Laparoscopic Sleeve Gastrectomy – a Retrospective Review of 250 Cases
Abstract
Introduction: Vertical calibrated gastrectomy, usually know as “gastric sleeve” (SG) by laparoscopy, is a promising technique for the surgical treatment of obesity. In this study, we present the results of our surgical center with this surgical procedure, compared them with other published studies and analyzed its impact on weight loss evolution. Material and methods: Observational retrospective study of 250 SG. Surgeries were included independently of being primary SG or redo surgery. The weight evolution data was analyzed only in patients submitted to SG as a primary bariatric procedure. Results: We found a mean operative time of 119 minutes, conversion to laparotomy in 2,0% of patients. Global 30-days morbidity of 15,6%, mostly minor complications (10,8%). Two surgical-related deaths (0,8%). The readmission rate was 9,2% and the reintervention rate was 5,6%. An anastomotic leak occurred in 2,8% of the patients. Mean pre-operative BMI was 44,6kg/m2 and the percentage of excess weight loss at one and two years after surgery was 78,5% and 81,5% respectively. Discussion: The results presented in this study are similar to those published in other case series when it comes to mean age, complications and laparotomy conversion rates. The observed weight loss was sustained throughout the follow-up period and was similar to that observed in other studies of both gastric sleeve and gastric by-pass. Conclusion: The results of this study support the validity of the use of gastric sleeve in the surgical treatment of morbid obesity as a good technical option.
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References
2. Obesity and overweight. Fact sheet N°311. May 2012. at http://www.who.int/mediacentre/factsheets/fs311/en/index.html.)
3. do Carmo I, Dos Santos O, Camolas J, et al. Overweight and obesity in Portugal: national prevalence in 2003-2005. Obes Rev 2008;9:11-9.
4. Austrheim-Smith I, Brethauer SA, Rogula T, Wolfe BM. Evolution of Bariatric Minimally Invasive Surgery. In: Schauer PR, Schirmer BD, Brethauer SA, eds. Minimally invasive bariatric surgery. New York: Springer; 2007:17-24.
5. Jossart G, Anthone G. The history of sleeve gastrectomy. Bariatric Times 2010;7:9-10.
6. Buchwald H, Estok R, Fahrbach K, Banel D, Sledge I. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery 2007;142:621-32; discussion 32-5.
7. Moreno-Egea A, Carrasco L, Girela E, Martin JG, Aguayo JL, Canteras M. Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. Archives of surgery 2002;137:1266-8.
8. Barnes TG, McFaul C, Abdelrazeq AS. Laparoscopic transabdominal preperitoneal repair of spigelian hernia-closure of the fascial defect is not necessary. Journal of laparoendoscopic & advanced surgical techniques Part A 2014;24:66-71.
9. Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg 2003;13:159-60.
10. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-13.
11. Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg 2012;22:721-31.
12. Deitel M, Crosby RD, Gagner M. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25-27, 2007. Obes Surg 2008;18:487-96.
13. Gagner M, Deitel M, Kalberer TL, Erickson AL, Crosby RD. The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009. Surg Obes Relat Dis 2009;5:476-85.
14. Deitel M, Gagner M, Erickson AL, Crosby RD. Third International Summit: Current status of sleeve gastrectomy. Surg Obes Relat Dis 2011;7:749-59.
15. Franco JV, Ruiz PA, Palermo M, Gagner M. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obesity surgery 2011;21:1458-68.
16. Garb J, Welch G, Zagarins S, Kuhn J, Romanelli J. Bariatric surgery for the treatment of morbid obesity: a meta-analysis of weight loss outcomes for laparoscopic adjustable gastric banding and laparoscopic gastric bypass. Obesity surgery 2009;19:1447-55.
17. O’Brien PE, McPhail T, Chaston TB, Dixon JB. Systematic review of medium-term weight loss after bariatric operations. Obesity surgery 2006;16:1032-40.
