Long-term Results on Weight Loss and Diabetes Remission after Laparoscopic Sleeve Gastrectomy for A Morbidly Obese Chinese Population

Summary Introduction: Bariatric surgery has amply demonstrated its benefit in the treatment of morbidly obese patients. After surgery, there is a progressive and significant decrease in weight in a high percentage of patients. Most comorbidities resolve, improving quality of life and increasing life expectancy. Methods and Objective: The literature review is based on a 10-year or longer follow-up of patients who underwent various bariatric surgery procedures. The long-term weight loss results and the clinical impact were evaluated. Results: The applied surgical techniques, including Rouxen-Y gastric Bypass (RYBG), Biliopancreatic Diversion, Scopinaro type (BPD), and Duodenal Switch (DS), have contributed to achieving very satisfactory long-term and sustainable weight loss results. According to the reviewed literature, the percentage of excessive BMI Loss (%EBMIL) for the various techniques was 67.9%, 70.7%, and 71.5% for RYGB, BPD, and DS, respectively. Patients undergoing BGYR have lost much more weight than non-surgical patients and can maintain long-term weight loss, reaching a Percentage of Excessive Weight Loss (%EWL) as high as 56.4% in 10 years. Patients who underwent Adjustable Gastric Band (AGB) presented with a %EWL of 45.9% in 10 years, but with very high re-operation rate range (8-78%). There are few studies in the literature on Laparoscopic Sleeve Gastrectomy, reporting weight loss results over ten years. According to the study carried out by Arman G. A., Himpens J., et al. isolated Laparoscopic Sleeve Gastrectomy (LGS) produced a satisfactory weight loss over ten years, reachingEBMIL of 62.5%. Amending LSG with a new surgical design with malabsorbtive component (in 25% of patients) increased the weight loss, achieving %EBMIL of 81.7%.The Vertical Band Gastroplasty technique resulted in EWL of 38.1 ± 28.8%, as shown by a mean follow-up of 17.3 years, with a high rate of re-operations and conversions.

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Single-Port Sleeve Gastrectomy Compared With Conventional Laparoscopic Sleeve Gastrectomy: 5-Year Follow-up of Weight Loss, Comorbidity Resolution, and Cost

Surgical Innovation ◽

10.1177/1553350620902550 ◽

2020 ◽

Vol 27 (3) ◽

pp. 265-271

Author(s):

Nesreen Khidir ◽

Michel Gagner ◽

Moamena El Matbouly ◽

Walid El Ansari ◽

Helmuth Billy ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Hospital Stay ◽

Laparoscopic Sleeve Gastrectomy ◽

Single Port ◽

Morbidly Obese ◽

Complication Rates ◽

Conventional Laparoscopic

Background. The Single-Port Instrument Delivery Extended Reach (SPIDER) surgical system is a safe revolutionary technology that defeated difficulties of single-incision surgery. We assessed the long-term outcomes of SPIDER sleeve gastrectomy (SPIDER SG) versus conventional laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients. Methods. Retrospective review of patients who underwent SPIDER SG or LSG in our center matched by the date of surgery (2012-2013). We reviewed weight loss results up to 5 years, complication rates, procedure and hospitalization durations, financial cost, and effect on comorbidities. Results. Patients underwent 200 SPIDER SG and 220 LSG. At baseline, SPIDER SG versus LSG patients had a mean body mass index of 43.8 ± 5.6 and 48.6 ± 8.1 kg/m2, respectively. At 1 year, both groups had comparable percentage of excess weight loss (%EWL). At 5 years, SPIDER SG had %EWL of 54.6 ± 24.8 compared with 57.8 ± 29.9 in LSG ( P = .4). Nine SPIDER SG (4.5%) required conversion to LSG. Complications occurred in both groups: 4% versus 4.1% ( P = .95). At 2-year follow-up, diabetes mellitus was reversed in 43% of SPIDER SG and 62% LSG. Despite a shorter hospital stay in SPIDER SG, the total cost was significantly higher ($2 041 477) compared with LSG ($1 773 834). The mean score of scar satisfaction was significantly more in SPIDER SG. Conclusions. SPIDER SG was safe with long-term effects on weight loss comparable to LSG. Despite the higher cost of SPIDER SG, a shorter hospital stay and better cosmesis were observed.

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Five-year outcomes for laparoscopic sleeve gastrectomy from a single center in Turkey

Annals of Saudi Medicine ◽

10.5144/0256-4947.2020.310 ◽

2020 ◽

Vol 40 (4) ◽

pp. 310-315

Author(s):

Hakan Seyit ◽

Halil Alis

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Weight Gain ◽

Laparoscopic Sleeve Gastrectomy ◽

Major Complication ◽

Long Term Results ◽

Randomized Controlled Studies ◽

The Mean

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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The effects of age on weight loss after sleeve gastrectomy

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.433 ◽

2021 ◽

Vol 8 ◽

Author(s):

Taha Anbara

Keyword(s):

Diabetes Mellitus ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Statistical Significance ◽

Age Groups ◽

Primary Treatment ◽

Morbidly Obese ◽

Safe Procedure ◽

The Impact

Introduction: Laparoscopic sleeve gastrectomy is a primary treatment of obesity among older adults and its satisfactory outcomes would be the main reason behind the popularity of this procedure. We aim to evaluate the impact of age on excess weight loss in adult morbidly obese subjects older than 60 years old following LSG.Methods: In this retrospective survey, 3,072 subjects were included in the study that underwent LSG in Erfan Hospital. Screening follow-up period was 12 months. The level of statistical significance was set at P < 0.05. We hired comorbid conditions to avoid bias results including hypertension, diabetes mellitus and dyslipidemia. Results: Of 3072 patients, 1879 cases were females (61.2%) and 1193 subjects were males (38.8 %). Mean %EBMIL of the group 12 months after surgery was 78.9 %. In younger than 60 years old group, mean %EBMIL 12 months postoperative 83 % and patients over 60 years demonstrated mean %EBMIL 74.9 %. There was an obvious difference among age groups in presence of diabetes mellitus and hypertension in the older group which was more frequent. Conclusion: To sum up, laparoscopic sleeve gastrectomy is safe procedure for older groups. Albeit, %EBMIL was significantly lower in older group compared to younger subjects, but resolution in comorbidities was satisfactory.

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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 Weight Loss Results After Laparoscopic Sleeve Gastrectomy

Metabolism and Pathophysiology of Bariatric Surgery ◽

10.1016/b978-0-12-804011-9.00042-x ◽

2017 ◽

pp. 235-248

Author(s):

K.G. Apostolou

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy

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The influence of patient’s age on metabolic and bariatric results of laparoscopic sleeve gastrectomy in 2-year observation

BMC Surgery ◽

10.1186/s12893-020-00989-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Paulina Woźniewska ◽

Inna Diemieszczyk ◽

Dawid Groth ◽

Łukasz Szczerbiński ◽

Barbara Choromańska ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Laboratory Data ◽

Morbidly Obese ◽

Significant Weight Loss ◽

Preoperative Body Mass Index ◽

Age Related ◽

Excess Bmi Loss

Abstract Background The incidence of obesity has been constantly growing and bariatric procedures are considered to be the most effective treatment solution for morbidly obese patients. The results of laparoscopic sleeve gastrectomy (LSG) may differ depending on patient’s age, gender, preoperative body mass index (BMI) and physical activity. Methods The aim of this study was to evaluate age-related differences in the outcome of LSG in terms of weight loss parameters, lipid and carbohydrate profile. The retrospective analysis of 555 patients who had undergone LSG was performed to compare the metabolic outcomes of surgery in individuals < 45 and ≥ 45 years old. Evaluation of weight loss parameters along with selected laboratory data was performed to demonstrate the results of LSG in 2 years follow-up. Results Overall, 238 males and 317 females (43%/57%) with median age of 43 years and median preoperative BMI of 46.41 (42.06–51.02) kg/m2 were analyzed. Patients in both groups presented significant weight loss at 24 months after the surgery with comparable percentage of total weight loss (40.95% in < 45 years old group and 40.44% in ≥ 45 years old group). The percentage of excess weight loss (78.52% vs. 74.53%) and percentage of excess BMI loss (91.95% vs. 88.01%) were higher in patients < 45 years old. However, the differences were not statistically significant (p = 0.662, p = 0.788 respectively). Patients under 45 years old experienced faster decrease in fasting glucose level that was observed after only 3 months (109 mg/dl to 95 mg/dl in < 45 years old group vs. 103.5 mg/dl to 99.5 mg/dl in ≥ 45 years old group, p < 0.001). Both groups presented improvement of lipid parameters during the observation. However, patients < 45 years old achieved lower values of LDL at 3 and 12 months follow-up (115 mg/dl vs. 126 mg/dl, p = 0.010; 114.8 mg/dl vs. 122 mg/dl, p = 0.002). Younger group of patients also showed superior improvement of triglycerides level. Conclusions LSG results in significant weight loss in all patients regardless age. In turn, superior and faster improvement in lipid and carbohydrate profile is achieved in patients under 45 years old.

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