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Laparoscopic Sleeve Gastrectomy for Morbid Obesity: 5 Years Experience from an Asian Center of Excellence

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is emerging as a popular “stand-alone” bariatric procedure. We report our 5 years experience with LSG as a single-stage bariatric procedure with which to study the technical progress, learning curve, complications, and follow-up results.

Methods

Prospectively collected data of 228 patients (145 females and 83 males), who underwent LSG for morbid obesity, from February 2007 to March 2012, was retrospectively analyzed.

Results

The mean age was 34.68 years (range, 18–62 years) and the mean preoperative body mass index (BMI) was 37.42 ± 4.75 kg/m2 (range, 32.08–65.69 kg/m2). Mean operative time was 60.63 ± 27.37 min. The mean BMI decreased to 26.15 ± 3.71 kg/m2 at 3 years (p < 0.001) and to 27.94 ± 4.08 kg/m2 at 5 years (p < 0.001). Mean percentage excess weight loss was 71.96 ± 21.30 % at 3 years and 63.71 ± 20.08 % at 5 years. The 30-day readmission rate was 3.07 %.Overall complication rate was 4.3 %, including strictures, leaks, peritonitis, gastrocutaneous fistula, and one (0.43 %) mortality. One patient with weight regain and another with stricture underwent conversion to Roux-en-Y gastric bypass. Complication rates significantly decreased after the first 50 cases (p = 0.022), suggesting an initial learning curve. Resolution of diabetes, hypertension, and hyperlipidemia was 66.67, 100, and 50 %, respectively, at 5 years.

Conclusions

LSG as a single-stage bariatric procedure is safe and durable, achieving weight loss and resolution of comorbidities up to 5 years. Adherence to technical details is pivotal in reducing complications associated with the initial learning phase.

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Acknowledgments

The authors would like to thank the entire staff of the Bariatric Surgery Center, E-Da Hospital for their help in obtaining the necessary information required for this paper and especially thank Miss Ivy Huang, the case manager, for helping with the data retrieval.

Conflicts of Interest

All authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Bariatric and Metabolic International Surgery Centre, E-Da Hospital, No. 1, E-Da Road, Jiaosu Village, Yan-chau District, Kaohsiung City, 82445, Taiwan

    Sanoop Koshy Zachariah, Po-Chih Chang, Andrea Se En Ooi, Ming-Che Hsin, Jason Yiu Kin Wat & Chih Kun Huang

  2. The Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510182, China

    Chih Kun Huang

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  1. Sanoop Koshy Zachariah
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  2. Po-Chih Chang
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Correspondence to Chih Kun Huang.

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Zachariah, S.K., Chang, PC., Ooi, A.S.E. et al. Laparoscopic Sleeve Gastrectomy for Morbid Obesity: 5 Years Experience from an Asian Center of Excellence. OBES SURG 23, 939–946 (2013). https://doi.org/10.1007/s11695-013-0887-1

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