title: Long-term Weight and Metabolic Effects of Laparoscopic Sleeve Gastrectomy Calibrated with a 50-Fr Bougie.
abstract: BACKGROUND
  Most surgeons calibrate the sleeve with 32-French (Fr) to 40-Fr bougies hypothesizing that smaller bougies are associated with greater weight loss and long-term lower weight regain. The purpose of this study was to assess the weight loss results and resolution of comorbidities 5 years after laparoscopic sleeve gastrectomy (LSG).
  
  
  METHODS
  A prospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy calibrated with a 50-Fr bougie between October 2007 and February 2010 was performed. Excess weight loss (EWL) and remission of comorbidities were investigated at 1, 2, and 5 years after surgery.
  
  
  RESULTS
  Fifty patients were included for the analysis. One year after surgery, mean excess weight loss (EWL) of 81.8 % was achieved, type 2 diabetes mellitus (T2DM) resolution rate was 76.9 %, hypertension resolution was observed in 73.3 %, sleep apnea hypopnea syndrome (SAHS) resolution in 100 % hypertriglyceridemia was normalized in all the cases, and hypercholesterolemia in 21.4 %. Two years after surgery, mean EWL was 84.4 % and comorbidity resolution rate similar to that obtained after the first postoperative year. Five years after surgery, mean EWL was 78.7 %, T2DM resolution 69.2 %, hypertension 66.7 %, SAHS 100 %, hypertriglyceridemia 100 %, and hypercholesterolemia 14.3 %.
  
  
  CONCLUSIONS
  LSG calibrated with a 50-Fr bougie obtained excellent results in weight loss and resolution comorbidities and their maintenance in the long-term follow-up in our series. In our opinion, the results depend more on a preoperative correct selection of candidates and a close postoperative follow-up, rather than using a narrow calibration bougie.
authors.affiliation: Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain. jruiztovar@gmail.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: Department of Psychiatry, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Rosana
authors.initials: R
authors.lastname: Martínez
authors.affiliation: Department of Psychiatry, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Bonete
authors.affiliation: Department of Psychiatry, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Rico
authors.affiliation: Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Lorea
authors.initials: L
authors.lastname: Zubiaga
authors.affiliation: Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Diez
authors.affiliation: Department of Surgical Nursery, Hospital Sureste, Madrid, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Llavero
mesh_terms: D000328:Adult; D000368:Aged; D002138:Calibration; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000601:surgery; D015228:Hypertriglyceridemia / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome; D015431:Weight Loss
keywords: 50-Fr bougie; Excess weight loss; Follow-up; Remission of comorbidities; Sleeve gastrectomy