title: Sleeve gastrectomy as a stand-alone bariatric operation for severe, morbid, and super obesity.
abstract: BACKGROUND
  The laparoscopic sleeve gastrectomy (LSG) is emerging as an effective bariatric operation and is especially attractive in high-risk populations. In this study we examine the efficacy of LSG as a stand-alone operation in the veteran population.
  
  
  METHODS
  This is a retrospective review of consecutive patients who underwent LSG as a stand-alone procedure at the Palo Alto Veterans Affairs medical center with a minimum 12-month follow-up.
  
  
  RESULTS
  Of 205 patients undergoing bariatric surgery, 71 patients had a sleeve gastrectomy, 40 of whom had the operation performed at least 12 months previously. Thirty-six (90%) were available for 1-year follow-up, with a mean follow-up duration of 22 months (range: 12-42), a mean body mass index of 48.3 kg/m(2), and an 83% male population. Mean percent excess weight loss was 61% at an average of 22 months, with no significant difference between severely obese, morbidly obese, and super obese cohorts. Diabetes remission was seen in 56% of patients, hypertension remission in 51.6%, and obstructive sleep apnea remission in 46.4%, and gastroesophageal reflux disease improved or did not change in 83%. Medication use significantly decreased after surgery.
  
  
  CONCLUSIONS
  LSG is safe and effective as a stand-alone bariatric operation in the high-risk veteran population. It is effective in severely obese, morbidly obese, and super obese patients. LSG induces remission or improvement in comorbidities of nearly all patients, translating to a decrease in medication use.
authors.affiliation: Department of Surgery, Stanford School of Medicine, Stanford, CA, USA. daneisenberg@stanford.edu
authors.forename: Dan
authors.initials: D
authors.lastname: Eisenberg
authors.forename: Anna
authors.initials: A
authors.lastname: Bellatorre
authors.forename: Nina
authors.initials: N
authors.lastname: Bellatorre
mesh_terms: D000368:Aged; D050110:Bariatric Surgery / Q000379:methods*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000601:surgery*; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology