Excessive weight loss after sleeve gastrectomy: a systematic review

Area of Science:

• Bariatric Surgery
• Metabolic and Endocrine Surgery
• Sleeve Gastrectomy

Background:

• The clinical effectiveness of sleeve gastrectomy (SG) as a primary bariatric intervention remains under investigation.
• Systematic analysis of excessive weight loss (EWL) following SG is crucial for understanding its long-term impact.

Purpose of the Study:

• To systematically analyze and compare excessive weight loss (EWL) in patients undergoing sleeve gastrectomy (SG).
• To evaluate the long-term efficacy of SG by comparing EWL rates with gastric bypass procedures.

Main Methods:

• A systematic literature search was conducted for studies on sleeve gastrectomy (SG) published between January 2003 and December 2010.
• Data from systematic reviews on gastric bypass procedures were used as a comparator for EWL analysis.

Main Results:

• The analysis included 123 papers detailing 12,129 patients, with most focusing on EWL at 12 months.
• Sleeve gastrectomy (SG) demonstrated maximum EWL at 24-36 months (mean 64.3%-66.0%).
• At 12 months, SG showed significantly lower EWL (56.1%) than gastric bypass (68.3%; p < 0.01), but differences were not significant at 24 months (SG 61.3% vs. gastric bypass 69.6%; p = 0.09).

Conclusions:

• Sleeve gastrectomy (SG) is an effective bariatric procedure with sustained excessive weight loss (EWL) outcomes.
• EWL following sleeve gastrectomy (SG) is comparable to gastric bypass at the 24-month postoperative mark.