Elsevier

Surgery for Obesity and Related Diseases

Volume 10, Issue 1, January–February 2014, Pages 177-183
Surgery for Obesity and Related Diseases

Review article
Review of long-term weight loss results after laparoscopic sleeve gastrectomy

https://doi.org/10.1016/j.soard.2013.11.007Get rights and content

Abstract

Sleeve gastrectomy (SG) has gained enormous popularity both as a first-stage procedure in high-risk super-obese patients and as a stand-alone procedure. The objective of this study was to evaluate the long-term weight loss results after SG published in the literature and compare them with the well-documented short-term and mid-term weight loss results. A detailed search in PubMed using the keywords “sleeve gastrectomy” and “long-term results” found 16 studies fulfilling the criteria of this study. A total of 492 patients were analyzed, with a follow-up of at least 5 years after laparoscopic sleeve gastrectomy (LSG) (373 at 5 years, 72 at 6 years, 13 at 7 years, and 34 at 8 or more years). Of the total number of patients, 71.1% were women (15 studies, n = 432 patients). Mean patient age was 45.1 years (15 studies, n = 432 patients). Mean preoperative body mass index in all 16 studies was 49.2 kg/m2. The mean percentage excess weight loss (%EWL) was 62.3%, 53.8%, 43%, and 54.8% at 5, 6, 7, and 8 or more years after LSG, respectively. The overall mean %EWL (defined as the average %EWL at 5 or more years after LSG) was 59.3% (12 studies, n = 377 patients). The overall attrition rate was 31.2% (13 studies). LSG seems to maintain its well-documented weight loss outcome at 5 or more years postoperatively, with the overall mean %EWL at 5 or more years after LSG still remaining>50%. The existing data support the role of LSG in the treatment of morbid obesity.

Section snippets

Materials and methods

A detailed search in PubMed for citations that included sleeve gastrectomy, using the keywords “sleeve gastrectomy 5-year weight loss results” found>100 studies. After an initial review of these studies, only 16 reports seemed to match our criteria; a review of these reports was conducted and the full text was reviewed.

Prospective and retrospective series reporting on LSG as a primary or as a staged procedure for the treatment of severe obesity were included if they reported weight loss results

Study characteristics

A total of 16 studies [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22] were extracted for the present review. Of the 16 studies, 8 were from Europe, 6 were from the United States, 1 was from Asia, and the remaining originated in Latin America. All studies, except for one [20], were from a single institution. Of the 16 studies, 4 stated clearly that SG was used as part of a staged therapeutic procedure or as a management strategy for a high-risk patient

Discussion

“Durable” weight loss is one important benefit of bariatric surgery, and this is a standard by which success or failure of weight-reducing procedures is measured. One of the most important issues regarding LSG is the durability of the weight loss result several years after the operation and, especially, at 5 or more years postoperatively. Most of the published studies agree that weight regain might be observed in patients after LSG at various time intervals after the operation and can be

Conclusion

LSG may be performed either as part of a staged approach in high-risk patients or as a primary bariatric procedure. The results of the present study show that LSG seems to maintain its well-documented weight loss outcome at 5 or more years postoperatively, with the overall mean %EWL at 5 or more years after LSG still remaining>50%. The existing data support the role of LSG in the treatment of morbid obesity.

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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