Long-term outcomes of laparoscopic sleeve gastrectomy from the Indian subcontinent

Background Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed metabolic surgery worldwide. There are few mid- to long-term studies for LSG, especially from the Indian subcontinent. Objective The primary outcome of the study was percent total weight loss (%TWL), and secondary outcom...

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Bibliographic Details
Published in:Obesity surgery 2019-12, Vol.29 (12), p.4043-4055
Main Authors: Misra, Shivanshu, Bhattacharya, Siddhartha, Saravana Kumar, S., Nandhini, B. Deepa, Saminathan, S. Christinajoice, Praveen Raj, P.
Format: Article
Language:English
Subjects:
Adult
Body Mass Index
Comorbidity
Diabetes
Diabetes Mellitus, Type 2 - therapy
Female
Follow-Up Studies
Gastrectomy
Glycated Hemoglobin A - analysis
Humans
India
Laparoscopy
Male
Medicine
Medicine & Public Health
Middle Aged
Obesity, Morbid - surgery
Original Contributions
Remission Induction
Retrospective Studies
Surgery
Weight Loss
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Summary:Background Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed metabolic surgery worldwide. There are few mid- to long-term studies for LSG, especially from the Indian subcontinent. Objective The primary outcome of the study was percent total weight loss (%TWL), and secondary outcomes included type 2 diabetes mellitus remission (T2DM) rates, comorbidity resolution rates, revisional surgeries, and complications related to LSG, 3 and 5 years after surgery. Method The study was a single-center, retrospective analysis from patients who underwent primary as well as revisional LSG between January 2012 and December 2013 from a tertiary care center in India. We included patients who completed a minimum follow-up of 5 years. Details of the patients were collected from outpatient and inpatient case sheet records, during their follow-up. Results Out of a total of 284 patients, 57% were females. Mean baseline body mass index (BMI) was 44.9 ± 7.9 kg/m 2 . The diabetic population comprised 14.8% of the total patients. Mean %TWL at 5 years was 26.0 ± 9.9%. T2DM remission at 1, 3, and 5 years were 78.5%, 71.4%, and 66.6%, respectively. Preoperative BMI ( p  = 0.02), glycosylated hemoglobin (HbA1c) ( p  = 0.04), duration of diabetes in years (p = 0.04), and preoperative insulin usage ( p  = 0.04) were the preoperative predictors for T2DM remission. Early ( 30 days) complications were seen in 4.5% and 0.7% of the population, respectively. Conclusion Weight loss after LSG was maintained in the majority of the patients, while a small proportion has significant weight regain at 5 years. T2DM resolution and other comorbidity resolutions were well supported after LSG.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-019-04103-z