Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure.
BACKGROUND
Laparoscopic sleeve gastrectomy is increasingly being used as a stand-alone procedure in bariatric surgery, with medium-term follow-up data now emerging. We present our early experience in patients with a mean body mass index (BMI) in the super-obese range.


METHODS
Review of prospectively collected data for the first 100 patients who underwent laparoscopic sleeve gastrectomy at Counties Manukau District Health Board between March 2007 and July 2008.


RESULTS
One hundred patients were identified, with a mean age of 43 years (range, 20-60 years). Maori and Pacific Islanders made up 31% of the patient subset. Patients had a mean BMI of 50.3 kg/m(2) (range, 34.5-72.8 kg/m(2)). Forty-five patients were super-obese. The median hospital stay was 2 days (range, 1-7 days). Mean follow-up was 12.0 months (range, 0.9-23.3 months). Mean excess weight loss was 62.9% (range, 7.2-129.0%). Twenty-five percent of patients were diabetic and 45% of patients were hypertensive pre-operatively. Diabetics and hypertension resolved or improved in 72% and 60% of patients, respectively. There was a major complication rate of 7%, including three staple-line leaks (one requiring laparotomy), two staple-line bleeds (one requiring laparotomy) and one infected haematoma. There were no deaths.


CONCLUSIONS
In this public hospital setting, laparoscopic sleeve gastrectomy has achieved satisfactory weight loss results with an acceptable complication rate in the medium-term.
Sammour
Tarik
T
Department of Surgery, South Auckland Clinical School, Middlemore Hospital, Private Bag, 93311, Otahuhu, Auckland, New Zealand. sammour@middlemore.co.nz
Hill
Andrew G
AG
Singh
Parry
P
Ranasinghe
Anudini
A
Babor
Richard
R
Rahman
Habib
H
D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology / Q000209:etiology; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult