Long-Term Outcomes of Sleeve Gastrectomy at a Veterans Affairs Medical Center

Introduction: Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric procedure for morbid obesity. However, there is limited data on long-term outcomes in the veteran population. This study attempts to determine long-term weight loss and resolution of comorbidities following an LSG in a veteran population. Methods: A retrospective review was performed of a prospectively maintained database of LSG patients at a single veterans Affairs Medical Center from 2013 to 2019. Patient preoperative factors, 5-year weight loss, resolution of comorbidities, and morbidities were collected and analyzed using univariate and multivariate analysis. An alpha level of 0.05 was used to determine significance. Statistical analyses were performed by using SAS version 9.4. Results: A total of 153 patients underwent LSG, with 98.7% completing a 5-year follow-up. At 5 years, rates of diabetes (50.9% versus 37.7%, P < .001), hypertension (59.2% versus 49.7%, P < .001), gastroesophageal reflux disease (51.6% versus 40.9%, P < .001), and sleep apnea (67.3% versus 40.9%, P < .001) were significantly reduced from baseline. Average total weight lost was 13.5% from baseline weight, with no perioperative mortalities. Preoperative body mass index (BMI) was the only factor predictive of postoperative BMI. Conclusions: LSG remains a safe and effective option for veterans with morbid obesity with concurrent resolution of several comorbidities. As the treatment of obesity continues to evolve, postoperative data remains critical to guide patient care.