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Long-Term Outcomes of Sleeve Gastrectomy: Weight Recurrence and Surgical Non-responders

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Abstract

Introduction

Sleeve gastrectomy (SG) is an effective procedure with remarkable weight loss and low complication rates. However, up to 30% of cases require revisional surgery in non-responders or patients who experience weight recurrence. We aim to report the rate of weight recurrence/non-responders (WR/NR) in patients who underwent SG and had more than 5 years of follow-up.

Methods

We performed a multicenter retrospective study of patients who underwent initial SG from 2008 to 2017. Patient demographics and weight loss outcomes up to 12 years after SG were collected. Surgical non-responders were defined as 20% weight regain compared to maximum weight loss. A chi-square test for categorical variables and a two-sample t-test for continuous variables were used. Data are summarized as mean ± standard deviation.

Results

From a total of 1263 patients, we included 339 patients (78% female, age 47.3 ± 11.2 years; baseline weight 125.8 ± 27.6 kg) with at least 5 years of follow-up (mean follow-up of 7.1 ± 1.8 years) (Table 1). Surgical non-response was demonstrated in 15.9% of patients (n=54) and 64.0% (n=217) had weight recurrence after SG (Fig. 1). There was a statistically significant difference in history of hypertension (p=0.046) and diabetes (p=0.032) as well as %TBWL at 1 year (p=0.005) and at longest follow-up (p<0.001) between patients who experienced WR/NR and those who did not.

Conclusions

Only 20% of patients who underwent SG and followed up for more than 5 years were able to maintain appropriate weight loss.

Graphical Abstract

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Authors and Affiliations

  1. Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr., 1st Floor, Orlando Health, Orlando, FL, USA

    Romulo Lind, Muhammad Ghanem, Muhammad Jawad & Andre F. Teixeira

  2. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Karl Hage & Omar M. Ghanem

  3. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Meera Shah

  4. Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA

    Robert A. Vierkant

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  1. Romulo Lind
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  2. Karl Hage
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Correspondence to Romulo Lind.

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Since the data was de-identified and is archival in nature, no patient consent was required.

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights

This study has been approved by the appropriate institutional research ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Key points

• WL performance in patients with a follow-up > 5 years after SG was analyzed.

• NR and WR were demonstrated in 15.9% of patients and 64.0% respectively.

• Preoperative diabetes and hypertension were more prevalent in NR/WR patients.

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Lind, R., Hage, K., Ghanem, M. et al. Long-Term Outcomes of Sleeve Gastrectomy: Weight Recurrence and Surgical Non-responders. OBES SURG 33, 3028–3034 (2023). https://doi.org/10.1007/s11695-023-06730-z

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  • DOI: https://doi.org/10.1007/s11695-023-06730-z

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