laparoscopic sleeve gastrectomy in a large monocentric series

Abstract

BackgroundLaparoscopic sleeve gastrectomy (SG) has gained great popularity as a stand-alone bariatric procedure because short- and mid-term outcomes in terms of weight loss and resolution of co-morbidities have been very positive. However, long-term results from large series still are sparse. ObjectivesTo evaluate the long-term clinical outcomes of SG in a large series of patients undergoing SG as a stand-alone procedure. SettingUniversity hospital in Italy. MethodsA retrospective analysis of prospectively collected data from 182 patients undergoing SG between 2006 and 2008 in the authors’ institution. Long-term outcomes at 6 and 7 years were analyzed in terms of weight loss and co-morbidities resolution. ResultsMean initial body mass index (BMI) was 45.9±7.3 kg/m2. Major postoperative complications occurred in 8 patients (5.4%): 4 leaks, 2 bleeding, 1 abdominal collection, and 1 dysphagia. All complications were managed conservatively. One hundred forty-eight patients (81.4%) completed the 72-month (6-year) follow-up. Thirty-seven patients (25%) reached a follow-up of 84 months. At year 6 follow-up the mean BMI and the mean percentage of excess weight loss (%EWL) were 30.2 kg/m2 and 67.3%, respectively. Mean total body weight loss was 44.9 kg, while a %EWL >50 was registered in 123 patients (83.1%). Preoperative BMI did not significantly influence postoperative %EWL. Remission of type 2 diabetes mellitus, arterial hypertension, obstructive sleep apnea syndrome, and gastroesophageal reflux disease symptoms occurred in 83.8%, 59.7%, 75.6%, and 64.7% of patients, respectively. Conclusion%EWL and resolution of co-morbidities appear to be sustained 6 and 7 years after SG. Preoperative BMI is not predictive for weight loss outcomes.