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Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity.
Surgery. 2009 Jan; 145(1):106-13.S

Abstract

BACKGROUND

Sleeve gastrectomy is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. The authors report their experience of laparoscopic sleeve gastrectomy (LSG), evaluate the efficacy of this procedure on weight loss, and analyze the short-term outcome.

METHODS

The data of 135 consecutive patients undergoing LSG between July 2004 and October 2007 were analyzed prospectively. LSG was indicated only for weight reduction with a body mass index (BMI) > 40 or > 35 kg/m(2) associated with severe comorbidity. Study endpoints included mean BMI, comorbidity, operative data, conversion to laparotomy, intraoperative complications, major and minor complication rates, excess weight loss, follow-up, and duration of hospital stay. Possible risk factors for postoperative gastric fistula (PGF) were investigated.

RESULTS

This series comprised 113 females and 22 males with a mean age of 40 years (range, 18-65). Mean weight was 132 kg (range, 94-186), and mean preoperative BMI was 48.8 kg/m(2) (range, 37-72). The mean operating time was 103 minutes (range, 30-550). No patients required conversion to laparotomy, and 96% of patients did not require drainage. The nasogastric tube was removed on postoperative day 1. The postoperative course was uneventful in 94.9% of cases, and the median duration of hospital stay was 3.8 days. The median follow-up was 12.7 months. The mean postoperative BMI decreased to 39.8 kg/m(2) at 6 months (P < .001). Average excess body weight loss was 38.6% and 49.4% at 6 months and 1 year, respectively. There was no mortality, and the major complication rate, corresponding to gastric fistula (PGF) in every case, was 5.1% (n = 7). Management of PGF required reoperation, radiologic and endoscopic procedures, and fibrin glue; the median hospital stay was 47 days. BMI > 60 kg/m(2) appears to be a risk factor for PGF.

CONCLUSION

LSG is a reproducible and seems to be an effective treatment to achieve significant weight loss after 12 months follow-up. LSG can be used as a standalone operation to obtain weight reduction. Management of PGF remains a major issue.

Authors+Show Affiliations

Federation of Digestive Diseases, Amiens North Hospital, University of Picardy, Amiens, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19081482

Citation

Fuks, David, et al. "Results of Laparoscopic Sleeve Gastrectomy: a Prospective Study in 135 Patients With Morbid Obesity." Surgery, vol. 145, no. 1, 2009, pp. 106-13.
Fuks D, Verhaeghe P, Brehant O, et al. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery. 2009;145(1):106-13.
Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., Delcenserie, R., & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-13. https://doi.org/10.1016/j.surg.2008.07.013
Fuks D, et al. Results of Laparoscopic Sleeve Gastrectomy: a Prospective Study in 135 Patients With Morbid Obesity. Surgery. 2009;145(1):106-13. PubMed PMID: 19081482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. AU - Fuks,David, AU - Verhaeghe,Pierre, AU - Brehant,Olivier, AU - Sabbagh,Charles, AU - Dumont,Frederic, AU - Riboulot,Michel, AU - Delcenserie,Richard, AU - Regimbeau,Jean-Marc, Y1 - 2008/09/30/ PY - 2007/12/21/received PY - 2008/07/07/accepted PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/1/14/medline SP - 106 EP - 13 JF - Surgery JO - Surgery VL - 145 IS - 1 N2 - BACKGROUND: Sleeve gastrectomy is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. The authors report their experience of laparoscopic sleeve gastrectomy (LSG), evaluate the efficacy of this procedure on weight loss, and analyze the short-term outcome. METHODS: The data of 135 consecutive patients undergoing LSG between July 2004 and October 2007 were analyzed prospectively. LSG was indicated only for weight reduction with a body mass index (BMI) > 40 or > 35 kg/m(2) associated with severe comorbidity. Study endpoints included mean BMI, comorbidity, operative data, conversion to laparotomy, intraoperative complications, major and minor complication rates, excess weight loss, follow-up, and duration of hospital stay. Possible risk factors for postoperative gastric fistula (PGF) were investigated. RESULTS: This series comprised 113 females and 22 males with a mean age of 40 years (range, 18-65). Mean weight was 132 kg (range, 94-186), and mean preoperative BMI was 48.8 kg/m(2) (range, 37-72). The mean operating time was 103 minutes (range, 30-550). No patients required conversion to laparotomy, and 96% of patients did not require drainage. The nasogastric tube was removed on postoperative day 1. The postoperative course was uneventful in 94.9% of cases, and the median duration of hospital stay was 3.8 days. The median follow-up was 12.7 months. The mean postoperative BMI decreased to 39.8 kg/m(2) at 6 months (P < .001). Average excess body weight loss was 38.6% and 49.4% at 6 months and 1 year, respectively. There was no mortality, and the major complication rate, corresponding to gastric fistula (PGF) in every case, was 5.1% (n = 7). Management of PGF required reoperation, radiologic and endoscopic procedures, and fibrin glue; the median hospital stay was 47 days. BMI > 60 kg/m(2) appears to be a risk factor for PGF. CONCLUSION: LSG is a reproducible and seems to be an effective treatment to achieve significant weight loss after 12 months follow-up. LSG can be used as a standalone operation to obtain weight reduction. Management of PGF remains a major issue. SN - 1532-7361 UR - https://www.unboundmedicine.com/medline/citation/19081482/Results_of_laparoscopic_sleeve_gastrectomy:_a_prospective_study_in_135_patients_with_morbid_obesity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0039-6060(08)00482-0 DB - PRIME DP - Unbound Medicine ER -