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- Title
Long-Term Outcome of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Japanese Patients.
- Authors
Seki, Yosuke; Kasama, Kazunori; Hashimoto, Kenkichi
- Abstract
Background: Recently, laparoscopic sleeve gastrectomy (LSG) as a standalone bariatric procedure has rapidly gained popularity worldwide mainly because of its technical simplicity and the relatively good short-term outcome. In Japan, according to a domestic survey, 71 % of the bariatric procedures performed were LSG. However, the number of studies reporting long-term results are still not enough; particularly, data for Asian patients are scarce. Objective: The objective of this study was to evaluate the long-term outcomes for LSG in morbidly obese Japanese regarding weight loss and safety. Methods: Between October 2005 and July 2013, 179 morbidly obese Japanese patients (Female 89/Male 90) underwent LSG as a standalone procedure. The mean age was 40.7 years (range, 20-72 years), and the mean preoperative body weight and body mass index (BMI) were 120.4 kg (range, 71.4-231.6 kg) and 43.3 kg/m (range, 30.9-76.5 kg/m), respectively. All patients were evaluated and managed under a strict multidisciplinary team approach. Results: The mean BMI declined to 30.0 ± 8.7 kg/m at 1 year, 29.1 ± 8.6 kg/m at 2 years, 28.8 ± 8.7 kg/m at 3 years, 29.3 ± 9.2 kg/m at 4 years, and 32.7 ± 13.6 kg/m at 5 years or more ( p < 0.001). The mean percent total body weight loss (%TWL) achieved was 32.4 ± 12.9 % at 1 year, 34.3 ± 12.9 % at 2 years, 34.4 ± 11.6 % at 3 years, 32.8 ± 10.9 % at 4 years, and 29.5 ± 11.8 % at 5 years or more. Super morbidly obese patients and patients whose gastric tube was created using a thicker (45 Fr.) bougie had a tendency to achieve less weight loss. Early and late complications occurred in 16 patients (8.9 %) and in seven patients (3.9 %), respectively. Revision surgeries were required in six patients (3.4 %). The reasons for revision surgery were insufficient weight loss in five patients and intractable gastroesophageal reflux disease (GERD) in one patient. Conclusion: LSG for Japanese morbidly obese patients is safe, effective, and acceptably durable up to 5 years although some complications unique to the procedure such as leakage from the staple line and intractable GERD occur. For super morbidly obese patients, other surgical options may be required.
- Subjects
JAPAN; GASTRECTOMY; LAPAROSCOPIC surgery; OVERWEIGHT persons; TREATMENT effectiveness; PUBLIC health
- Publication
Obesity Surgery, 2016, Vol 26, Issue 1, p138
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-015-1728-1