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Postoperative Outcomes, Weight Loss Predictors, and Late Gastrointestinal Symptoms Following Laparoscopic Sleeve Gastrectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Objective

To evaluate the outcomes, weight loss predictors, and gastrointestinal symptoms of patients after laparoscopic sleeve gastrectomy (LSG).

Methods

The postoperative medical status of the patients was obtained retrospectively using a questionnaire and was compared to existing medical data before the surgery.

Results

We included 201 candidates, 178 patients completed mean of 3 years of follow-up. Mean excess body weight loss (%EWL) was 65.14% ± 15.74 at 6 months, 78.53% ± 20.28 at 12 months, and 74.32% ± 23.92 at 3 years after LSG. Older age (P = 0.018), higher baseline BMI (P = 0.003), and higher number of medications (P < 0.001) were negative predictors for EWL%. Total weekly hours of physical activity was found to be a positive predictor for EWL% (P = 0.008). Remission rates of co-morbidities were 83.5% for dyslipidemia (P < 0.001), 65.8% for hypertension (P < 0.001), 62.1% for type 2 diabetes mellitus (T2DM) (P < 0.001), and 60.7% for gastroesophageal reflux (GERD) (P < 0.001). Late gastrointestinal symptoms were as follows: emesis in 25.9%, constipation in 24.7%, diarrhea in 4.5%, food intolerance in 22.5% and alopecia in 42.7% of the patients.

Conclusion

Our study shows LSG as a potential tool in achieving almost 75% of EWL% with significant remission of co-morbidities, along with various late gastrointestinal symptoms.

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References

  1. World Health Organization. Obesity: Preventing and managing the Global Epidemic. Vol. 1997, Executive summary, WHO Technical Report Series (TRS). 2010. p. 5–8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25196564.

  2. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity Among Adults and Youth: United States, 2011-2014. NCHS Data Brief. 2015;(219):1–8.

    Google Scholar 

  3. Sturm R., Hattori A. Morbid Obesity Rates Continue to Rise Rapidly in the US. Int J Obes (Lond). 2013 Jun; 37(6): 889–891. https://doi.org/10.1038/ijo.2012.159.

  4. World health organization. Obesity and overweight [fact sheet], 2016. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/.

  5. Buchwald H., Avidor Y., Braunwald E., Pories W., Fahrbach K., Schoelles K., Bariatric surgery: A systematic review and meta-analysis. JAMA. 2004; 292(14):1724–1728.

    Article  CAS  PubMed  Google Scholar 

  6. Buchwald H., Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013; 23(4):427–436. https://doi.org/10.1007/s11695-012-0864-0.

    Article  PubMed  Google Scholar 

  7. ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2012; 8(3):e21–e26. https://doi.org/10.1016/j.soard.2012.02.001.

    Article  Google Scholar 

  8. NIH conference. Gastrointestinal Surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991; 115 (12):956–961.

    Article  Google Scholar 

  9. Golomb I., Ben David M., Glass A., Kolitz T., Keidar A. Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy. JAMA Surg. 2015; 150 (11):1051–1057. https://doi.org/10.1001/jamasurg.2015.2202.

    Article  PubMed  Google Scholar 

  10. Boza C., Daroch D., Barros D., León F., Funke R., Crovari F. Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure. Surg Obes Relat Dis. 2014; 10(6):1129–1133. https://doi.org/10.1016/j.soard.2014.03.024.

    Article  PubMed  Google Scholar 

  11. Contreras JE., Santander C., Court I., Bravo J. Correlation between age and weight loss after bariatric surgery. Obes Surg. 2013; 23(8):1286–1289. https://doi.org/10.1007/s11695-013-0905-3.

    Article  PubMed  Google Scholar 

  12. Chang SH., Stoll CRT., Song J., Varela JE., Eagon CJ., Colditz GA. The Effectiveness and Risks of Bariatric Surgery. JAMA Surg. 2014; 149(3):275. https://doi.org/10.1001/jamasurg.2013.3654.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Padwal R., Klarenbach S., Wiebe N.et al. Bariatric surgery: A systematic review and network meta-analysis of randomized trials. Obes Rev. 2011; 12(8):602–621. https://doi.org/10.1111/j.1467-789X.2011.00866.x.

    Article  CAS  PubMed  Google Scholar 

  14. Mizrahi I., Alkurd A., Ghanem M., et al. Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years. Obes Surg. 2014; 24(6):855–860. https://doi.org/10.1007/s11695-014-1177-2.

    Article  PubMed  Google Scholar 

  15. Schauer P. Bariatric Surgery versus Intensive Medical Therapy for Diabetes. N Engl J Med. 2014; 371(7):680–682. https://doi.org/10.1056/NEJMoa1401329.

    Article  Google Scholar 

  16. Al Khalifa K., Al Ansari A., Alsayed AR., Violato C. The impact of sleeve gastrectomy on hyperlipidemia: A systematic review. J Obes. 2013; 2013 (Ldl). https://doi.org/10.1155/2013/643530.

  17. Atkins ER., Preen DB., Jarman C., Cohen LD. 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. Obes Surg. 2012; 22(1):97–104. https://doi.org/10.1007/s11695-011-0493-z.

    Article  PubMed  Google Scholar 

  18. Prasad P., Tantia O., Patle N., Khanna S., Sen B. An analysis of 1-3-year Follow-up results of laparoscopic sleeve gastrectomy: An indian perspective. Obes Surg. 2012; 22(3):507–514. https://doi.org/10.1007/s11695-012-0599-y.

    Article  PubMed  Google Scholar 

  19. Pallati PK., Shaligram A., Shostrom VK., Oleynikov D., McBride., Goede MR., Improvement in gastroesophageal reflux disease symptoms after various bariatric procedures: review of the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2014; 10(3):502–7. https://doi.org/10.1016/j.soard.2013.07.018.

    Article  PubMed  Google Scholar 

  20. Himpens J., Dobbeleir J., Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010; 252(2):319–324. https://doi.org/10.1097/SLA.0b013e3181e90b31.

    Article  PubMed  Google Scholar 

  21. Sarwer DB., Dilks RJ., West-Smith L. Dietary intake and eating behavior after bariatric surgery: Threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis. 2011; 7(5):644–651. https://doi.org/10.1016/j.soard.2011.06.016.

    Article  PubMed  Google Scholar 

  22. Handzlik-Orlik G., Holecki M., Orlik B., Wylelol M., Dulawa J. Nutrition management of the post-bariatric surgery patient. Nutr Clin Pract. 2015; 30(3):383–392. https://doi.org/10.1177/0884533614564995.

    Article  PubMed  Google Scholar 

  23. Yu J., Zhou X., Li L., Li S., Tan J., Li Y., Sun X. The Long-Term Effects of Bariatric Surgery for Type 2 Diabetes: Systematic Review and Meta-analysis of Randomized and Non-randomized Evidence. Obes. Surg. 2015; 25 (1):143–158.

    Article  PubMed  Google Scholar 

  24. Weiner S., Sauerland S., Fein M., Blanco R., Pomhoff I., Weiner RA. The Bariatric Quality of Life (BQL) Index: A Measure of Well-being in Obesity Surgery Patients. Obes. Surg. 2005; 15 (4):538–545.

    Article  PubMed  Google Scholar 

  25. Poylin V., Serrot FJ., Madoff RD., Ikrumuddin S., Mellgren A., Lowry AC., Melton GB. Obesity and bariatric surgery: a systematic review of associations with defecatory dysfunction. Color. Dis. 2011; 13 (6):e92–e103.

    Article  CAS  Google Scholar 

  26. de Zwaan M., Hilbert A., Swan-Kremeier L., et al. Comprehensive interview assessment of eating behavior 18-35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010; 6(1):79–85.

  27. Schweiger C., Weiss R., Keidar A. et al., Effect of Different Bariatric Operations on Food Tolerance and Quality of Eating. Obes Surg. 2010; 20(10):1393–1399.

    Article  PubMed  Google Scholar 

  28. Ruiz-Tovar J., Oller I., Llavero C., Zubiaga L., Diez M., Arroyo A., Calero A., Calpena R. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg. 2014; 80(5):466–471.

    PubMed  Google Scholar 

  29. Bobowicz M., Lehmann A., Orlowski M., Lech P., Michalik M. Preliminary Outcomes 1Â Year after Laparoscopic Sleeve Gastrectomy Based on Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg. 2011; 21(12):1843–1848.

  30. Christian NJ., King WC., Yanovski SZ., Courcoulas AP., Belle SH. Validity of self-reported weights following bariatric surgery. JAMA. 2013; 31(22):2454–2456.

    Article  Google Scholar 

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Author information

Author notes

  1. M. Goldenshluger, A. Goldenshluger, and L. Keinan-Boker contributed equally to the work.

Authors and Affiliations

  1. General and Oncological Department C, Chaim Sheba Medical Center—Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 5265601, Tel Hashomer, Israel

    Michael Goldenshluger

  2. Department of Nutrition, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Ariela Goldenshluger & Tair Ben-Porat

  3. Israel Ministry of Health, Center for Disease Control, Ramat Gan, Israel

    Lital Keinan-Boker

  4. Clalit Health Services, Jerusalem District, Israel

    Matan Joel Cohen

  5. Department of Surgery, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel

    Heba Gerasi, Majd Amun, Mahmud Abu-Gazala, Abed Khalaileh, Yoav Mintz & Ram Elazary

Authors
  1. Michael Goldenshluger
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  2. Ariela Goldenshluger
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  3. Lital Keinan-Boker
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  4. Matan Joel Cohen
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Contributions

Dr. Goldenshluger—writing the manuscript, data analysis, and interpretation.

Mrs. Goldenshluger—initiating the research, drafting the manuscript design, recruiting the research team, data analysis, and interpretation. Equal contribution to first author.

Dr. Keinan Boker—supervision of the research, interpretation of the data, and final approval of the version to be published.

Dr. Cohen—statistical analysis and linguistic editing.

Mrs. Ben-Porat—data gathering and analysis.

Mrs. Gerasi—patient recruitment and data gathering.

Mr. Amun—patient recruitment and data gathering.

Dr. Abu-Gazala—patient recruitment and data gathering.

Dr. Mintz—writing and final approval of the version to be published.

Dr. Elazary—interpretation of the data, final approval of the version to be published and instruction.

Corresponding author

Correspondence to Michael Goldenshluger.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research board. For this type of study, formal consent was not required.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

The paper was presented as an oral presentation at the 2016 national biennial meeting of Israel Society for Endoscopic Surgery in Eylat, Israel.

M. Goldenshluger and A. Goldenshluger both are co-authors.

L. Keinan-Boker and R. Elazary are both instructors.

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Goldenshluger, M., Goldenshluger, A., Keinan-Boker, L. et al. Postoperative Outcomes, Weight Loss Predictors, and Late Gastrointestinal Symptoms Following Laparoscopic Sleeve Gastrectomy. J Gastrointest Surg 21, 2009–2015 (2017). https://doi.org/10.1007/s11605-017-3585-9

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  • DOI: https://doi.org/10.1007/s11605-017-3585-9

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