TY - JOUR
T1 - Experience with laparoscopic sleeve gastrectomy for morbid versus super morbid obesity
AU - Tagaya, Nobumi
AU - Kasama, Kazunori
AU - Kikkawa, Rie
AU - Kanahira, Eiji
AU - Umezawa, Akiko
AU - Oshiro, Takashi
AU - Negishi, Yuka
AU - Kurokawa, Yoshimochi
AU - Nakazato, Tetsuya
AU - Kubota, Keiichi
PY - 2009/10
Y1 - 2009/10
N2 - Background: We evaluated the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for super morbid obesity in patients with an initial body mass index (BMI) of <50 or <50. Methods: Between October 2005 and January 2008, we performed LSG in 30 patients. There were 20 males and 10 females with a mean age of 38 years. Mean initial body weight and BMI were 139 kg and 49.1 kg/m2, respectively. Sleeve gastrectomy was carried out using a linear stapler from the greater curvature of the antrum 5 cm proximal from the pyloric ring up to the angle of His alongside a 45-Fr. bougie. Results: Laparoscopic procedures were performed successfully in all patients. The mean operation time was 92 min, and blood loss was minimal. The BMI change and weight loss at the 1-, 3-, 6-, 9-, 12-, and 18-month follow-up points of patients with an initial BMI of <50 and ≥50 were 34.2 and 57.4, 32.1 and 53.7, 29.6 and 50.8, 29.5 and 51.2, 27.8 and 52.2, and 29.7 and 45.5 kg/m2 and 96.8 and 172.2, 89.5 and 157.0, 83.4 and 144.8, 84.0 and 145.4, 78.0 and 153.4, and 84.5 and 119.5 kg, respectively. The patients with a BMI of <50 obtained good outcomes, but weight loss reached a plateau at 9 months after surgery in patients with a BMI of ≥50. Postoperative complications included leakage, bleeding, stricture, and peritonitis in one patient each. There was no surgical mortality. Most of the co-morbidities improved after surgery. Conclusions: Sleeve gastrectomy is a feasible and safe treatment for super morbid obesity, but evaluation of long-term outcome is necessary to determine whether it is a durable procedure in terms of effectiveness. We expect that patients with a BMI of <50 are good candidates for LSG as a definitive treatment, and, if those with a BMI of ≥50 hope for further weight loss, a second-step procedure may be required.
AB - Background: We evaluated the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for super morbid obesity in patients with an initial body mass index (BMI) of <50 or <50. Methods: Between October 2005 and January 2008, we performed LSG in 30 patients. There were 20 males and 10 females with a mean age of 38 years. Mean initial body weight and BMI were 139 kg and 49.1 kg/m2, respectively. Sleeve gastrectomy was carried out using a linear stapler from the greater curvature of the antrum 5 cm proximal from the pyloric ring up to the angle of His alongside a 45-Fr. bougie. Results: Laparoscopic procedures were performed successfully in all patients. The mean operation time was 92 min, and blood loss was minimal. The BMI change and weight loss at the 1-, 3-, 6-, 9-, 12-, and 18-month follow-up points of patients with an initial BMI of <50 and ≥50 were 34.2 and 57.4, 32.1 and 53.7, 29.6 and 50.8, 29.5 and 51.2, 27.8 and 52.2, and 29.7 and 45.5 kg/m2 and 96.8 and 172.2, 89.5 and 157.0, 83.4 and 144.8, 84.0 and 145.4, 78.0 and 153.4, and 84.5 and 119.5 kg, respectively. The patients with a BMI of <50 obtained good outcomes, but weight loss reached a plateau at 9 months after surgery in patients with a BMI of ≥50. Postoperative complications included leakage, bleeding, stricture, and peritonitis in one patient each. There was no surgical mortality. Most of the co-morbidities improved after surgery. Conclusions: Sleeve gastrectomy is a feasible and safe treatment for super morbid obesity, but evaluation of long-term outcome is necessary to determine whether it is a durable procedure in terms of effectiveness. We expect that patients with a BMI of <50 are good candidates for LSG as a definitive treatment, and, if those with a BMI of ≥50 hope for further weight loss, a second-step procedure may be required.
KW - Bariatric surgery
KW - Laparoscopic surgery
KW - Sleeve gastrectomy
KW - Super morbid obesity
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U2 - 10.1007/s11695-008-9774-6
DO - 10.1007/s11695-008-9774-6
M3 - Article
C2 - 19067089
AN - SCOPUS:70350120741
VL - 19
SP - 1371
EP - 1376
JO - Obesity Surgery
JF - Obesity Surgery
SN - 0960-8923
IS - 10
ER -