title: Effects of laparoscopic sleeve gastrectomy in patients with morbid obesity and metabolic disorders.
abstract: OBJECTIVE
  Obesity and its correlation with other pathological conditions determine the onset of the metabolic syndrome, which exposes the patient to a higher risk of major cardiovascular complications. Laparoscopic sleeve gastrectomy (LSG) is a bariatric surgical procedure that appears to influence both the reduction of fat mass and the action of some gastrointestinal hormones.
  
  
  METHODS
  Between January 2011 and July 2013, 23 patients with morbid obesity underwent LSG and follow-up. In the evaluation of patients, the criteria for metabolic syndrome given by the International Diabetes Federation were followed. A multidisciplinary team of experts evaluated patients before surgery and in subsequent scheduled postoperative visits at 7, 30, 60, and 90 days and 4, 5, 6, 9, and 12 months. Anthropometric and metabolic parameters were analyzed.
  
  
  RESULTS
  The mean excess weight loss was 8.57±3.02%, 17.65±6.40%, 25.47±7.90%, 33.76±9.27%, 41.83±10.71%, 46.02±13.90%, 52.60±14.05%, 58.48±16.07%, and 62.59±21.29% at 7, 30, 60, and 90 days and 4, 5, 6, 9, and 12 months, respectively. In the same observational period there was an excellent improvement of metabolic indices. None of the patients previously taking prescribed hypoglycemic drugs restarted therapy. Mean fasting plasma glucose significantly decreased compared with the preoperative values. Blood pressure had a statistically significant improvement. Modification in the lipid profile was more variable. During the period of observation 22 of 23 patients reported in this study did not fit the criteria for metabolic syndrome.
  
  
  CONCLUSIONS
  Morbid obesity and related diseases may benefit from a surgical approach in selected patients. Randomized controlled trials are needed to evaluate the role of LSG.
authors.affiliation: 1 Department of Digestive Surgery, St. Maria Hospital , Terni, Italy .
authors.forename: Jacopo
authors.initials: J
authors.lastname: Desiderio
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.forename: Vittorio
authors.initials: V
authors.lastname: Scalercio
authors.forename: Eva
authors.initials: E
authors.lastname: Mirri
authors.forename: Ilenia
authors.initials: I
authors.lastname: Grandone
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.forename: Jacopo
authors.initials: J
authors.lastname: Penzo
authors.forename: Alberto
authors.initials: A
authors.lastname: Santoro
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Fatati
authors.forename: Amilcare
authors.initials: A
authors.lastname: Parisi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003925:Diabetic Angiopathies / Q000378:metabolism / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism / Q000517:prevention & control / Q000601:surgery*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D018579:Patient Selection; D012074:Remission Induction; D016896:Treatment Outcome; D015431:Weight Loss