Short- and Mid-term Outcomes of Sleeve Gastrectomy for Morbid Obesity: The Experience of the Spanish National Registry

Background Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and long-term results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric...

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Published in:Obesity surgery 2009-09, Vol.19 (9), p.1203-1210
Main Authors: Sánchez-Santos, Raquel, Masdevall, Carlos, Baltasar, Aniceto, Martínez-Blázquez, Candido, García Ruiz de Gordejuela, Amador, Ponsi, Enric, Sánchez-Pernaute, Andres, Vesperinas, Gregorio, Del Castillo, Daniel, Bombuy, Ernest, Durán-Escribano, Carlos, Ortega, Luis, Ruiz de Adana, Juan Carlos, Baltar, Javier, Maruri, Ignacio, García-Blázquez, Emilio, Torres, Antonio
Format: Article
Language:English
Subjects:
Adult
Body Mass Index
Female
Gastrectomy - adverse effects
Gastrectomy - statistics & numerical data
Gastrointestinal surgery
Humans
Laparoscopy
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Obesity
Obesity, Morbid - complications
Obesity, Morbid - epidemiology
Obesity, Morbid - surgery
Registries
Spain - epidemiology
Surgery
Suture Techniques
Treatment Outcome
Weight Loss
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Summary:Background Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and long-term results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric procedure. Methods Data were obtained from 17 centers and collected in a database. Technical issues, preoperative comorbid conditions, hospital stay, early and late complications, and short- and mid-term weight loss were analyzed. Results Five hundred forty patients were included; 76% were women. Mean BMI was 48.1 ± 10. Mean age was 44.1 ± 11.8. Morbidity rate was 5.2% and mortality rate 0.36%. Complications presented more frequently in superobese patients (OR, 2.8 (1.18–6.65)), male (OR, 2.98 (1.26–7.0)), and patients >55 years old (OR, 2.8 (1.14–6.8)). Staple-line reinforcement was related to a lower complication rate (3.7 vs 8.8%; p  = 0.039). Mean hospital stay was 4.8 ± 8.2 days. Mean follow-up was 16.5 ± 10.6 months (1–73). Mean percent excess BMI loss (EBL) at 3 months was 38.8 ± 22, 55.6 ± 8 at 6 months, 68.1 ± 28 at 12 months, and 72.4 ± 31 at 24 months. %EBL was superior in patients with lower initial BMI and lower age. Bougie caliber was an inverse predictive factor of %EBL at 12 and 24 months (RR, 23.3 (11.4–35.2)). DM is remitted in 81% of the patients and HTA improved in 63.2% of them. A second-stage surgery was performed in 18 patients (3.2%). Conclusions LSG provides good short- and mid-term results with a low morbid-mortality rate. Better results are obtained in younger patients with lowest BMI. Staple-line reinforcement and a thinner bougie are recommended to improve outcome.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-009-9892-9