title: Long term predictors of success after laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  To evaluate early, mid and long term efficacy of laparoscopic sleeve gastrectomy as a definitive management of morbid obesity and to study factors that may predict its success.
  
  
  METHODS
  A retrospective study was conducted by reviewing the database of patients who underwent LSG as a definitive bariatric procedure, from April 2005 to March 2013. Univariate and multivariate analysis were performed.
  
  
  RESULTS
  1395 patients were included in this study. Mean age was 33 years and women:men ratio was 74:26. The mean preoperative BMI was 46 kg/m(2). Operative time was 113 ± 29 min. Reinforcement of staple line was done only in 447 (32%) cases. 11 (0.79%) cases developed postoperative leak, with total number of complications 72 (5.1%) and 0% mortality. Percentage of excess weight loss (%EWL) was 42%, 53%, 61%, 73%, 67%, 61%, 59% and 57% at 6 months, 1-7 years. Remission of diabetes (DM), hypertension (HTN) and hyperlipidaemia (HLP) occurred 69%, 54% and 43% respectively. 56 (4%) patients underwent revision surgery, for insufficient weight loss (n = 37) and severe reflux symptoms (n = 19). Mean follow up was 76 ± 19 (range: 6-103) months. Smaller bougie size and leaving smaller antrum were associated with significant %EWL. Bougie ≤36F remained significant in multivariate analysis.
  
  
  CONCLUSIONS
  This study supports safety, effectiveness and durability of LSG as a sole definitive bariatric procedure. Smaller bougie size and shorter distance from pylorus were associated with significant %EWL.
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt. Electronic address: surg_latif@hotmail.com.
authors.forename: M E
authors.initials: ME
authors.lastname: Abd Ellatif
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: E
authors.initials: E
authors.lastname: Abdallah
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: W
authors.initials: W
authors.lastname: Askar
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: W
authors.initials: W
authors.lastname: Thabet
authors.affiliation: Hepatobiliary Surgical Department, National Liver Institute, Menoufiya University, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Aboushady
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: A E
authors.initials: AE
authors.lastname: Abbas
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: El Hadidi
authors.affiliation: Department of Digestive Surgery, TBRI, Cairo, Egypt.
authors.forename: A F
authors.initials: AF
authors.lastname: Elezaby
authors.affiliation: Department of Digestive Surgery, TBRI, Cairo, Egypt.
authors.forename: A F
authors.initials: AF
authors.lastname: Salama
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: I E
authors.initials: IE
authors.lastname: Dawoud
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Moatamed
authors.affiliation: Department of Surgery, Jahra Hospital, Kuwait.
authors.forename: M
authors.initials: M
authors.lastname: Wahby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Bougie size; Gastrectomy; Leak; Morbid obesity