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 longterm results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric p...

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Detalles Bibliográficos
Autores: Sánchez Santos, Raquel, Masdevall, Carles, Baltasar, Aniceto, Martínez Blazquez, Cándido, García Ruiz de Gordejuela, Amador, Ponsi, Enric, Sánchez Pernaute, Andrés, 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
Tipo de recurso: artículo
Fecha de publicación:2009
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/71402
Acceso en línea:http://hdl.handle.net/10810/71402
Access Level:acceso abierto
Palabra clave:Sleeve gastrectomy
Mid-term results
Spanish National Registry
Obesity surgery
Descripción
Sumario:Background Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and longterm 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 24months (RR, 23.3 (11.4–35.2)). DMis 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.