Early and mid-term outcomes of single-stage laparoscopic sleeve gastrectomy.

BACKGROUND

This is the largest single-centre series of single-stage laparoscopic sleeve gastrectomy (LSG) reporting on perioperative outcomes, weight loss, comorbidity resolution including urological outcomes and results in the super obese. Review of prospectively collected data for patients who underwent LSG from March 2007-August 2009.

METHODS

There were 253 patients with a mean age of 44 years (SD, 9) and a mean preoperative body mass index (BMI) of 50 kg/m(2) (SD, 7). There were 17 (7%) major complications and no deaths. The mean follow-up was 9 months. One hundred and seventy-one patients with a mean follow-up of 12 months had a mean postoperative weight loss of 41 kg (SD, 16) and mean excess BMI (meBMI) loss of 59% (SD, 22).

RESULTS

One hundred fourteen patients were super obese (BMI, >50 kg/m(2)). The mean weight loss was 45 kg (SD, 18), and the meBMI lost was 49% (SD, 21). Super-obese patients experienced more complications (p = 0.02) and lost less eBMI (49% vs. 61%; p < 0.01). Fifty-three patients (46%) remained morbidly obese (BMI, >40 kg/m(2)) postoperatively. Hypertension and diabetes improved or resolved in 73 (79%) and 73 (90%) patients, respectively. Stress urinary incontinence was reported preoperatively in 60 (32%) females, and complete resolution or improvement was reported in 54 (90%) patients.

CONCLUSIONS

LSG provides satisfactory weight loss and resolution of comorbidities in the short- and medium-term with inferior, though acceptable, results in the super obese.