Outcomes in Super Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Super obese patients remain a challenge for management because of large liver size resulting in decreased work space and associated comorbidities.

To study outcomes in super obese patients undergoing Laparoscopic sleeve gastrectomy (LSG).

Retrospective data of 123 patients undergoing LSG from January 2008 to March 2015 were analyzed prospectively.

Mean age and body mass index (BMI) of 123 patients (± 2 standard deviation [SD]) were 39.9 ± 23.3 years and 55.6 ± 10.54 kg/m², respectively. Mean percentage excess weight loss (%EWL) (± 2 SD) at 1, 3, 5, and 7 years was 63% ± 36.7%, 62.3% ± 29.0%, 56.5% ± 35.8%, and 58.6% ± 40.3%, respectively. The preoperative BMI correlated with %EWL at 1 year (r² = 0.0397, P = .044). Staple line leak, bleeding, deep venous thrombosis, and 30-day mortality occurred in 1.6%, 0%, 0.8%, and 0% of the patients, respectively. Stricture formation and new onset gastroesophageal reflux disease (GERD) occurred in 0.8% patients each. Of the diabetic patients, 72.2% had remission and the rest required decreased dosage of oral hypoglycemic medications. Hypertension, obstructive sleep apnea, and GERD improved in 68.2%, 100%, and 25% of the patients, respectively. However, 25% of patients had worsening in GERD symptoms.

Super obese patients undergoing LSG as the primary procedure have reasonable weight loss of 62% and 56% at 3 and 5 years, respectively, with significant resolution of comorbidities.