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Is sleeve gastrectomy a therapeutic procedure for all obese patients?
Int J Surg. 2016 Jun; 30:48-55.IJ

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) is a worldwide surgical procedure for morbid obesity. However patients selection is still anecdotal. The aim of this study is to analyse clinical and anthropometric parameters correlated with LSG and to check the validity of this procedure for different categories of obese patients.

METHODS

Two-hundred one consecutive patients were submitted to LSG as a primary bariatric procedure between 2008 and 2014. One year follow-up was completed in 159 patients. Smaller groups of patients completed 2 and 3 years follow-up (78, 46 patients respectively). Median preoperative body mass index (BMI) was 45.4 kg/m2 (range: 34.8-73.8); 135 patients (80%) had one or more comorbidities. Potential correlations between age, gender, preoperative BMI, preoperative excess weight, early excess weight loss (EWL) and 1 and 3 year-EWL were investigated.

RESULTS

All procedures were regularly completed with laparoscopic approach without conversion to laparotomy. Postoperative complications occurred in six patients (3.7%); no postoperative mortality was observed. Median one-year BMI and EWL were 32.8 kg/m2 and 55.34%, respectively. Three year-EWL was significantly influenced by age, and early EWL. A complete normalization of glycemic levels after the three-year follow-up was also observed in high percentage of diabetic patients. In patients with preoperative BMI>50 kg/m2 we observed most failure cases in terms of EWL and the worst metabolic results.

CONCLUSIONS

Our experience indicates that LSG is a safe procedure with satisfactory three-year late weight loss in patients with preoperative BMI <50 kg/m2. Promising results, in terms of improvements of comorbidities, were also observed. These results make LSG one of the most attractive first stage surgical procedure for morbid obesity.

Authors+Show Affiliations

Department of Medicine, Surgery and Neurosciences, Unit of Bariatric Surgery, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.Department of Medicine, Surgery and Neurosciences, Unit of Bariatric Surgery, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.Department of Medicine, Surgery and Neurosciences, Unit of Bariatric Surgery, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.Department of Medicine, Surgery and Neurosciences, Unit of Bariatric Surgery, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.Department of Medicine, Surgery and Neurosciences, Unit of General Surgery, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy. Electronic address: frr.fra@gmail.com.Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27109203

Citation

Vuolo, Giuseppe, et al. "Is Sleeve Gastrectomy a Therapeutic Procedure for All Obese Patients?" International Journal of Surgery (London, England), vol. 30, 2016, pp. 48-55.
Vuolo G, Voglino C, Tirone A, et al. Is sleeve gastrectomy a therapeutic procedure for all obese patients? Int J Surg. 2016;30:48-55.
Vuolo, G., Voglino, C., Tirone, A., Colasanto, G., Gaggelli, I., Ciuoli, C., Ferrara, F., & Marrelli, D. (2016). Is sleeve gastrectomy a therapeutic procedure for all obese patients? International Journal of Surgery (London, England), 30, 48-55. https://doi.org/10.1016/j.ijsu.2016.04.026
Vuolo G, et al. Is Sleeve Gastrectomy a Therapeutic Procedure for All Obese Patients. Int J Surg. 2016;30:48-55. PubMed PMID: 27109203.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is sleeve gastrectomy a therapeutic procedure for all obese patients? AU - Vuolo,Giuseppe, AU - Voglino,Costantino, AU - Tirone,Andrea, AU - Colasanto,Giuseppina, AU - Gaggelli,Ilaria, AU - Ciuoli,Cristina, AU - Ferrara,Francesco, AU - Marrelli,Daniele, Y1 - 2016/04/22/ PY - 2015/12/14/received PY - 2016/04/12/revised PY - 2016/04/14/accepted PY - 2016/4/26/entrez PY - 2016/4/26/pubmed PY - 2017/3/23/medline KW - Bariatric surgery KW - Excess weight loss KW - Morbidity KW - Obesity KW - Sleeve gastrectomy SP - 48 EP - 55 JF - International journal of surgery (London, England) JO - Int J Surg VL - 30 N2 - BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a worldwide surgical procedure for morbid obesity. However patients selection is still anecdotal. The aim of this study is to analyse clinical and anthropometric parameters correlated with LSG and to check the validity of this procedure for different categories of obese patients. METHODS: Two-hundred one consecutive patients were submitted to LSG as a primary bariatric procedure between 2008 and 2014. One year follow-up was completed in 159 patients. Smaller groups of patients completed 2 and 3 years follow-up (78, 46 patients respectively). Median preoperative body mass index (BMI) was 45.4 kg/m2 (range: 34.8-73.8); 135 patients (80%) had one or more comorbidities. Potential correlations between age, gender, preoperative BMI, preoperative excess weight, early excess weight loss (EWL) and 1 and 3 year-EWL were investigated. RESULTS: All procedures were regularly completed with laparoscopic approach without conversion to laparotomy. Postoperative complications occurred in six patients (3.7%); no postoperative mortality was observed. Median one-year BMI and EWL were 32.8 kg/m2 and 55.34%, respectively. Three year-EWL was significantly influenced by age, and early EWL. A complete normalization of glycemic levels after the three-year follow-up was also observed in high percentage of diabetic patients. In patients with preoperative BMI>50 kg/m2 we observed most failure cases in terms of EWL and the worst metabolic results. CONCLUSIONS: Our experience indicates that LSG is a safe procedure with satisfactory three-year late weight loss in patients with preoperative BMI <50 kg/m2. Promising results, in terms of improvements of comorbidities, were also observed. These results make LSG one of the most attractive first stage surgical procedure for morbid obesity. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/27109203/Is_sleeve_gastrectomy_a_therapeutic_procedure_for_all_obese_patients L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(16)30056-5 DB - PRIME DP - Unbound Medicine ER -