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Laparoscopic Sleeve Gastrectomy for Super Obese Patients: Forty-eight Percent Excess Weight Loss After 6 to 8 Years With 93% Follow-Up

Eid, George M. MD; Brethauer, Stacy MD; Mattar, Samer G. MD; Titchner, Rebecca L. RD; Gourash, William MSN, CRNP; Schauer, Philip R. MD

doi: 10.1097/SLA.0b013e31825fe905
Original Articles

Objectives: In this study, we report long-term outcomes of high-risk, high-BMI (body mass index) patients who underwent laparoscopic sleeve gastrectomy (LSG).

Background: Short- and medium-term data appear to support the effectiveness of LSG, but long-term data to support its durability are sparse.

Methods: A prospective database was reviewed on all high-risk patients who underwent LSG as part of a staged approach for surgical treatment of severe obesity between January 2002 and February 2004. We included only patients who did not proceed to second-stage surgery (gastric bypass). Analyzed data included demographics, BMI, comorbidities, and surgical outcomes. All partial gastrectomies were performed using a 50F bougie.

Results: Seventy-four patients underwent LSG, and follow-up data were available on 69 of 74 patients (93%). The mean age was 50 years (25–78) and the mean number of co-morbidities was 9.6. Perioperative mortality (<30 days) was zero, and the incidence of short- and long-term postoperative complications was 15%. The mean overall follow-up time period was 73 months (38–95). Mean excess weight loss (EWL) at 72, 84, and 96 months after LSG was 52%, 43%, and 46%, respectively, with an overall EWL of 48%. The mean BMI decreased from 66 kg/m2(43–90) to 46 kg/m2 (22–73). Seventy-seven percent of the diabetic patients showed improvement or remission of the disease.

Conclusions: This study reports the longest follow-up of LSG patients thus far and supports the effectiveness, safety, and durability of laparoscopic sleeve gastrectomy as a definitive therapeutic option for severe obesity, even in high-risk, high-BMI patients.

This study reports the longest follow-up (93% at 6–8 years) of laparoscopic sleeve gastrectomy (LSG) patients thus far. It supports the effectiveness, safety, and durability of LSG as a definitive therapeutic option for severe obesity, even in high-risk, high-BMI (body mass index) patients.

*Department of Veterans Affairs, Pittsburgh Healthcare System, University Drive, Pittsburgh, PA

Division of Minimally Invasive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA

Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH

§Department of Surgery, Indiana University, Indianapolis, IN.

Reprints: George M. Eid, MD, Magee Women's Hospital of University of Pittsburgh Medical Center, 3380 Boulevard of the Allies, Pittsburgh, PA 15213. E-mail:

Disclosure: This study was supported by a research grant from Covidien. The contents do not represent the views of the Department of Veterans Affairs or the United States Government.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.