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

Background: Laparoscopic sleevegastrectomy(SG)hasgainedgreatpopularityasastand-alone bariatric procedurebecauseshort-andmid-termoutcomesintermsofweightlossandresolutionof co-morbidities havebeenverypositive.However,long-termresultsfromlargeseriesstillaresparse. Objectives: To evaluatethelong-termclinicaloutcomesofSGinalargeseriesofpatients undergoing SGasastand-aloneprocedure. Setting: University hospitalinItaly. Methods: A retrospectiveanalysisofprospectivelycollecteddatafrom182patientsundergoingSG between 2006and2008intheauthors’ institution. Long-termoutcomesat6and7yearswere analyzed 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-upof84 months. Atyear6follow-upthemeanBMIandthemeanpercentageofexcessweightloss(%EWL) were 30.2kg/m2 and 67.3%,respectively.Meantotalbodyweightlosswas44.9kg,whilea%EWL 450 wasregisteredin123patients(83.1%).PreoperativeBMIdidnotsignificantly influence postoperative %EWL.Remissionoftype2diabetesmellitus,arterialhypertension,obstructivesleep apnea syndrome,andgastroesophagealreflux diseasesymptomsoccurredin83.8%,59.7%,75.6%, and 64.7%ofpatients,respectively. Conclusion: %EWL andresolutionofco-morbiditiesappeartobesustained6and7yearsafterSG. Preoperative BMIisnotpredictiveforweightlossoutcomes