title: Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy.
abstract: BACKGROUND
  LSG has been increasingly performed. Long-term follow-up is necessary.
  
  
  METHODS
  During the Fourth International Consensus Summit on LSG in New York Dec. 2012, an online questionnaire (SurveyMonkey®) was filled out by 130 surgeons experienced in LSG. The survey was submitted directly to the statisticians.
  
  
  RESULTS
  The 130 surgeons performed 354.9 ± SD 453 LSGs/surgeon (median 175), for a total of 46,133 LSGs. The LSGs had been performed over 4.9 ± 2.7 year (range 1-10). Of the 46,133 LSGs, 0.2 ± 1.0 % (median 0, range 0-10 %) were converted to an open operation. LSG was intended as the sole operation in 93.1 ± 14.8 %; in 3.0 ± 6.3 %, a second stage became necessary. Of the 130 surgeons, 40 (32 %) use a 36F bougie, which was most common (range 32-50F). Staple-line is reinforced by 79 %; of these, 57 % use a buttress and 43 % over-sew. Mean %EWL at year 1 was 59.3 %; year 2, 59.0 %; year 3, 54.7 %; year 4, 52.3 %; year 5, 52.4 %; and year 6, 50.6 %. If a second-stage operation becomes necessary, preference was: RYGB 46 %, duodenal switch 24 %, re-sleeve 20 %, single-anastomosis duodenoileal bypass 3 %, sleeve plication 3 %, minigastric bypass 3 %, non-adjustable band 2 %, and side-to-side jejunoileal anastomosis 1 %. Complications were: high leak 1.1 %, hemorrhage 1.8 %, and stenosis at lower sleeve 0.9 %. Postoperative gastroesophageal reflux occurred in 7.9 ± 8.2 % but was variable (0-30 %). Mortality was 0.33 ± 1.6 %, which translates to ≈ 152 deaths. Eighty-nine percent order multivitamins (including vitamin D, calcium, and iron) and 72 % order B12. A PPI is ordered by 29 % for 1 month, 29 % for 3 months, and others for 1-12 months depending on the case.
  
  
  CONCLUSIONS
  LSG was relatively safe. Further long-term surveillance is necessary.
authors.affiliation: Clinical Professor of Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA, gagner.michel@gmail.com.
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
authors.forename: Mervyn
authors.initials: M
authors.lastname: Deitel
authors.forename: Ann L
authors.initials: AL
authors.lastname: Erickson
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
mesh_terms: D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012086:Reoperation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss
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