Experience with laparoscopic sleeve gastrectomy for morbid versus super morbid obesity

Nobumi Tagaya, Kazunori Kasama, Rie Kikkawa, Eiji Kanahira, Akiko Umezawa, Takashi Oshiro, Yuka Negishi, Yoshimochi Kurokawa, Tetsuya Nakazato, Keiichi Kubota

    研究成果: Article査読

    41 被引用数 (Scopus)


    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.

    ジャーナルObesity Surgery
    出版ステータスPublished - 2009 10月

    ASJC Scopus subject areas

    • 外科
    • 内分泌学、糖尿病および代謝内科学
    • 栄養および糖尿病


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