title: Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asian cohort.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) has become a popular bariatric operation worldwide.
  
  
  OBJECTIVE
  To report early outcomes of patients with LSG performed.
  
  
  METHODS
  University hospital and a restructured hospital, Singapore.
  
  
  METHODS
  Data of patients who underwent LSG as a primary procedure from 2008 to 2013 were analyzed for change in body mass index (BMI), percentage of weight loss (%WL), and percentage of excess weight loss (%EWL). The remission of obesity-related co-morbidities after LSG was analyzed. Logistic regression analyses were performed to determine predictive factors for perioperative complication and suboptimal EWL.
  
  
  RESULTS
  Two hundred operations were performed on a cohort that consisted of 74 Chinese, 57 Malay, and 52 Indian patients and 17 patients from other ethnic groups. Mean preoperative weight and BMI were 118.1±26.8 kg and 43.0±8.0 kg/m(2), respectively. Mean follow-up duration was 16.7±9.4 months. At 6, 12, 24 and 36 months, the percentage of patients followed-up were 79.5%, 75.7%, 50.0%, and 50.0%, and the mean %EWL were 51.2%, 61.2%, 60.9%, and 51.0%, respectively. Postoperative complications occurred in 9 patients (4.5%), 5 of whom (2.5%) required reoperation. There was no mortality in our series. Remission of type 2 diabetes mellitus (T2DM) was significantly associated with achieving>50% EWL (P = .009). Patients>50 years of age and higher preoperative BMI were significant factors for failure to achieve>50% EWL at 1 year after LSG.
  
  
  CONCLUSIONS
  LSG is a safe and effective operation for achieving significant weight loss and improvement of co-morbidities in multiethnic Asian population. Adequate EWL is important to achieve remission of T2DM. Older patients and higher preoperative BMI are predictive factors for suboptimal EWL.
authors.affiliation: Department of Surgery, National University Hospital, Singapore.
authors.forename: Siok Siong
authors.initials: SS
authors.lastname: Ching
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Anton Kui Sing
authors.initials: AK
authors.lastname: Cheng
authors.affiliation: Department of Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Lucy Wai Cheng
authors.initials: LW
authors.lastname: Kong
authors.affiliation: Department of Surgery, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Davide
authors.initials: D
authors.lastname: Lomanto
authors.affiliation: Department of Surgery, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: jimmy_so@nuhs.edu.sg.
authors.forename: Jimmy Bok Yan
authors.initials: JB
authors.lastname: So
authors.affiliation: Department of Surgery, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Asim
authors.initials: A
authors.lastname: Shabbir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
keywords: Asian; Bariatric surgery; Laparoscopic sleeve gastrectomy; Multiethnic cohort; Remission of obesity-related co-morbidities