The impact of laparoscopic sleeve gastrectomy on weight loss and obesity-associated comorbidities: the results of 3 years of follow-up.

Abstract

Laparoscopic sleeve gastrectomy is one of the most recent advances in the surgical treatment of morbid obesity. Extended follow-up studies of large cohorts are needed to establish the usefulness of the operation. The objectives of this study are to delineate the role of sleeve gastrectomy in weight loss and in comorbidities among obese patients. Patients who underwent laparoscopic sleeve gastrectomy in a single bariatric center were followed up for a 3-year period. Weight loss and status of several comorbidities were assessed at the 1st, 3rd, 6th, 12th, 18th, 24(th), and 36th postoperative month. Overall, after 3 years of follow-up of 88 patients, the mean body mass index (BMI) of the patients was 29.8 kg/m(2) (SD ±6.1), the % total weight loss was 38.1% (SD ±12.9), the % excess weight loss was 69.5% (SD ±17.5), and the % estimated BMI loss was 81.4% (SD ±22.3). These parameters changed significantly over the first year of follow-up (p < 0.001) and subsequently stabilized. The percentages of patients with hypertension (33.3%), hyperlipidemia (26.4%), diabetes mellitus (20.7%), obstructive sleep apnea (20.2%), and gastroesophageal reflux disease (GERD-27%) were significantly reduced (10.5, 9.2, 1.1, 1.1, and 9.2% respectively at 36 months postoperation), while 10 new cases of GERD appeared postoperatively. However, only three of the new GERD cases required medication, and only one of them experienced symptoms that persisted after the 3-year period. Three years of close follow-up of patients who had undergone laparoscopic sleeve gastrectomy demonstrated satisfactory weight loss results. Promising results were also obtained regarding various comorbidities of obese patients. Longer follow-up studies for more patients are needed to delineate the exact role of sleeve gastrectomy on postoperative outcomes.