A prospective multicenter study of 163 sleeve gastrectomies:: Results at 1 and 2 years

被引:227
作者
Nocca, D. [1 ]
Krawczykowsky, D. [2 ]
Bomans, B. [1 ]
Noel, P.
Picot, M. C. [1 ]
Blanc, P. M. [1 ]
de Hons, C. de Seguin [3 ]
Millat, B. [1 ]
Gagner, M. [4 ]
Monnier, L. [1 ]
Fabre, J. M. [1 ]
机构
[1] CHU Montpellier, Montpellier, France
[2] CH Vitry le Francois, Vitry Sur Seine, France
[3] Clin St Louis, Aubagne, France
[4] Cornell Univ, New York Prebyterian Hosp, Weill Coll Med, New York, NY 10021 USA
关键词
laparoscopic sleeve; gastrectomy morbid obesity; prospective evaluation;
D O I
10.1007/s11695-007-9288-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Good results obtained after laparoscopic sleeve gastrectomy (LSG), in terms of weight loss and morbidity, have been reported in few recent studies. Our team has designed a multicenter prospective study for the evaluation of the effectiveness and feasibility of this operation as a restrictive procedure. Methods From January 2003 to September 2006, 163 patients (68% women) with an average age of 41.57 years, were operated on with a LSG. Indications for this procedure were morbid obese [body mass index (BMI)> 40 kg/m(2)] or severe obese patients (BMI> 35 kg/m(2)) with severe comorbidities (diabetes, sleep apnea, hypertension.) with high-volume eating disorders and superobese patients (BMI> 50 kg/m(2)). Results The average BMI was 45.9 kg/m(2). Forty-four patients (26.99%) were superobese, 84 (51.53%) presented with morbid obesity, and 35 (21.47%) were severe obese patients. Prospective evaluations of excess weight loss, mortality, and morbidity have been analyzed. Laparoscopy was performed in 162 cases (99.39%). No conversion to laparotomy had to be performed. There was no operative mortality. Perioperative complications occurred in 12 cases (7.36%). The reoperation rate was 4.90% and the postoperative morbidity was 6.74% due to six gastric fistulas (3.66%), in which four patients (2.44%) had a previous laparoscopic adjustable gastric banding. Long-term morbidity was caused by esophageal reflux symptoms (11.80%). The percentage of loss in excessive body weight was 48.97% at 6 months, 59.45% at 1 year (120 patients), 62.02% at 18 months, and 61.52% at 2 years (98 patients). No statistical difference was noticed in weight loss between obese and extreme obese patients. Conclusions The sleeve gastrectomy seems to be a safe and effective restrictive bariatric procedure to treat morbid obesity in selected patients. LSG may be proposed for volume-eater patients or to prepare superobese patients for laparoscopic gastric bypass or laparoscopic duodenal switch. However, weight regained, quality of life, and evolution of morbidities due to obesity need to be evaluated in a long-term follow up.
引用
收藏
页码:560 / 565
页数:6
相关论文
共 18 条
[11]   Biliopancreatic diversion with duodenal switch [J].
Marceau, P ;
Hould, FS ;
Simard, S ;
Lebel, S ;
Bourque, RA ;
Potvin, M ;
Biron, S .
WORLD JOURNAL OF SURGERY, 1998, 22 (09) :947-954
[12]   Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI ≥50) [J].
Milone, L ;
Strong, V ;
Gagner, M .
OBESITY SURGERY, 2005, 15 (05) :612-617
[13]   Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: Initial results in 10 patients [J].
Mognol, P ;
Chosidow, D ;
Marmuse, JP .
OBESITY SURGERY, 2005, 15 (07) :1030-1033
[14]   Laparoseopic vertical banded gastroplasty - A multicenter prospective study of 200 procedures [J].
Nocca, D. ;
Aggarwal, R. ;
Blanc, P. ;
Gallix, B. ;
Di Mauro, G. L. ;
Millat, B. ;
Hons, C. De Seguin des ;
Deneve, E. ;
Rodier, J. G. ;
Tincani, G. ;
Pierredon, M. A. ;
Fabre, J. M. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2007, 21 (06) :870-874
[15]   Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient [J].
Regan, JP ;
Inabnet, WB ;
Gagner, M ;
Pomp, A .
OBESITY SURGERY, 2003, 13 (06) :861-864
[16]   Laparoscopic sleeve gastrectomy as treatment for morbid obesity: Technique and short-term outcome [J].
Roa, Paul E. ;
Kaidar-Person, Orit ;
Pinto, David ;
Cho, Minyoung ;
Szomstein, Samuel ;
Rosenthal, Raul J. .
OBESITY SURGERY, 2006, 16 (10) :1323-1326
[17]   Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients [J].
Silecchia, Gianfranco ;
Boru, Cristian ;
Pecchia, Alessandro ;
Rizzello, Mario ;
Casella, Giovanni ;
Leonetti, Frida ;
Basso, Nicola .
OBESITY SURGERY, 2006, 16 (09) :1138-1144
[18]  
UEDA K, 2007, SURG OBES RELAT 0330