Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity:A prospective study

作     者：Carlos Hoyuela 

作者机构：Department of General and Digestive SurgeryHospital PlatóUniversitat Autònoma de Barcelona08006 BarcelonaSpain 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第4期

页      面：109-117页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：袖子 gastrectomy 疾病的肥胖 Bariatric 外科 肥胖外科 Laparoscopy 长期的结果 5 年的结果 

摘      要：AIM To prospectively evaluate the postoperative morbimortality and weight loss evolution of patients who underwent a laparoscopic sleeve gastrectomy(LSG) as a primary bariatric procedure during 5 years of follow-up. METHODS Since 2006,data from patients undergoing a highly restrictive primary LSG have been prospectively registered in a database and analysed. Preoperative co-morbid conditions,operating time,hospital stay,early and late complications rate and evolution of weight loss after 5 years of follow-up were analysed.RESULTS A total of 156 patients were included,74.3% of whom were women. The mean age was 43.2 ± 13.1 years and the mean body mass index(BMI) was 41.5 ± 7.9 kg/m^2. Seventy patients(44.8%) presented a BMI under 40 kg/m^2. The mortality rate was 0%. The leakage rate was 1.2%,and the total 30-d morbidity rate was 5.1%(8/156). With a mean follow-up of 32.7 ± 28.5(range 6-112) mo,the mean percent of excess of weight loss(%EWL) was 82.0 ± 18.8 at 1 year,76.7 ± 21.3 at 3 years and 60.3 ± 28.9 at 5 years. The mean percent of excess of BMI loss(%EBMIL) was 94.9 ± 22.4 at 1 year,89.4 ± 27.4 at 3 years and 74.8 ± 29.4 at 5 years. Patients with preoperative BMI less than 40 kg/m^2 achieved greaterweight loss than did the overall study population. Diabetes remitted in 75% of the patients and HTA improved in 71.7%. CPAP masks were withdrawn in all patients with obstructive sleep apnoea.CONCLUSION LSG built with a narrow 34 F bougie and starting 3 cm from the pylorus proved to be safe and highly effective in terms of weight loss as a stand-alone procedure,particularly in patients with a preoperative BMI lower than 40 kg/m^2.