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Five-Year Outcomes of Laparoscopic Sleeve Gastrectomy in Japanese Patients with Class I Obesity

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Abstract

Background

Bariatric surgery is being recognized increasingly as an effective treatment for obesity and related comorbidities. In Japan, the cost of laparoscopic sleeve gastrectomy (LSG) is covered by the national health insurance for adults with a body mass index (BMI) ≥ 35 kg/m2 and specific comorbidities (type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), and obstructive sleep apnea syndrome (OSAS)). However, only 0.6% of the adult population have a BMI ≥ 35 kg/m2. In contrast, 4.3% have class I obesity (a BMI of 30–34.9 kg/m2). The BMI of Asians with central obesity-induced diabetes and other metabolic disorders is much lower than that of Westerners.

Objectives

To evaluate the medium-term (up to 5 years) outcomes of LSG performed in Japanese patients with class I obesity.

Methods

One hundred eighteen consecutive patients with class I obesity treated by LSG at our center between August 2007 and December 2018 were included in a retrospective study. Mean preoperative body weight (BW) and BMI were 88.6 ± 10.3 kg and 32.8 ± 1.6 kg/m2, respectively. Weight loss, comorbidity status, and adverse events were assessed.

Results

Mean BW/BMI at 1, 3, and 5 years after LSG decreased significantly to 66.6 ± 11.2 kg/24.6 ± 2.8 kg/m2, 68.0 ± 14.0 kg/25.4 ± 4.0 kg/m2, and 69.1 ± 12.9 kg/26.5 ± 3.0 kg/m2, respectively. Mean total weight loss at 1, 3, and 5 years was 24.7 ± 8.2%, 21.8 ± 12.1%, and 18.5 ± 9.7%, respectively. Metabolic disorders such as T2DM, HT, and DL improved significantly. There was no mortality.

Conclusion

LSG is safe, yields excellent weight loss, and improves obesity-related comorbidities in Japanese patients with class I obesity.

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Acknowledgments

The authors thank Prof. Tina Tajima of St. Marianna University School of Medicine for her meticulous English editing.

Funding

The study was funded by departmental resources only.

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Authors and Affiliations

  1. Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan

    Yosuke Seki, Kazunori Kasama, Eri Kikkawa, Renzo Yokoyama, Taiki Nabekura, Akihiko Sano & Manabu Amiki

  2. Department of Surgery, Kawasaki Saiwai Hospital, 31-27 Omiyacho, Saiwai-ku, Kawasaki-shi, Kanagawa, Japan

    Manabu Amiki

  3. Department of Surgery, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan

    Yoshimochi Kurokawa

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  1. Yosuke Seki
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  2. Kazunori Kasama
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Correspondence to Yosuke Seki.

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Conflict of Interest

The authors have no commercial associations that might constitute a conflict of interest related to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethics approval of this study was granted by the Institutional Review Board of Yotsuya Medical Cube (Ref No. YCR19006).

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Informed consent was obtained from all individual participants included in the study.

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Seki, Y., Kasama, K., Kikkawa, E. et al. Five-Year Outcomes of Laparoscopic Sleeve Gastrectomy in Japanese Patients with Class I Obesity. OBES SURG 30, 4366–4374 (2020). https://doi.org/10.1007/s11695-020-04789-6

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