Long-term results after laparoscopic sleeve gastrectomy in a large monocentric series

Background: Laparoscopic sleevegastrectomy(SG)hasgainedgreatpopularityasastand-alonebariatric procedurebecauseshort-andmid-termoutcomesintermsofweightlossandresolutionofco-morbidities havebeenverypositive.However,long-termresultsfromlargeseriesstillaresparse.Objectives: To evaluatethelong-termclinicaloutcomesofSGinalargeseriesofpatientsundergoing SGasastand-aloneprocedure.Setting: University hospitalinItaly.Methods: A retrospectiveanalysisofprospectivelycollecteddatafrom182patientsundergoingSGbetween 2006and2008intheauthors’ institution. Long-termoutcomesat6and7yearswereanalyzed intermsofweightlossandco-morbiditiesresolution.Results: Mean initialbodymassindex(BMI)was45.9 7.3 kg/m2. Majorpostoperativecom-plications occurredin8patients(5.4%):4leaks,2bleeding,1abdominalcollection,and1dys-phagia. Allcomplicationsweremanagedconservatively.Onehundredforty-eightpatients(81.4%)completed the72-month(6-year)follow-up.Thirty-sevenpatients(25%)reachedafollow-upof84months. Atyear6follow-upthemeanBMIandthemeanpercentageofexcessweightloss(%EWL)were 30.2kg/m2 and 67.3%,respectively.Meantotalbodyweightlosswas44.9kg,whilea%EWL450 wasregisteredin123patients(83.1%).PreoperativeBMIdidnotsignificantly influencepostoperative %EWL.Remissionoftype2diabetesmellitus,arterialhypertension,obstructivesleepapnea syndrome,andgastroesophagealreflux diseasesymptomsoccurredin83.8%,59.7%,75.6%,and 64.7%ofpatients,respectively.Conclusion: %EWL andresolutionofco-morbiditiesappeartobesustained6and7yearsafterSG.Preoperative BMIisnotpredictiveforweightlossoutcomes