title: Laparoscopic Sleeve Gastrectomy: Co-morbidity Profiles and Intermediate-Term Outcomes.
abstract: Bariatric surgery is effective at achieving sustained weight loss and improving the control and resolution of obesity-related co-morbidities. Most studies that have demonstrated co-morbidity resolution in patients undergoing laparoscopic sleeve gastrectomy (LSG) only follow patients for the short term (less than 1 year) or follow a relatively small cohort (<100 patients) for the intermediate or long term (more than 5 years). We report our experience following a large cohort of morbidly obese patients who underwent LSG with intermediate-term follow-up.
  
  
  
  We retrospectively reviewed 435 consecutive patients who underwent LSG from January 2004 to November 2013. Co-morbidities investigated included diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia (HL). A co-morbidity was determined to be resolved if the patient was no longer taking any medication to treat that specific co-morbidity.
  
  
  
  Mean follow-up was 26 ± 25 months (range = 1-112). Mean postoperative total weight loss (%TWL) at 6, 12, 24, 36, 48, 60, and 72 months were 23.6, 29.9, 29.5, 25.2, 26.7, 25.4, and 24.3 %, respectively. The incidence of all three co-morbidities was found to be significantly lower at the last patient follow-up. The resolution rates for DM, HTN, and HL were 59, 31, and 50 %, respectively. In patients who continued to have co-morbidities, the mean numbers of medications for DM (1.2 ± 0.7 vs. 0.5 ± 0.7, p < 0.0001), HTN (1.8 ± 1.1 vs. 1.3 ± 1.2, p < 0.0001), and HL (0.9 ± 0.7 vs. 0.6 ± 0.6, p < 0.0001) postoperatively were all significantly less.
  
  
  
  LSG is effective at achieving significant and sustained weight loss, improvement in co-morbidity profiles, and a reduction in poly-pharmacy for these conditions over intermediate-term follow-up.
authors.affiliation: Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Abelson
authors.affiliation: Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA. cha9043@med.cornell.edu.
authors.forename: Cheguevera
authors.initials: C
authors.lastname: Afaneh
authors.affiliation: Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dolan
authors.affiliation: Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA.
authors.forename: Genevevie
authors.initials: G
authors.lastname: Chartrand
authors.affiliation: Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dakin
authors.affiliation: Department of Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th St, Box 294, New York, NY, 10065, USA.
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
mesh_terms: D000328:Adult; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Co-morbidity resolution; Intermediate-term follow-up; Laparoscopic sleeve gastrectomy; Weight loss