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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Impact of Laparoscopic Sleeve Gastrectomy on Esophageal Physiology

Romanian Journal of Internal Medicine ◽

10.2478/rjim-2021-0008 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Andrada-Loredana Popescu ◽

Florentina Ioniţa-Radu ◽

Mariana Jinga ◽

Vasile-Daniel Balaban ◽

Raluca-Simona Costache ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

High Resolution ◽

Laparoscopic Sleeve Gastrectomy ◽

Lower Esophageal Sphincter ◽

Esophageal Manometry ◽

Morbidly Obese ◽

Esophageal Physiology ◽

Esophageal Sphincter ◽

The Impact

Abstract Introduction: Laparoscopic sleeve gastrectomy (LSG) is a popular weight loss surgery technique, but the impact on esophageal physiology and esophagogastric junction is still debatable. The aim of our study was to evaluate the manometric changes of the lower esophageal sphincter (LES) after LSG in order to indicate LES manometry pre- procedure. Methods: In a prospective study we evaluated clinically, with upper gastrointestinal endoscopy, and high-resolution esophageal manometry 45 morbidly obese patients before, and 6-12 months after LSG. Results: The BMI (body mass index) decreased from 46.28±5.79 kg/m2 to 32.28±4.65 kg/m2 postoperatively (p <0.01), with a reduction of ~14 kg/m2 of BMI, 39.9 (±11.9) kg body weight and 29.9 (± 6.2)% of the TWL (Total Weight Loss index), in a median interval of 7.9 months. Gastroesophageal reflux disease (GERD) prevalence increased from 17.8% to 31.1% postoperatively, with new GERD onset in 22.2%, but mild symptomatology (the median GERDHRQL score increased from 1.56 to 2.84 points). Postoperatory reflux was associated with lower esophageal sphincter (LES) hypotonia, shortening of LES length and IIGP (increased intragastric pressure). Hiatal hernia repair rate was 17.8%, and proton pump inhibitor consumption 20%. After weight loss, the 10 cases of esophagitis discovered preoperatively cured, but 3 patients were diagnosed with de novo esophagitis. The prevalence of manometric dysmotility after LSG was 28.9%, lower than before surgery (44.4%). Conclusion: Even if GERD remains the main limitation of LSG, the high-resolution esophageal manometry has proved useful and should be implemented in morbidly obese evaluation protocol, to better select the bariatric procedure.

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Early Outcomes of Laparoscopic Sleeve Gastrectomy (LSG) in Morbidly Obese Patients

10.53350/pjmhs211572269 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2269-2271

Author(s):

Rahmat Ullah Shah ◽

Adnan Badar ◽

Hafiz Niamat Ullah ◽

Sadia Shah ◽

Sheikh Muhammad Ibqar Azeem ◽

...

Keyword(s):

Diabetes Mellitus ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Body Weight Loss ◽

Excess Body Weight ◽

Morbidly Obese ◽

Obese Patients ◽

Comorbid Conditions

Objective: To determine the early outcomes of laparoscopic sleeve gastrectomy with respect to weight loss and amelioration of comorbid conditions in morbidly obese patients. Study Design: Prospective descriptive study. Place and Duration of Study: MTI-Lady Reading hospital Peshawar and Royal Imperial hospital Swat from January 2018 to January 2020. Materials and Methods: Total thirty-eight morbidly obese patients of either sex with age range of 25-65 years were included in this study. Informed written consent was taken from all the patients and their demographic details such as age, sex and comorbid conditions were recorded. All the patients underwent laparoscopic sleeve gastrectomy. Preoperative and postoperative data such as body mass index, total & excess weight loss and impact on comorbidities were analyzed. Bariatric Analysis and Reporting Outcome System (BAROS) scoring system was used to analyze the outcomes. Follow-up was taken at 1 year post-operatively. Results: Majority were female 25 (65.8%) patients and 13 (34.2%) males with mean age of 45.39±9.64 years. Comorbidities such as hypertension, diabetes mellitus, hyperlipidemia and obstructive sleep apnoea were recorded in 13.2%, 26.3%, 7.9% and 10.53% patients respectively. Mean excess body weight loss (EWL) was 60.25±12.7 kg and mean body mass index loss was 15.14+9.33 kg/m2at 1 year follow up. Postoperative systolic blood pressure improvement was observed in 23 (60.5%) patients. A significant improvement was observed regarding diabetes mellitus (preoperatively mean HbA1C 9.7±5.9 vs postoperatively mean HbA1C 4.42±3.6) p-value <0.001. According to the BAROS score, 5 (13.3%) showed excellent, 14 (36.8%) showed very good, 17 (44.74%) showed good, 2 (5.3%) showed fair and no patient showed poor outcomes. Satisfaction rate among patients was 94.7%. Conclusion: Laparoscopic sleeve gastrectomy is an excellent procedure both in terms of weight loss and amelioration of comorbid conditions in morbidly obese patients. Key words: Sleeve gastrectomy, Laparoscopic, Excess body weight loss, Morbid obesity

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Prevalence of Cholecystitis in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy

British Journal Of Surgical Science ◽

10.54323/bjoss.2021.3 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Bandr ALI ◽

Farah Alshammari ◽

Hamad Almakinzy ◽

Mansour Alshehri

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Statistical Significance ◽

Categorical Variables ◽

Morbidly Obese ◽

Rapid Weight Loss ◽

Continuous Variables ◽

Increased Risk

Background Aims: Rapid weight loss after laparoscopic sleeve gastrectomy is associated with an increased risk of cholelithiasis. With 7-15% of patients requiring cholecystectomy after bariatric surgery, there is ongoing debate regarding the potential benefits of performing cholecystectomy with the primary bariatric surgery. The goals of this study were to investigate the frequency and timing of cholecystectomies post LSG and determine the associated risk of choledocholithiasis post LSG in Prince Sultan Military Medical City, Riyadh. Subjects and methods: A retrospective cohort study of 1112 patients undergoing LSG. The inclusion criteria are patients who are age above 18 years old who underwent laparoscopic sleeve gastrectomy (LSG). Statistical analysis: Analysis was performed using IBM’s Statistical Package for the social Sciences (SPSS) version 21.0. Results were expressed in numbers and percentages for categorical variables. Continuous variables were expressed as means and standard deviations. All the comparisons were analyzed using non-parametric methods. The level selected for statistical significance was a probability value <0.05. Results: Our results shows the main cause of having cholecystitis is the significant loss of weight within the first six months Conclusion: A 17.9% incidence of symptomatic cholelithiasis was noted among post-LSG patients over a period of seven years. Rapid weight loss was the only risk factor that contributed to the development of post-LSG gallbladder stone disease.

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One-year outcome of laparoscopic sleeve gastrectomy in morbidly obese adolescents

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00098-4 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Mohamed El ghazeery ◽

Mohamed Elsawaf ◽

Mohamed Ashour ◽

Mohamed Metwaly ◽

Mohamed Hashish

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Fatty Infiltration ◽

Adolescent Obesity ◽

Morbidly Obese ◽

Safe Procedure ◽

Short Term ◽

Obese Adolescents ◽

Important Health ◽

One Year

Abstract Background Adolescent obesity is an important health issue. Non-surgical weight management programs, even the most aggressive, have shown modest weight reduction results. Laparoscopic sleeve gastrectomy (LSG) is gaining reliability as a low surgical risk bariatric procedure with proper efficiency for this age group. The aim of this study was to present our initial experience with LSG in morbidly obese adolescents and to report short-term clinical and metabolic outcome. Results Mean age was 16.43 years, and mean preoperative weight and body mass index (BMI) were 132.68 kg and 48.90 respectively. Mean excess weight loss (EWL) was 54.11 kg 1 year after LSG, corresponding to 74 EWL% as well as mean BMI loss (BML) of 19.89. LSG improved fatty infiltration of the liver in 75% of cases and other comorbidities in 100% of patients. Conclusions LSG proved to be a safe procedure with significant short-term clinical and metabolic success for adolescent obesity.

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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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