Laparoscopic Sleeve Gastrectomy Performed with Intent to Treat Morbid Obesity: A Prospective Single-Center Study of 261 Patients with a Median Follow-up of 1 Year

Abstract

Background

The aim of the study is to look at laparoscopic sleeve gastrectomy as a procedure with intent to cure morbid obesity. Secondary endpoints are related to the safety profile of the procedure.

Methods

This is a prospective clinical study conducted in a single university surgical clinic.

Results

Two hundred sixty-one patients (2.5:1 female to male ratio, median age of 37 years) underwent sleeve gastrectomy. Median preoperative body mass index (BMI) was 45.2 kg/m². Mortality and morbidity rates were 0.7% and 8.4%, respectively. Risk factors for postoperative complications were history of diabetes mellitus under medical treatment (OR, 4.0; p = 0.014) and prior bariatric operation on the same patient (OR, 5.7, p = 0.034). Median follow-up was 12 months (range 1–29 months). A BMI > 50 kg/m² is connected with greater weight loss. Analysis of the percentage of excess weight loss (%EWL) during follow-up at specific time intervals showed a rapid increase for the first 12 months followed by a more gradual rise thereafter. The median %EWL for the first year of follow-up was 65.7 (range 33.8–102.3). The median BMI for the patients that had completed at least 1 year of follow-up was 30.5 kg/m² (range 21.2–42.7). The overall success rate after the first year was 74.3% when accounted for %EWL > 50 and 81.7% for BMI < 35 kg/m².

Conclusions

The actual long-term efficacy of the procedure remains to be confirmed. Morbidity rates may prove higher than expected especially during the learning curve.