Letter to the Editor: “Long-Term Results after Laparoscopic Sleeve Gastrectomy with Concomitant Posterior Cruroplasty: 5-Year Follow-up”

ABSTRACT BACKGROUND: There are no long-term results for laparoscopic sleeve gastrectomy (LSG) from Turkey. OBJECTIVES: Assess the outcomes of LSG at 5 years. DESIGN: Retrospective. SETTING: Training and research hospital. PATIENTS AND METHODS: The study included patients with LSG performed from August 2012 to December 2013. The data was prospectively collected with the aim of providing 5-year outcomes. MAIN OUTCOME MEASURES: Changes in percentage excessive weight loss (%EWI) and BMI. Changes in the pharmacological treatment status of patients with type 2 diabetes mellitus and hypertension. SAMPLE SIZE AND CHARACTERISTICS: 120 patients (89 female) completed follow up; mean age 37 years (range, 19-63 years), mean preoperative BMI 48.3 kg/m 2 (range 40-80.4 kg/m 2 ). RESULTS: After a mean 5.6-year follow-up, the mean (SD) postoperative weight loss was 43.5 (11.8) kg and the mean (SD) BMI loss was 16.1 (4.4). The mean %EWL value was 62.9% (range, 30-101%). Most patients (87.5%, n=105) achieved satisfactory %EWL values. The major complication rate was 6.6%. After surgery, 74.2% of patients taking medication for hypertension were able to stop treatment, while 12.9% reduced the dose, of patients that took medication for diabetes, all had a dosage reduction. CONCLUSIONS: We showed that LSG is an acceptable bariatric procedure, but in the long-term there may be weight gain and frequent reflux symptoms. We think renewed weight gain can be partially prevented by close clinical follow-up. There is a need for long-term randomized controlled studies with long-term follow-up to clearly define the indications for LSG. LIMITATIONS: Retrospective, incomplete clinical visits, GERD symptoms not objectively assessed. CONFLICT OF INTEREST: None.

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Laparoscopic sleeve gastrectomy for morbid obesity and Klinefelter syndrome: clinical report on two patients, with long-term follow-up

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-020-00951-2 ◽

2020 ◽

Cited By ~ 2

Author(s):

Emanuela Bianciardi ◽

Paolo Orsaria ◽

Cinzia Niolu ◽

Alberto Siracusano ◽

Paolo Gentileschi

Keyword(s):

Morbid Obesity ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Klinefelter Syndrome ◽

Clinical Report ◽

Long Term Follow Up

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Five-Year Outcome of Laparoscopic Sleeve Gastrectomy, Resolution of Comorbidities, and Risk for Cumulative Nutritional Deficiencies

Scandinavian Journal of Surgery ◽

10.1177/1457496918783723 ◽

2018 ◽

Vol 108 (1) ◽

pp. 10-16 ◽

Cited By ~ 10

Author(s):

E. M. Kikkas ◽

T. Sillakivi ◽

J. Suumann ◽

Ü. Kirsimägi ◽

T. Tikk ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Total Cholesterol ◽

Laparoscopic Sleeve Gastrectomy ◽

Excess Weight Loss ◽

Density Lipoprotein ◽

Nutritional Deficiencies ◽

Low Density

Background and Aims: The aim of this study was to evaluate the long-term (5-year follow-up) results of laparoscopic sleeve gastrectomy in terms of weight loss and obesity-related comorbidities, as well as the risk factors associated with postoperative nutritional deficiencies. Material and Methods: The first 99 consecutive patients who underwent laparoscopic sleeve gastrectomy for the treatment of morbid obesity between October 2008 and August 2011 at Tartu University Hospital were followed prospectively in cohort study. The outpatient hospital follow-up visits were conducted at 3 months, 1 year, and 5 years postoperatively. At 5 years, the follow-up rate was 90.9%; 86 laparoscopic sleeve gastrectomy patients were included in final analysis. Results: The mean excess weight loss (%EWL) was 44.3% ± 13.0%, 75.8% ± 23.1%, and 61.0% ± 24.3% at 3 months, 1 year, and 5 years, respectively. A linear association between preoperative weight and weight at 5 years was found. Remission rates at 5-year follow-up for type 2 diabetes, hypertension, dyslipidemia, and obstructive sleep apnea were 68.8%, 32.7%, 27.4%, and 61.5%, respectively (all p < 0.05). There was a statistical difference (p < 0.05) in the dynamics of triglyceride, low-density lipoprotein, and high-density lipoprotein level at 5-year follow-up but the level of total cholesterol did not show significant improvement. The risk for cumulative iron, vitamin B12 deficiency, and anemia was 20%, 48%, and 28%, respectively. Conclusion: In conclusion, laparoscopic sleeve gastrectomy ensured long-term excess weight loss 61.0% at 5 years. Laparoscopic sleeve gastrectomy has a long-term effect on significant improvement in the median values of triglycerides, low-density lipoproteins, and high-density lipoproteins, but not on total cholesterol levels. There is a risk of postoperative vitamin B12 and iron deficiency.

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Long-Term Effects of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Body Composition and Bone Mass Density

Obesity Facts ◽

10.1159/000512450 ◽

2020 ◽

pp. 1-10

Author(s):

Julian Bühler ◽

Silvan Rast ◽

Christoph Beglinger ◽

Ralph Peterli ◽

Thomas Peters ◽

...

Keyword(s):

Vitamin D ◽

Gastric Bypass ◽

Body Composition ◽

Sleeve Gastrectomy ◽

Bone Mass ◽

Laparoscopic Sleeve Gastrectomy ◽

Mass Density ◽

Bone Mass Density

Background: Currently, the two most common bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Long-term data comparing the two interventions in terms of their effect on body composition and bone mass density (BMD) are scarce. Objective: The aim of this study was to assess body composition and BMD at least 5 years after LSG and LRYGB. Setting: Department of Endocrinology and Nutrition, St. Claraspital Basel and St. Clara Research Ltd., Basel, Switzerland. Methods:Bariatric patients at least 5 years after surgery (LSG or LRYGB) were recruited, and body composition and BMD were measured by means of dual-energy X-ray absorptiometry. Data from body composition before surgery were included in the analysis. Blood samples were taken for determination of plasma calcium, parathyroid hormone, vitamin D3, alkaline phosphatase, and C-terminal telopeptide, and the individual risk for osteoporotic fracture assessed by the Fracture Risk Assessment Tool score was calculated. After surgery, all patients received multivitamins, vitamin D3, and zinc. In addition, LRYGB patients were prescribed calcium. Results: A total of 142 patients were included, 72 LSG and 70 LRYGB, before surgery: median body mass index 43.1, median age 45.5 years, 62.7% females. Follow-up after a median of 6.7 years. For LRYGB, the percentage total weight loss at follow-up was 26.3% and for LSG 24.1% (p = 0.243). LRYGB led to a slightly lower fat percentage in body composition. At follow-up, 45% of both groups had a T score at the femoral neck below –1, indicating osteopenia. No clinically relevant difference in BMD was found between the groups. Conclusions:At 6.7 years after surgery, no difference in body composition and BMD between LRYGB and LSG was found. Deficiencies and bone loss remain an issue after both interventions and should be monitored.

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