Laparoscopic sleeve gastrectomy: long-term weight loss outcomes

Background: Laparoscopic sleeve gastrectomy (LSG) has become an increasingly popular stand-alone weight loss surgery, but there is a paucity of long-term efficacy data. Objective: To determine long-term outcomes for patients undergoing LSG. Setting: Tertiary care university hospital in the United States. Methods: This study presents a case series of the first 16 patients undergoing LSG at our institution. Inclusion criteria were accepted indications for bariatric surgery, and exclusion criteria were any prior bariatric surgery, gastrectomy, substance abuse, uncontrolled psychiatric illness, end-stage organ disease, or advanced-stage cancer. Patients were followed for 7 years. Outcomes included percent excess weight loss (%EWL), percent weight loss (%WL), resolution of co-morbidities, and major and minor complications. Results: Patients enrolled in this study had a mean body mass index (BMI) of 43.5 kg/m(2) and a mean age of 49, and 14 of 16 patients were women. Fourteen of 16 patients had 7-year follow-ups with a mean %WL of 29.6% +/- 8.95 and a mean %EWL of 59.6% +/- 89.9%. At 7 years, 11 of 14 patients achieved >50% EWL. One-year follow-up data revealed a mean EWL of 72% +/- 20%, which was significantly greater than the %EWL at 7 years (P = .005). Complications included 1 partial obstruction at the gastric incisura angularis and 1 subacute leak; both were managed endoscopically. There were no reoperations and no deaths. Five of 14 patients experienced new-onset gastroesophageal reflux disease. Conclusions: At 7 years postoperative, the LSG remained a durable and successful operation. (C) 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.