The role of laparoscopic sleeve gastrectomy as a treatment for morbid obesity; review of outcomes.

Abstract

Global prevalence of obesity has soared. Where lifestyle and medical treatments have failed, laparoscopic sleeve gastrectomy (LSG) is increasingly regarded as a good surgical procedure for morbid obesity. Following the introduction of LSG, we assessed our surgical outcomes. We reviewed a consecutive series of LSGs from January 2009 to January 2015. Our primary focus was to assess the success of this procedure on the percentage excess body weight loss (%EWL), Body Mass Index (BMI), hypertension and diabetes. Additionally, we evaluated the rate of procedure-related complications. There were 183 consecutive patients evaluated. Median age was 45years (24-73). The majority were female (73.2%, n=134). At 1year post-op, median %EWL was 57.6%. There was an associated median reduction in BMI of 16kg/m2 (0-33). At 2 years, median %EWL was sustained at 58.4%. The median reduction in BMI was 16kg/m2 (4-32). At 2-year post-op, 78.9% of diabetic patients had their diabetic medications completely discontinued, while a further 15.8% having their medication reduced. 34.6% of hypertensive patients had their antihypertensives discontinued, with 50% having medications reduced. There was no procedure related mortality. 3.3% (n=6) of patients had a confirmed staple-line leak. This study shows LSG is a safe and successful management strategy for morbid obesity. In addition to the direct effects of sustained weight loss, it highlights indirect effects that LSG has on obesity-related health issues, with substantial reduction in diabetic and anti-hypertensive medications. Our results reaffirm international studies of the beneficial effects of LSG on Type II diabetes and hypertension.