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Short- and Mid-term Outcomes of Sleeve Gastrectomy for Morbid Obesity: The Experience of the Spanish National Registry

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Abstract

Background

Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and long-term results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric procedure.

Methods

Data were obtained from 17 centers and collected in a database. Technical issues, preoperative comorbid conditions, hospital stay, early and late complications, and short- and mid-term weight loss were analyzed.

Results

Five hundred forty patients were included; 76% were women. Mean BMI was 48.1 ± 10. Mean age was 44.1 ± 11.8. Morbidity rate was 5.2% and mortality rate 0.36%. Complications presented more frequently in superobese patients (OR, 2.8 (1.18–6.65)), male (OR, 2.98 (1.26–7.0)), and patients >55 years old (OR, 2.8 (1.14–6.8)). Staple-line reinforcement was related to a lower complication rate (3.7 vs 8.8%; p = 0.039). Mean hospital stay was 4.8 ± 8.2 days. Mean follow-up was 16.5 ± 10.6 months (1–73). Mean percent excess BMI loss (EBL) at 3 months was 38.8 ± 22, 55.6 ± 8 at 6 months, 68.1 ± 28 at 12 months, and 72.4 ± 31 at 24 months. %EBL was superior in patients with lower initial BMI and lower age. Bougie caliber was an inverse predictive factor of %EBL at 12 and 24 months (RR, 23.3 (11.4–35.2)). DM is remitted in 81% of the patients and HTA improved in 63.2% of them. A second-stage surgery was performed in 18 patients (3.2%).

Conclusions

LSG provides good short- and mid-term results with a low morbid-mortality rate. Better results are obtained in younger patients with lowest BMI. Staple-line reinforcement and a thinner bougie are recommended to improve outcome.

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Acknowledgments

We would like to thank the members of the multidisciplinary bariatric teams in the participating hospitals: Complejo Hospitalario de Pontevedra, Hospital Universitari de Bellvitge (Barcelona), Hospital Virgen de los Lirios (Alcoy), Hospital Txagorritxu (Vitoria), Hospital San José (Vitoria), Centro Médico Delfos (Barcelona), Hospital Clínico San Carlos (Madrid), Hospital La Paz (Madrid), Hospital Virgen de la Paloma (Madrid), Hospital Universitario de Reus, Hospital de Mataró, Hospital Clinico Universitario (Salamanca), Clínica Santísima Trinidad (Salamanca), Hospital Universitario de Getafe, Hospital de Conxo (Santiago de Compostela), Hospital de Meixoeiro (Vigo), Hospital de Albacete.

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Correspondence to Raquel Sánchez-Santos.

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Sánchez-Santos, R., Masdevall, C., Baltasar, A. et al. Short- and Mid-term Outcomes of Sleeve Gastrectomy for Morbid Obesity: The Experience of the Spanish National Registry. OBES SURG 19, 1203–1210 (2009). https://doi.org/10.1007/s11695-009-9892-9

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