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Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience
Hanaa Dakour Aridi1, Ramzi Alami1, Hani Tamim2
1Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Background:
Long-term data of laparoscopic sleeve gastrectomy (LSG) are still scarce in the Middle East.
Objectives:
The aim of this study was to assess the efficacy and safety at 5 years and beyond.
Setting:
Tertiary referral hospital between April 2007 and March 2015.
Methods:
A retrospective review of 76 patients who underwent LSG at the senior author's institution between April 2007 and March 2010.
Results:
Mean preoperative body mass index (BMI) was 42.8±7.1 kg/m2. Follow-up rates were 90.4%, 86.3%, and 77.8% at 5, 6, and 7 years, respectively. Percentage of excess weight loss (%EWL) was 69.8%±28.7% at 5 years, 70.6%±32.7% at 6 years, and 76.6%±21.2% at 7 years, respectively. Mean total weight loss was 26.5%±8.7%, 24.9%±8.8%, and 26.6%±6.0% at 5, 6, and 7 years, respectively. %EWL at 5-years was significantly higher for patients with a preoperative BMI<45 kg/m2 (83.1% versus 46.3%, P<.0001). LSG improved or resolved diabetes, hypertension, and asthma in 87.5%, 68%, and 81.7% of patients, respectively. New onset gastroesophageal acid reflux disease developed in 21.2% of patients. Long-term complications included hiatal hernias necessitating repair (1.4%), incisional hernias (2.7%), and symptomatic gallstones (9.6%), as well as depression necessitating admission (4.1%).
Conclusion:
In the present patient population, LSG resulted in satisfactory %EWL and co-morbidity resolution after 5 years. The results were excellent for patients with a BMI<45 kg/m2. De novo acid reflux symptoms developed in 1 of 5 patients. Cholelithiasis necessitating cholecystectomy was the most common long-term complication.