title: Five-year results of laparoscopic sleeve gastrectomy: effects on gastroesophageal reflux disease symptoms and co-morbidities.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is becoming the most performed bariatric procedure; however, data available on long-term follow-up are scanty.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the 5-year efficacy of LSG on weight loss, gastroesophageal reflux disease (GERD) symptoms, and obesity-associated co-morbidities.
  
  
  METHODS
  Tertiary-care referral hospital.
  
  
  METHODS
  This study retrospectively analyzed 105 obese patients undergoing LSG from January 2006 to December 2009. The preoperative evaluation included demographic characteristics, evaluation of co-morbidities, a double-contrast barium swallow, and an upper-gastrointestinal endoscopy. The following data were collected at 1, 3, and 5 years after surgery: weight, improvement/remission of co-morbidities, complications, and revisional surgery.
  
  
  RESULTS
  According to preoperative body mass index (BMI), patients were divided into Group 1 (n = 61) with BMI≤50 kg/m(2) and Group 2 (n = 44) with BMI>50 kg/m(2). The follow-up rate was 94% after 5 years (n = 99). Delta BMI (BMI at follow-up-preoperative BMI) was significantly higher in Group 2 than in Group 1 at 1-3 years and 5 years (P<.001). Furthermore, at 5 years, Group 2 showed a significantly higher percentage total weight loss (%TWL) (26.6%±18.3% versus 33.5%±12.9%, P = .006) than Group 1, whereas percentage excess weight loss was similar (58.4%±21.8% versus 55.3%±19.5%, P = .5).Younger age at surgery and absence of postoperative GERD were associated with a better %TWL at 5 years (P<.001 and P = .03).
  
  
  CONCLUSIONS
  LSG is an effective procedure at long-term, with good weight loss outcomes and with a considerable improvement of obesity-associated co-morbidities. Younger age at surgery and absence of postoperative GERD were associated with a better %TWL at 5 years.
authors.affiliation: General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Angrisani
authors.affiliation: Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Santonicola
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy. Electronic address: ariolahasani@libero.it.
authors.forename: Ariola
authors.initials: A
authors.lastname: Hasani
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nosso
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
authors.forename: Brunella
authors.initials: B
authors.lastname: Capaldo
authors.affiliation: Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Iovino
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D006949:Hyperlipidemias / Q000601:surgery; D006973:Hypertension / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies
keywords: Bariatric surgery; Diabetes remission; Gastroesophageal reflux disease; Long-term results; Sleeve gastrectomy; Weight loss