American journal of surgery · 2025
Ten-year outcomes of sleeve gastrectomy in a single-center series of 156 patients: weight loss and need of revisional surgery.
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Liagre Arnaud, Martini Francesco, Van Haverbeke Olivier, Boudry Hubert, Petrucciani Niccolo
Аннотация
BACKGROUND: The long-term sustainability of sleeve gastrectomy (SG) has been questioned. The aim of the article is to evaluate the results of SG at 10-year follow-up in a high-volume referral center for bariatric surgery.
METHODS: Data of patients who underwent SG between 2004 and 2010 were analyzed. Revisional surgery was proposed in case of weigh recurrence (WR), non-response to primary bariatric metabolic surgery or gastroesophageal reflux (GERD) resistant to medical treatment.
RESULTS: SG was performed in 156 patients, with mean BMI of 47.6 kg/m2. After 10 years, 117 out of 153 patients were evaluated (32 patients lost to follow-up (20.5 %) and four died due to causes unrelated to SG). Mean follow-up duration was 144 ± 13 months. Forty-six patients (39.4 %) did not receive any further bariatric surgery. In this population, the average BMI was 35.1 kg/m2, EWL was 55.2 % and TWL was 25.5 % 10 years after SG. 71 patients underwent a second bariatric procedure (60.6 %). The average time between SG and redo-surgery was 51.9 months. Reasons for conversion were weight regain (WR) (53 %), non-response (38 %), GERD resistant to medical treatment (7 %), and gastric stricture (1.4 %). A high BMI (from 46 to over 50) was most often associated with a second bariatric surgery.
CONCLUSIONS: The present series reports a high rate of revisional surgery after SG at 10 years, for weight recurrence or GERD. On the other hand, patients who did not need revisional surgery had good outcomes in terms of WL and QoL. Patients with lower BMI(<41) at the time of SG experienced the lower rate of WR, non-response and revisional surgery.
METHODS: Data of patients who underwent SG between 2004 and 2010 were analyzed. Revisional surgery was proposed in case of weigh recurrence (WR), non-response to primary bariatric metabolic surgery or gastroesophageal reflux (GERD) resistant to medical treatment.
RESULTS: SG was performed in 156 patients, with mean BMI of 47.6 kg/m2. After 10 years, 117 out of 153 patients were evaluated (32 patients lost to follow-up (20.5 %) and four died due to causes unrelated to SG). Mean follow-up duration was 144 ± 13 months. Forty-six patients (39.4 %) did not receive any further bariatric surgery. In this population, the average BMI was 35.1 kg/m2, EWL was 55.2 % and TWL was 25.5 % 10 years after SG. 71 patients underwent a second bariatric procedure (60.6 %). The average time between SG and redo-surgery was 51.9 months. Reasons for conversion were weight regain (WR) (53 %), non-response (38 %), GERD resistant to medical treatment (7 %), and gastric stricture (1.4 %). A high BMI (from 46 to over 50) was most often associated with a second bariatric surgery.
CONCLUSIONS: The present series reports a high rate of revisional surgery after SG at 10 years, for weight recurrence or GERD. On the other hand, patients who did not need revisional surgery had good outcomes in terms of WL and QoL. Patients with lower BMI(<41) at the time of SG experienced the lower rate of WR, non-response and revisional surgery.