Sustained clinical and economic impact of sleeve gastrectomy: Beyond weight loss

Obesity represents a growing public health problem with significant clinical and economic implications. Sleeve gastrectomy (SG) is currently the most widely performed bariatric procedure worldwide. This study evaluates its clinical effectiveness and its impact on healthcare resource utilization in a referral hospital.

Retrospective study of a prospective series of 321 patients who underwent SG between 2011 and 2020, with a minimum follow-up of five years. Anthropometric variables, comorbidities, and healthcare resource utilisation were analysed. For the economic assessment, 42 patients with complete data were included, applying a bottom-up real-costing approach. Comparisons were stratified by age, sex, and baseline BMI.

The percentage of excess BMI loss at 5 years was 62.4%. Significant remission was observed in metabolic syndrome (64%), type 2 diabetes (63.5%), and hypertension (52.7%), with a lower impact on dyslipidaemia. The economic analysis showed a mean reduction of 1.6 primary care visits, 2.7 hospital visits, and an average saving of ;673 per patient per year. In multimorbid patients, savings reached ;1262 per year.

Sleeve gastrectomy is an effective and safe intervention, providing sustained clinical benefits and a significant reduction in healthcare expenditure, particularly among patients with multiple comorbidities. These findings support its inclusion in public health strategies aimed at ensuring the sustainability of the healthcare system.