Short- and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry.
BACKGROUND
Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and long-term results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric procedure.


METHODS
Data were obtained from 17 centers and collected in a database. Technical issues, preoperative comorbid conditions, hospital stay, early and late complications, and short- and mid-term weight loss were analyzed.


RESULTS
Five hundred forty patients were included; 76% were women. Mean BMI was 48.1 +/- 10. Mean age was 44.1 +/- 11.8. Morbidity rate was 5.2% and mortality rate 0.36%. Complications presented more frequently in superobese patients (OR, 2.8 (1.18-6.65)), male (OR, 2.98 (1.26-7.0)), and patients >55 years old (OR, 2.8 (1.14-6.8)). Staple-line reinforcement was related to a lower complication rate (3.7 vs 8.8%; p = 0.039). Mean hospital stay was 4.8 +/- 8.2 days. Mean follow-up was 16.5 +/- 10.6 months (1-73). Mean percent excess BMI loss (EBL) at 3 months was 38.8 +/- 22, 55.6 +/- 8 at 6 months, 68.1 +/- 28 at 12 months, and 72.4 +/- 31 at 24 months. %EBL was superior in patients with lower initial BMI and lower age. Bougie caliber was an inverse predictive factor of %EBL at 12 and 24 months (RR, 23.3 (11.4-35.2)). DM is remitted in 81% of the patients and HTA improved in 63.2% of them. A second-stage surgery was performed in 18 patients (3.2%).


CONCLUSIONS
LSG provides good short- and mid-term results with a low morbid-mortality rate. Better results are obtained in younger patients with lowest BMI. Staple-line reinforcement and a thinner bougie are recommended to improve outcome.
Sánchez-Santos
Raquel
R
Servicio de Cirugía General y Digestiva, Complejo Hospitalario de Pontevedra, C/Mourente s/n, Pontevedra 36021, Spain. raquelsanchezsantos@gmail.com
Masdevall
Carlos
C
Baltasar
Aniceto
A
Martínez-Blázquez
Candido
C
García Ruiz de Gordejuela
Amador
A
Ponsi
Enric
E
Sánchez-Pernaute
Andres
A
Vesperinas
Gregorio
G
Del Castillo
Daniel
D
Bombuy
Ernest
E
Durán-Escribano
Carlos
C
Ortega
Luis
L
Ruiz de Adana
Juan Carlos
JC
Baltar
Javier
J
Maruri
Ignacio
I
García-Blázquez
Emilio
E
Torres
Antonio
A
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D012042:Registries; D013030:Spain / Q000453:epidemiology; D013536:Suture Techniques; D016896:Treatment Outcome; D015431:Weight Loss