Abstract
Background
Laparoscopic sleeve gastrectomy (LSG) has become very popular nowadays among bariatric surgeons because of its surgical simplicity and good postoperative results. We present our experience on LSG as a single stage primary bariatric procedure for morbid obesity and its 1–3-year follow-up results.
Methods
Between March 2008 and March 2011, a total of 110 patients underwent laparoscopic sleeve gastrectomy. Two patients were excluded from the study and thus the prospectively maintained data of 108 patients were retrospectively reviewed and outcomes were recorded.
Results
The mean patient age was 39.3 ± 11.1 years, mean body mass index was 44.5 ± 6.8, mean excess body weight was 54.1 ± 16.3 kg, and the mean American Society of Anesthesiologists score was 3.1 ± 0.57. The mean operative time for the LSG procedure was 64.8 ± 10.6 min. The minimum follow-up duration was 6 months and maximum of 36 months. The mean postoperative percent excess body weight loss achieved was 67.5 ± 13.0 at 1 year, 71.1 ± 13.8 at 2 years, and 66.09 ± 14.3 at 3 years. At the end of 3 years, there was 83.3% resolution in diabetes, 85.7% resolution in hypertension, and 85.71% resolution in dyslipidemia. There were no reports of postoperative hemorrhage, gastric leak, deep venous thrombosis, pulmonary embolism, delayed gastric tube stricture, and operative mortality.
Conclusions
LSG is a safe and effective bariatric procedure with low perioperative complications. Before it is considered as a single stage primary procedure, a long-term prospective comparative study with other bariatric procedures is required.
Similar content being viewed by others
References
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.
Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.
Sjostrom L, Narbro K, Karason K, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.
Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.
Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14(4):492–7.
Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.
Sammour T, Hill AG, Singh P, et al. Laparoscopic sleeve gastrectomy as a single stage bariatric procedure. Obes Surg. 2010;20:271–5.
Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15:1030–3.
Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.
Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–9.
Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.
Abbatini F, Rizzello M, Casella G, et al. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass and adjustable gastric banding on type 2 diabetes. Surg Endosc. 2010;24:1005–10.
Misra A, Chowbey P, Makkar BM, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. JAPI. 2009;57:163–70.
Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2:CD003641.
Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37(4):275–81.
Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.
Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8:267–82.
Marceau P, Hould FS, Simard S, et al. Bilio-pancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.
Gagner M, Patterson E. Laparoscopic biliopancreatic diversion with duodenal switch. Dig Surg. 2000;17:547–66.
Arias E, Martinez PR, Ka Ming Li V, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19:544–8.
Menenakos E, Stamou KM, Albanopoulos K, et al. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year. Obes Surg. 2010;20(3):276–82.
Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.
Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today. 2008;38:481–3.
Brethauer SA, Hamsmel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.
Trelles N, Gagner M. Updated review of sleeve gastrectomy. The open Gastroenterol J. 2008;2:41–9.
Chowbey PK, Dhawan K, Khullar R, et al. Laparoscopic sleeve gastrectomy: an Indian experience—surgical technique and early result. Obes Surg. 2010;20:1340–7.
Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the result of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.
Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.
Han SM, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.
Chen B, Kiriakopoulos A, Tsakayannis D, et al. Reinforcement does not necessarily reduce the rate of staple line leaks after sleeve gastrectomy. A review of the literature and clinical experiences. Obes Surg. 2009;19:166–72.
Rubin M, Yehoshua RT, Stein M, et al. Laparoscopic sleeve gastrectomy with minimal morbidity. Early results in 120 morbidly obese patients. Obes Surg. 2008;18(12):1567–70.
Baker RS, Foote J, Brady R, et al. The science of stapling and leaks. Obes Surg. 2004;14:1290–8.
Consten EC, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14:1360–6.
Dapri G, Cadiere GB, Himpens J. Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing three different techniques. Obes Surg. 2010;20:462–7.
Cuenca-Abente F, Parra JD, Oelschlager BK. Laparoscopic sleeve gastrectomy: an alternative for recurrent paraesophageal hernias in obese patients. JSLS. 2006;10(1):86–9.
Jacobs M, Bisland W, Gomez E, et al. Laparoscopic sleeve gastrectomy: a retrospective review of 1 and 2 years results. Surg Endosc. 2010;24:781–5.
Himpens J, Dobbeleir J, Peeters G. Long term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.
Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196(5):e56–9.
Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy morbid obesity. World J Gastroenterol. 2008;14(6):821–7.
Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci. 1994;39(2):315–20.
Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg. 2010;20(4):447–53.
Acarturk TO, Wachtman G, Heil B, et al. Panniculectomy as an adjuvant to bariatric surgery. Ann Plast Surg. 2004;53:360–6.
Nemerofsky RB, Oliak DA, Capella JF. Body lift: an account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg. 2006;117(2):414–30.
Chandawarkar RY. Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med. 2006;27:61–72.
Conflicts of Interest
All authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Prasad, P., Tantia, O., Patle, N. et al. An Analysis of 1–3-Year Follow-up Results of Laparoscopic Sleeve Gastrectomy: an Indian Perspective. OBES SURG 22, 507–514 (2012). https://doi.org/10.1007/s11695-012-0599-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-012-0599-y