title: Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) has been established as a reliable bariatric procedure, but questions have emerged regarding its long-term results. Our aim is to report the long-term outcomes of LSG as a primary bariatric procedure.
  
  
  METHODS
  Retrospective analysis of patients submitted to LSG between 2005 and 2007 in our institution. Long-term outcomes at 5 years were analyzed in terms of body mass index (BMI), excess weight loss (EWL) and co-morbidities resolution. Surgical success was defined as %EWL>50%. Also, we compared long-term results according to preoperative BMI, using Mann-Whitney test.
  
  
  RESULTS
  A total of 161 LSG were analyzed, and 114 patients (70.8%) were women. The median age was 36 years old (range 16-65), median preoperative BMI was 34.9 kg/m(2) (interquartile range [IQR], 33.3-37.5). A total of 112 patients (70%) completed 5 years of follow-up. At the fifth year, median BMI and %EWL was 28.5 kg/m(2) (IQR: 25.8-31.9) and 62.9% (IQR: 45.3-89.6), respectively, with a surgical success of 73.2% of followed patients. According to preoperative BMI, surgical success was achieved in 80% of patients with BMI<35 kg/m(2), 75% of BMI 35-40 kg/m(2), and 52.6% of BMI>40 kg/m(2), with significant lower %EWL in patients with BMI>40 kg/m(2) (P = .001 and .004). Dyslipidemia and insulin resistance resolution was 80.7% and 84.7%, respectively. A total of 26.7% of patients reported new-onset gastroesophageal reflux symptoms at 5 years.
  
  
  CONCLUSIONS
  LSG as a primary procedure is a reliable surgery. We observed positive long-term outcomes of %EWL and co-morbidities resolution. In our series, best results are seen in patients with preoperative BMI<40 kg/m(2).
authors.affiliation: Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: bozauc@mac.com.
authors.forename: Camilo
authors.initials: C
authors.lastname: Boza
authors.affiliation: Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: David
authors.initials: D
authors.lastname: Daroch
authors.affiliation: Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Diego
authors.initials: D
authors.lastname: Barros
authors.affiliation: Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Felipe
authors.initials: F
authors.lastname: León
authors.affiliation: Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Funke
authors.affiliation: Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Crovari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002677:Chile; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Bariatric surgery; Laparoscopic sleeve gastrectomy; Long-term results