Early results of a Canadian laparoscopic sleeve gastrectomy experience.
BACKGROUND
Sleeve gastrectomy (SG) is a relatively new bariatric procedure with a number of advantages compared with Roux-en-Y gastric bypass. However, SG also has a number of disadvantages and associated risks. We sought to examine perioperative complications and outcomes of laparoscopic SG (LSG) in a single major Canadian bariatric surgery centre (Victoria, BC).


METHODS
Since June 2008, LSG has been performed at our centre and we reviewed the cases of all patients. We conducted a retrospective chart review in April 2010.


RESULTS
Thirty-four patients had LSG, and none was lost to follow-up. Indications for LSG over other bariatric procedures were patient preference (n=28), severe obesity with a body mass index (BMI) greater than 60 kg/m(2) (n=5) and severe upper abdominal adhesions (n=1). All but 1 of the cohort were women, and the average age was 48 (standard deviation [SD] 11) years. Preoperatively, the average BMI was 50.3 (SD 7.7) kg/m(2). Preoperative obesity-related comorbidity rates were 56% (n=19) for type 2 diabetes mellitus (T2DM), 50% (n=17) for hypertension, 32% (n=11) for dys lipidemia, 62% (n=21) for obstructive sleep apnea (OSA), 62% (n=21) for knee and/or hip pain and 44% (n=15) for depression and/or anxiety. The mean duration of surgery was 74 (SD 21) minutes. There were 2 major perioperative complications: 1 staple line leak and 1 staple line hemorrhage. The median stay in hospital was 1 day. Postoperative upper gastrointestinal imaging studies were conducted in 11 patients; 1 was positive for staple line leak. Histopathology on the excised gastric segments revealed chronic helicobacter pylori gastritis in 2 patients and small gastrointestinal stromal tumours in 1 patient. The mean postoperative follow-up interval was 10 months. Weight loss averaged 27.4 (SD 9.0) kg. Overall weight loss was 3.3 (SD 1.8) kg/month. Resolution occurred in 74% of patients with T2DM, 53% with hypertension, 45% with dyslipidemia, 76% with OSA, 38% with joint pain and 20% with depression/anxiety. Overall satisfaction was rated as excellent by 68% of patients, good by 29% and poor by 3% of patients.


CONCLUSIONS
Preliminary analysis of our experience with LSG indicates that this is an effective and safe procedure for the treatment of obesity.
Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
Carola
C
Behrens
Bao Q
BQ
Tang
Bradley J
BJ
Amson
D000328:Adult; D000368:Aged; D002170:Canada; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
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