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Long-Term Outcome of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Japanese Patients

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Abstract

Background

Recently, laparoscopic sleeve gastrectomy (LSG) as a standalone bariatric procedure has rapidly gained popularity worldwide mainly because of its technical simplicity and the relatively good short-term outcome. In Japan, according to a domestic survey, 71 % of the bariatric procedures performed were LSG. However, the number of studies reporting long-term results are still not enough; particularly, data for Asian patients are scarce.

Objective

The objective of this study was to evaluate the long-term outcomes for LSG in morbidly obese Japanese regarding weight loss and safety.

Methods

Between October 2005 and July 2013, 179 morbidly obese Japanese patients (Female 89/Male 90) underwent LSG as a standalone procedure. The mean age was 40.7 years (range, 20–72 years), and the mean preoperative body weight and body mass index (BMI) were 120.4 kg (range, 71.4–231.6 kg) and 43.3 kg/m2 (range, 30.9–76.5 kg/m2), respectively. All patients were evaluated and managed under a strict multidisciplinary team approach.

Results

The mean BMI declined to 30.0 ± 8.7 kg/m2 at 1 year, 29.1 ± 8.6 kg/m2 at 2 years, 28.8 ± 8.7 kg/m2 at 3 years, 29.3 ± 9.2 kg/m2 at 4 years, and 32.7 ± 13.6 kg/m2 at 5 years or more (p < 0.001). The mean percent total body weight loss (%TWL) achieved was 32.4 ± 12.9 % at 1 year, 34.3 ± 12.9 % at 2 years, 34.4 ± 11.6 % at 3 years, 32.8 ± 10.9 % at 4 years, and 29.5 ± 11.8 % at 5 years or more. Super morbidly obese patients and patients whose gastric tube was created using a thicker (45 Fr.) bougie had a tendency to achieve less weight loss. Early and late complications occurred in 16 patients (8.9 %) and in seven patients (3.9 %), respectively. Revision surgeries were required in six patients (3.4 %). The reasons for revision surgery were insufficient weight loss in five patients and intractable gastroesophageal reflux disease (GERD) in one patient.

Conclusion

LSG for Japanese morbidly obese patients is safe, effective, and acceptably durable up to 5 years although some complications unique to the procedure such as leakage from the staple line and intractable GERD occur. For super morbidly obese patients, other surgical options may be required.

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References

  1. Presented at the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) annual meeting in 2014 (Montreal, Canada).

  2. Tagaya N, Kasama K, Inamine S, et al. Evaluation of the excluded stomach by double-balloon endoscopy after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17(9):1165–70.

    Article  PubMed  Google Scholar 

  3. The annual surveys and questionnaires of laparoscopic bariatric surgery and endoscopic intragastric balloon placement 2013. The Japan Consortium of Obesity and Metabolic Surgery (JCOMS).

  4. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5(4):469–75.

    Article  PubMed  Google Scholar 

  5. Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(1):177–83.

    Article  PubMed  Google Scholar 

  6. Zachariah SK, Chang PC, Ooi AS, et al. Laparoscopic sleeve gastrectomy for morbid obesity: 5 years experience from an Asian center of excellence. Obes Surg. 2013;23(7):939–46.

    Article  PubMed  Google Scholar 

  7. Kasama K, Tagaya N, Kanahira E, et al. Has laparoscopic bariatric surgery been accepted in Japan? The experience of a single surgeon. Obes Surg. 2008;18(11):1473–8.

    Article  PubMed  Google Scholar 

  8. Guidelines for Clinical Application of Laparoscopic Bariatric Surgery. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). http://www.sages.org/publications/guidelines/guidelines-for-clinical-application-of-laparoscopic-bariatric-surgery/.

  9. Tagaya N, Kasama K, Kikkawa R, et al. Experience with laparoscopic sleeve gastrectomy for morbid versus super morbid obesity. Obes Surg. 2009;19(10):1371–6.

    Article  PubMed  Google Scholar 

  10. Teramoto T, Sasaki J, Ueshima H, et al. Treatment—Therapeutic lifestyle modification. J Atheroscler Thromb. 2008;15(3):109–15.

    Article  PubMed  Google Scholar 

  11. Oshiro T, Kasama K, Umezawa A, et al. Successful management of refractory staple line leakage at the esophagogastric junction after a sleeve gastrectomy using the HANAROSTENT. Obes Surg. 2010;20(4):530–4.

    Article  PubMed  Google Scholar 

  12. Rosenthal RJ. International sleeve gastrectomy expert panel. International sleeve gastrectomy expert panel consensus statement: Best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.

    Article  PubMed  Google Scholar 

  13. Lee WJ, Wang W, Chen TC, et al. Clinical significance of central obesity in laparoscopic bariatric surgery. Obes Surg. 2003;13:921–5.

    Article  PubMed  Google Scholar 

  14. Dietary Guidelines for Americans 2005, U.S. Department of Health and Human Services, U.S. Department of Agriculture, p 29.

  15. Eisenberg D, Bellatorre A, Bellatorre N. Sleeve gastrectomy as a stand-alone bariatric operation for severe, morbid, and super obesity. JSLS. 2013;17(1):63–7.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Al Falah HM, AlSalamah SM, Abdullah M, et al. An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbidly obese patients. Saudi Med J. 2013;34(5):503–10.

    PubMed  Google Scholar 

  17. Alexandrou A, Felekouras E, Giannopoulos A, et al. What is the actual fate of super-morbid-obese patients who undergo laparoscopic sleeve gastrectomy as the first step of a two-stage weight-reduction operative strategy? Obes Surg. 2012;22(10):1623–8.

    Article  PubMed  CAS  Google Scholar 

  18. Lemanu DP, Srinivasa S, Singh PP, et al. Single-stage laparoscopic sleeve gastrectomy: Safety and efficacy in the super-obese. J Surg Res. 2012;177(1):49–54.

    Article  PubMed  Google Scholar 

  19. Zerrweck C, Sepúlveda EM, Maydón HG, et al. Laparoscopic gastric bypass vs. sleeve gastrectomy in the super obese patient: Early outcomes of an observational study. Obes Surg. 2014;24(5):712–7.

    Article  PubMed  Google Scholar 

  20. Abdallah E, El Nakeeb A, Yousef T, et al. Impact of the extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study). Obes Surg. 2014;24(10):1587–94.

    Article  PubMed  Google Scholar 

  21. Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leakage after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9,991 cases. Ann Surg. 2013;257(2):231–7.

    Article  PubMed  Google Scholar 

  22. Spivak H, Rubin M, Sadot E, et al. Laparoscopic sleeve gastrectomy using a 42-French versus 32-French bougie: the first-year outcome. Obes Surg. 2014;24(7):1090–3.

    Article  PubMed  Google Scholar 

  23. Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(8):1171–7.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank Ms. Sandra Cave who assisted in the proof-reading of this manuscript.

Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

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

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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 & Kenkichi Hashimoto

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  1. Yosuke Seki
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  2. Kazunori Kasama
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  3. Kenkichi Hashimoto
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Correspondence to Yosuke Seki.

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Seki, Y., Kasama, K. & Hashimoto, K. Long-Term Outcome of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Japanese Patients. OBES SURG 26, 138–145 (2016). https://doi.org/10.1007/s11695-015-1728-1

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  • DOI: https://doi.org/10.1007/s11695-015-1728-1

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