Midterm Results of Primary vs. Secondary Laparoscopic Sleeve Gastrectomy (LSG) as an Isolated Operation
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We investigated early and midterm results of laparoscopic sleeve gastrectomy (LSG) as an isolated primary and secondary operation after failed gastric banding.
Between May 2004 and October 2007, a total of 70 patients (female 77%, mean age 43 (21–65) years, mean initial body mass index (BMI) 46 (35–61) kg/m2) were prospectively evaluated and operated by LSG. In 41 patients, LSG was performed as a primary operation (group 1) and in 29 patients as a secondary procedure after failed gastric banding (group 2). The overall average follow-up time after LSG was 24 (12–53) months; follow-up rate 1 year after operation was 100%, after 2 years 98%, and after 3 years 95%.
There were no intraoperative complications, no conversion with shorter operation time in group 1 (91 vs. 132 min, p = 0.001). Early morbidity of LSG was 5% (major) and 7% (minor); mortality was zero. Average excessive BMI loss after 1 year was 65% (9–127%), after 2 years 63% (13–123%), and after 3 years 60% (9–111%). Midterm morbidity was 13%. There was no significant difference between the two groups regarding early and midterm morbidity, reoperation rate for complications (11.4%), or insufficient weight loss (7%).
LSG is a safe bariatric procedure with good weight loss in the first 3 years postop. It can be used as an isolated initial treatment and as a secondary treatment after failed gastric banding. However, in the absence of long-term results, we suggest LSG to be performed only in controlled trials.
KeywordsLaparoscopic sleeve gastrectomy Morbid obesity Bariatric surgery Outcome Complications
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