Midterm results of primary vs. secondary laparoscopic sleeve gastrectomy (LSG) as an isolated operation.
BACKGROUND
We investigated early and midterm results of laparoscopic sleeve gastrectomy (LSG) as an isolated primary and secondary operation after failed gastric banding.


METHODS
Between May 2004 and October 2007, a total of 70 patients (female 77%, mean age 43 (21-65) years, mean initial body mass index (BMI) 46 (35-61) kg/m(2)) were prospectively evaluated and operated by LSG. In 41 patients, LSG was performed as a primary operation (group 1) and in 29 patients as a secondary procedure after failed gastric banding (group 2). The overall average follow-up time after LSG was 24 (12-53) months; follow-up rate 1 year after operation was 100%, after 2 years 98%, and after 3 years 95%.


RESULTS
There were no intraoperative complications, no conversion with shorter operation time in group 1 (91 vs. 132 min, p = 0.001). Early morbidity of LSG was 5% (major) and 7% (minor); mortality was zero. Average excessive BMI loss after 1 year was 65% (9-127%), after 2 years 63% (13-123%), and after 3 years 60% (9-111%). Midterm morbidity was 13%. There was no significant difference between the two groups regarding early and midterm morbidity, reoperation rate for complications (11.4%), or insufficient weight loss (7%).


CONCLUSIONS
LSG is a safe bariatric procedure with good weight loss in the first 3 years postop. It can be used as an isolated initial treatment and as a secondary treatment after failed gastric banding. However, in the absence of long-term results, we suggest LSG to be performed only in controlled trials.
Uglioni
Bettina
B
Department of Surgery, Claraspital, Kleinriehenstrasse 30, 4016, Basel, Switzerland.
Wölnerhanssen
Bettina
B
Peters
Thomas
T
Christoffel-Courtin
Caroline
C
Kern
Beatrice
B
Peterli
Ralph
R
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D012086:Reoperation; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult