Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy in Morbidly Obese and Super Obese Patients.

Background Laparoscopic sleeve gastrectomy (LSG) is a modified procedure derived from a biliopancreatic diversion (BPD)-duodenal switch. The present study evaluated the role of LSG in morbidly and super obese patients and compare its efficacy between the two groups. Methodology A retrospective review was conducted in Dr. Sulaiman Al Habib Specialist Hospital, Riyadh, KSA, from January 2020 to April 2021. Patients' records were divided into two groups, morbidly obese (body mass index (BMI): 40-49 kg/m) and super obese (BMI: 50-59 kg/m), who were admitted to the department for laparoscopic sleeve gastrectomy during the study duration. However, patients with a history of gut surgery, hernias, comorbid use of illicit substances, and psychiatric disorders were excluded. For all patients, a routine preoperative investigation protocol was conducted. Postoperative surgical complications were also recorded. The Clavien-Dindo classification (CDC) score was applied to record surgical complications. Data collection was done using a semi-structured questionnaire. The Statistical Package for Social Sciences (SPSS) version 26 (IBM, Chicago, USA) was used to perform data analysis. Results A total of 176 patient records were included in this analysis, of which 126 (71.6%) were females. There were 101 (57.1%) patients who were morbidly obese and 76 (42.9%) who were super obese. The mean duration of follow-up records in this study was 23.2 ± 3.6 weeks, which was slightly longer in the morbidly obese group. Change in BMI was higher in the super obese patients (18.6 ± 3.1 versus 10.5 ± 1.9). Final body weight was still lower in the morbidly obese group as they were relatively slimmer even before the procedure. A higher reduction in excess weight loss (EWL) is seen in the morbidly obese group. Comorbidity resolution status was also remarkable with the procedure. Overall, there were procedure-associated complications in 11 (10.9%) patients in the morbidly obese group and 10 (13.2%) in the super obese group. Conclusion Laparoscopic sleeve gastrectomy is a safe procedure in morbidly and super obese patients. It is effective in sustainable total and excess weight loss over time. It is also effective in comorbidity resolution. Complications with LSG are minimal and nonserious. LSG should be the recommended procedure in morbidly and super obese patients with adverse health consequences to improve their morbidity, mortality, and overall quality of life.