title: Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience.
abstract: BACKGROUND
  Long-term data of laparoscopic sleeve gastrectomy (LSG) are still scarce in the Middle East.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacy and safety at 5 years and beyond.
  
  
  METHODS
  Tertiary referral hospital between April 2007 and March 2015.
  
  
  METHODS
  A retrospective review of 76 patients who underwent LSG at the senior author's institution between April 2007 and March 2010.
  
  
  RESULTS
  Mean preoperative body mass index (BMI) was 42.8±7.1 kg/m2. Follow-up rates were 90.4%, 86.3%, and 77.8% at 5, 6, and 7 years, respectively. Percentage of excess weight loss (%EWL) was 69.8%±28.7% at 5 years, 70.6%±32.7% at 6 years, and 76.6%±21.2% at 7 years, respectively. Mean total weight loss was 26.5%±8.7%, 24.9%±8.8%, and 26.6%±6.0% at 5, 6, and 7 years, respectively. %EWL at 5-years was significantly higher for patients with a preoperative BMI<45 kg/m2(83.1% versus 46.3%, P<.0001). LSG improved or resolved diabetes, hypertension, and asthma in 87.5%, 68%, and 81.7% of patients, respectively. New onset gastroesophageal acid reflux disease developed in 21.2% of patients. Long-term complications included hiatal hernias necessitating repair (1.4%), incisional hernias (2.7%), and symptomatic gallstones (9.6%), as well as depression necessitating admission (4.1%).
  
  
  CONCLUSIONS
  In the present patient population, LSG resulted in satisfactory %EWL and co-morbidity resolution after 5 years. The results were excellent for patients with a BMI<45 kg/m2. De novo acid reflux symptoms developed in 1 of 5 patients. Cholelithiasis necessitating cholecystectomy was the most common long-term complication.
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hanaa
authors.initials: H
authors.lastname: Dakour Aridi
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Ramzi
authors.initials: R
authors.lastname: Alami
authors.affiliation: Biostatistics Unit, Clinical Research Institute, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hani
authors.initials: H
authors.lastname: Tamim
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Shamseddine
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Tarek
authors.initials: T
authors.lastname: Fouani
authors.affiliation: Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: bs21@aub.edu.lb.
authors.forename: Bassem
authors.initials: B
authors.lastname: Safadi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000209:etiology; D006551:Hernia, Hiatal / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
keywords: Bariatric surgery; Laparoscopic sleeve gastrectomy; Obesity; Weight loss