VSG Maintenance Group
Long-term results of laparoscopic sleeve gastrectomy for obesity
Long-term results of laparoscopic sleeve gastrectomy for obesity.
Division of Bariatric Surgery, AZ St-Blasius, Kroonveldlaan, Dendermonde, Belgium.
OBJECTIVE: To determine the mid- and long-term efficacy and possible side effects of laparoscopic sleeve gastrectomy as treatment for morbid obesity.
SUMMARY BACKGROUND DATA: Laparoscopic sleeve gastrectomy is still controversial as single and final treatment for morbid obesity. Some favorable short-term results have been published, however long-term results are still lacking.
METHODS: In the period between November 2001 and October 2002, 53 consecutive morbidly obese patients who, according to our personal algorithm, were qualified for restrictive surgery were selected for laparoscopic sleeve gastrectomy. Of the 53 patients, 11 received an additional malabsorptive procedure at a later stage because of weight regain. The percentage of excess weight loss (EWL) was assessed at 3 and 6 years postoperatively. A retrospective review of a prospectively collected database was performed for evaluation after 3 years. Recently, after the sixth postoperative year, patients were again contacted and invited to fill out a questionnaire.
RESULTS: Full cooperation was obtained in 41 patients, a response rate of 78%. Although after 3 years a mean EWL of 72.8% was documented, after 6 years EWL had dropped to 57.3%, which according to the Reinhold criteria is still satisfactory. These results included 11 patients who had benefited from an additional malabsorptive procedure (duodenal switch) and 2 patients who underwent a "resleeve" between the third and sixth postoperative year. Analyzing the results of the subgroup of 30 patients receiving only sleeve gastrectomy, we found a 3-year %EWL of 77.5% and 6+ year %EWL of 53.3%. The differences between the third and sixth postoperative year were statistically significant in both groups. Concerning long-term quality of life patient acceptance stayed good after 6 + years despite the fact that late, new gastro-esophageal reflux complaints appeared in 21% of patients.
CONCLUSIONS: In this long-term report of laparoscopic sleeve gastrectomy, it appears that after 6+ years the mean excess weight loss exceeds 50%. However, weight regain and de novo gastroesophageal reflux symptoms appear between the third and the sixth postoperative year. This unfavorable evolution might have been prevented in some patients by continued follow-up office visits beyond the third year. Patient acceptance remains good after 6+ years.
It said the "unfavorable evolution" might have been avoided if they were give long term care/ follow up! This 1 report is not what I would base my possible future results on! But take note......long term care follow up and support are important for success.........but you all already knew that! Mini.....please note if I sound a bit defensive or miffed, it is not directed at you! just a bit of the collateral damage from all the BS surgery wars around here lately!
something must have happened for it to show statistically that most had a problem between year 3-6 and they are suggesting that its because they lost follow up care.. which still pushes home the fact we need to keep our head in the game.
and dont worry i dont mind you being defensive, i just think even the reports that do not look so stella are important info to have, because maybe there is something we can learn from them, even if it is to not give up on oh and or support groups.
6lbs under goal weight
Join US On The VSG Maintenance Group Forum!!
And while I don't like some of what I read, I choose to look on the positive side and plan to put myself in the category of one of the ones who maintains the loss over 6 years. I already lost 100% of excess weight; not 50%. I got rid of acid reflux with hernia repair. If I get reflux again i can take meds for it. The main thing is commitment to long term management of this issue. My surgeon provides 5 year follow up. And I am sure that if I want more I can purchase it and its worth is. And I will probably be hanging around here at OH in 5 years blathering about the same stuff. And if I need to start my own support group locally I will do so. So during years three to six I guess I know to be especially vigilent and gotta get the exercise element well in place by then - my main failure.
So lets see what we can learn from this to advance our own success. Diane