Laparoscopic Sleeve Gastrectomy for Super Obese Patients

Abstract

Objectives: In this study, we report long-term outcomes of high-risk, high-BMI (body mass index) patients who underwent laparoscopic sleeve gastrectomy (LSG). Background: Short- and medium-term data appear to support the effectiveness of LSG, but long-term data to support its durability are sparse. Methods: A prospective database was reviewed on all high-risk patients who underwent LSG as part of a staged approach for surgical treatment of severe obesity between January 2002 and February 2004. We included only patients who did not proceed to second-stage surgery (gastric bypass). Analyzed data included demographics, BMI, comorbidities, and surgical outcomes. All partial gastrectomies were performed using a 50F bougie. Results: Seventy-four patients underwent LSG, and follow-up data were available on 69 of 74 patients (93%). The mean age was 50 years (25–78) and the mean number of co-morbidities was 9.6. Perioperative mortality (2(43–90) to 46 kg/m² (22–73). Seventy-seven percent of the diabetic patients showed improvement or remission of the disease. Conclusions: This study reports the longest follow-up of LSG patients thus far and supports the effectiveness, safety, and durability of laparoscopic sleeve gastrectomy as a definitive therapeutic option for severe obesity, even in high-risk, high-BMI patients.