Liagre Arnaud, Martini Francesco, Van Haverbeke Olivier, Boudry Hubert, Petrucciani Niccolo
Ramsay Générale de Santé, Clinique des Cedres, Bariatric Surgery Unit, Cornebarrieu, France.
Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, Sapienza University, Rome, Italy.
Am J Surg. 2025 Oct;248:116525. doi: 10.1016/j.amjsurg.2025.116525. Epub 2025 Jul 16.
The long-term sustainability of sleeve gastrectomy (SG) has been questioned. The aim of the article is to evaluate the results of SG at 10-year follow-up in a high-volume referral center for bariatric surgery.
Data of patients who underwent SG between 2004 and 2010 were analyzed. Revisional surgery was proposed in case of weigh recurrence (WR), non-response to primary bariatric metabolic surgery or gastroesophageal reflux (GERD) resistant to medical treatment.
SG was performed in 156 patients, with mean BMI of 47.6 kg/m2. After 10 years, 117 out of 153 patients were evaluated (32 patients lost to follow-up (20.5 %) and four died due to causes unrelated to SG). Mean follow-up duration was 144 ± 13 months. Forty-six patients (39.4 %) did not receive any further bariatric surgery. In this population, the average BMI was 35.1 kg/m2, EWL was 55.2 % and TWL was 25.5 % 10 years after SG. 71 patients underwent a second bariatric procedure (60.6 %). The average time between SG and redo-surgery was 51.9 months. Reasons for conversion were weight regain (WR) (53 %), non-response (38 %), GERD resistant to medical treatment (7 %), and gastric stricture (1.4 %). A high BMI (from 46 to over 50) was most often associated with a second bariatric surgery.
The present series reports a high rate of revisional surgery after SG at 10 years, for weight recurrence or GERD. On the other hand, patients who did not need revisional surgery had good outcomes in terms of WL and QoL. Patients with lower BMI(<41) at the time of SG experienced the lower rate of WR, non-response and revisional surgery.
袖状胃切除术（SG）的长期可持续性受到质疑。本文旨在评估在一家大型肥胖症手术转诊中心进行10年随访的SG结果。
分析了2004年至2010年间接受SG的患者数据。如果出现体重复发（WR）、对初次肥胖症代谢手术无反应或药物治疗无效的胃食管反流（GERD），则建议进行翻修手术。
156例患者接受了SG，平均体重指数为47.6kg/m²。10年后，对153例患者中的117例进行了评估（32例失访（20.5%），4例因与SG无关的原因死亡）。平均随访时间为144±13个月。46例患者（39.4%）未接受任何进一步的肥胖症手术。在这一人群中，SG后10年的平均体重指数为35.1kg/m²，额外体重减少率（EWL）为55.2%，总体重减少率（TWL）为25.5%。71例患者接受了第二次肥胖症手术（60.6%）。SG与再次手术之间的平均时间为51.9个月。转换的原因是体重恢复（WR）（53%）、无反应（38%）、药物治疗无效的GERD（7%）和胃狭窄（1.4%）。高体重指数（从46到超过50）最常与第二次肥胖症手术相关。
本系列报告了SG术后10年因体重复发或GERD进行翻修手术的高发生率。另一方面，不需要翻修手术的患者在体重减轻和生活质量方面有良好的结果。SG时体重指数较低（<41）的患者体重复发、无反应和翻修手术的发生率较低。
