Abstract
Background The aim of this study is to clarify the feasibility and effect of laparoscopic sleeve gastrectomy (LSG) on comorbidities, graft function and quality of life in patients under went renal transplantation (RT) Methods This is a retrospective review of 5 patients who underwent laparoscopic sleeve gastrectomy (LSG) after kidney transplantation. Patients demographic data, anthropometric parameters, effect on comorbidities, postoperative course, immunosuppressive medications, cause of renal transplantation (RT), renal function, survival of graft, and post-sleeve gastrectomy quality of life in obese patients with history of renal transplantation (RT) were assessed using BAROS–Moorhead–Ardelt survey Results From September 2015 to September, 2019, 5 renal transplant patients underwent underwent laparoscopic sleeve gastrectomy (LSG); 60% were female and 40 were male with an average body mass index (BMI) before surgery of 41.28 ± 5.8 kg/m2 (range 36–55). Associated comorbidities: 100% of the patients had hypertension (HTN) and dyslipidemia (DSL), Whereas 3 patients (60%) had type 2 diabetes mellitus (T2D) and 1 patient had gout (20%). The average time between renal transplantation (RT) and laparoscopic sleeve gastrectomy (LSG) was 5.6 ± 5 years (range 3–9). Average operative duration was 61 ± 16.5 min (range 50–70), and there were neither postoperative morbidity nor mortality. At 17.9 ± 13.6 months (range 7–48) of follow-up period, body mass index (BMI) was 28.8 ± 6.3 kg/m2 (range 25–42). Regarding patients with hypertension (HTN) and dyslipidemia (DSL), improvement in blood pressure, triglyceride and cholesterol levels was observed and all cases were able to decrease their medications. Regarding diabetic patients, insulin was stopped in all patients and replaced with oral hypoglycemic medication only (linagliptin). Renal graft function and proteinuria level decreased in all cases (100%). All patients claimed to have excellent quality of life. Conclusion LSG showed excellent outcomes regarding weight reduction, improvement and resolution of comorbidities, kidney function and quality of life in this high risk group of patients.
Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life.
