, Volume 22, Issue 1, pp 97-104
Date: 22 Aug 2011

Improved Obesity Reduction and Co-morbidity Resolution in Patients Treated with 40-French Bougie Versus 50-French Bougie Four Years after Laparoscopic Sleeve Gastrectomy. Analysis of 294 Patients

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Abstract

Background

We compared percent excess body mass index loss (%EBMIL) and resolution of dyslipidaemia, hypertension, and type 2 diabetes mellitus in the 4 years following laparoscopic sleeve gastrectomy (LSG) between patients calibrated with a 40-French (40F) or a 50-French (50F) bougie.

Methods

We conducted a longitudinal retrospective descriptive study of routinely collected pre- and post-surgical data from 294 patients who underwent LSG at a single surgical centre (50F—n = 106, 40F—n = 185). Obesity measurements were taken prior to surgery and at regular intervals until 48 months post-surgery. Co-morbidity resolution was also assessed across the 48-month observation period. Multivariate regression modelling was used to control analyses for baseline obesity and sociodemographic variables.

Results

At 48 months post-surgery mean (±SD) %EBMIL was 60.2 ± 27.6% and 45.4 ± 38.4% for those treated with the 40F and 50F bougie, respectively. After controlling for sociodemographic variables and baseline excess weight, mean %EBMIL was 15.5% greater with a 40F bougie compared with a 50F bougie at the end of follow-up. The likelihood of dyslipidaemia resolution within 48 months post-LSG was 19.0 times greater (p = 0.006), hypertension resolution 3.6 times greater (p = 0.005) and type 2 diabetes mellitus resolution 5.2 times greater (p = 0.034) by 4 years post-surgery in patients treated with the 40F bougie compared with a 50F bougie.

Conclusion

Improved obesity reduction and resolution of dyslipidaemia, hypertension and type 2 diabetes mellitus is experienced during the 4 years following surgery by patients treated with a 40F bougie compared with the 50F. These findings remain when controlling for potential confounding clinical and sociodemographic factors.

The study was funded by the School of Population Health at The University of Western Australia, who have no commercial/financial interest in the results of this study.