title: Laparoscopic sleeve gastrectomy in the South Pacific. Retrospective evaluation of 510 patients in a single institution.
abstract: BACKGROUND
  The South Pacific has a high prevalence of obesity and super-obesity. We reviewed our experience with laparoscopic sleeve gastrectomy (LSG) to evaluate its efficacy and safety.
  
  
  METHODS
  A retrospective review of a prospectively collected database of LSGs carried out by one surgeon in one center. The percentage of excess weight loss and the rate of resolution or improvement of comorbidities reflected efficacy, and major complications or mortalities reflected safety.
  
  
  RESULTS
  From January 2008 to February 2013, we performed 510 surgeries and included 494 consecutive patients (367 females) (45.5 ± 11.2 years) in our study. LSG was the primary procedure in 384 patients, 6 patients had redo bariatric surgery after failure of initial LSG, 57 patients had a history of gastric banding with insufficient weight loss or band-related complications, and 46 super-obese patients had an intragastric balloon placed before LSG. Average starting body mass index was 47.8 kg m(-2). Mean percent excess weight loss was 64.3% at 1 year; 67.3% at 2 years and 66.4% at 3 years. The percentages of resolved comorbidities were as follows: hypertension: 48.3%, type 2 diabetes mellitus: 72.5%, dyslipidemia: 61.0%, and obstructive sleep apnea: 77.8%. The mortality rate was 1/494. The postoperative morbidity included gastric fistula in 3.0%, hemorrhaging in 2.4%, and postoperative gastroesophageal reflux in 9.4%.
  
  
  CONCLUSIONS
  In the South Pacific, LSG is a safe and effective means of treating morbid obesity with sustained weight loss and resolution of comorbid medical conditions.
authors.affiliation: Faculty of Sport Sciences, CETAPS, EA n°3832, University of Rouen, France. Electronic address: frederic.lemaitre@univ-rouen.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lemaître
authors.affiliation: Clinique de la Baie des Citrons, Noumea, New Caledonia.
authors.forename: Philippe
authors.initials: P
authors.lastname: Léger
authors.affiliation: Department of Surgery and Endocrinology, Strasbourg, France.
authors.forename: Marius
authors.initials: M
authors.lastname: Nedelcu
authors.affiliation: Department of Surgery, Faculty of Medicine of Montpellier, CHU Montpellier, France.
authors.forename: David
authors.initials: D
authors.lastname: Nocca
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D015905:Gastric Balloon; D015390:Gastric Bypass / Q000379:methods; D005747:Gastric Fistula / Q000209:etiology; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011184:Postoperative Period; D015995:Prevalence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Laparoscopic sleeve gastrectomy; Morbidity; South Pacific; Weight loss