Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow-up of 1 year.
BACKGROUND
The aim of the study is to look at laparoscopic sleeve gastrectomy as a procedure with intent to cure morbid obesity. Secondary endpoints are related to the safety profile of the procedure.


METHODS
This is a prospective clinical study conducted in a single university surgical clinic.


RESULTS
Two hundred sixty-one patients (2.5:1 female to male ratio, median age of 37 years) underwent sleeve gastrectomy. Median preoperative body mass index (BMI) was 45.2 kg/m(2). Mortality and morbidity rates were 0.7% and 8.4%, respectively. Risk factors for postoperative complications were history of diabetes mellitus under medical treatment (OR, 4.0; p = 0.014) and prior bariatric operation on the same patient (OR, 5.7, p = 0.034). Median follow-up was 12 months (range 1-29 months). A BMI > 50 kg/m(2) is connected with greater weight loss. Analysis of the percentage of excess weight loss (%EWL) during follow-up at specific time intervals showed a rapid increase for the first 12 months followed by a more gradual rise thereafter. The median %EWL for the first year of follow-up was 65.7 (range 33.8-102.3). The median BMI for the patients that had completed at least 1 year of follow-up was 30.5 kg/m(2) (range 21.2-42.7). The overall success rate after the first year was 74.3% when accounted for %EWL > 50 and 81.7% for BMI < 35 kg/m(2).


CONCLUSIONS
The actual long-term efficacy of the procedure remains to be confirmed. Morbidity rates may prove higher than expected especially during the learning curve.
Menenakos
Evangelos
E
Department of Endoscopic Surgery, Hippocratio Hospital, 20-22, Alkimahou Street, Athens, 11634, Greece.
Stamou
Konstantinos M
KM
Albanopoulos
Konstantinos
K
Papailiou
Joanna
J
Theodorou
Demetrios
D
Leandros
Emmanuel
E
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects; D015390:Gastric Bypass / Q000379:methods* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult