title: Two lessons from a 5-year follow-up study of laparoscopic sleeve gastrectomy: persistent, relevant weight loss and a short surgical learning curve.
abstract: BACKGROUND
  Like Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy (LSG) has been validated as a bariatric surgery procedure in its own right. However, the few studies of the long-term outcomes of LSG have only featured small patient populations. The objective of the present study was to evaluate weight loss 5 years after LSG and assess the surgical learning curve for this procedure.
  
  
  METHODS
  We performed a retrospective, single-center study of a prospective database including all consecutive patients having undergone LSG at Amiens University Medical Center between November 2004 and July 2007. Data (weight, body mass index [BMI], percentage of excess weight loss [EWL], percentage of excess BMI loss, and percentage weight loss [PWL]) were collected during follow-up (particularly after 5 years).
  
  
  RESULTS
  The study population comprised 118 patients (100 females [85%]; mean ± SD age, 40 ± 11 years; mean preoperative weight, 131 ± 22 kg; mean preoperative BMI, 47.7 ± 7 kg/m(2)). LSG was performed after failure of gastric banding in 23 cases (19%) and after failure of an intragastric balloon in 1 (0.8%). In all, 95 patients (81%) were analyzed ≥60 months after the LSG (mean follow-up period, 71 ± 9 months). The PWL and EWL were 25 ± 14% and 46 ± 26%, respectively. Eleven patients had undergone a second bariatric operation within 5 years of the LSG. Concerning the 84 patients in whom only LSG was the only operation, the PWL and EWL were 23 ± 14% and 43 ± 25%, respectively. The EWL was >50% in 35 of these 84 patients (42%) and between 25 and 50% in 30 cases (36%). Optimal weight results were achieved after only 28 LSG had been performed, which testifies to a shorter learning curve than for most other bariatric surgery techniques.
  
  
  CONCLUSIONS
  Isolated LSG is a quickly mastered bariatric surgery technique with a short learning curve. It enables a mean PWL of >25% and an EWL of >50% in >40% of cases.
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France.
authors: Flavien
authors: F
authors: Prevot
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France.
authors: Pierre
authors: P
authors: Verhaeghe
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France.
authors: Aurélien
authors: A
authors: Pequignot
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France.
authors: Lionel
authors: L
authors: Rebibo
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France.
authors: Cyril
authors: C
authors: Cosse
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France.
authors: Abdennaceur
authors: A
authors: Dhahri
authors: Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, Amiens, France. Electronic address: regimbeau.jean-marc@chu-amiens.fr.
authors: Jean-Marc
authors: JM
authors: Regimbeau
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015431:Weight Loss