Long-term weight loss in laparoscopic sleeve gastrectomy.
INTRODUCTION
Laparoscopic sleeve gastrectomy (LSG) has become an option as a bariatric surgical technique. There is a lack of long-term results of this procedure in the literature. The aim of this study is to present weight loss results of LSG for up to 7 years of follow-up.


METHODS
A retrospective series of patients who underwent LSG between 2008 and 2011 was examined. The primary endpoint was weight loss: percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and body mass index (BMI) were reported. Failure was defined as %EWL<50%. Multivariate analysis for weight loss was performed. The complications rate was reported.


RESULTS
A total of 148 patients met the inclusion criteria; 76.3% were female. Mean preoperative BMI was 36 ± 4 kg/m2. Mean operative time was 89.3 ± 3.2 minutes. Follow-up at 5, 6, and 7 years was 77.7%, 83.3%, and 82.2%, respectively. Mean %EWL and %TWL at 1, 3, 5, and 7 years was 93.2%, 80.7%, 70.6%, and 51.7%, and 27.2%, 23.3%, 20.4%, and 16.3%, respectively. The failure rate was 30.4% at the fifth year and 51.4% at the seventh year. High preoperative BMI was related to worse %EWL (P<0.001) but not to %TWL. Preoperative BMI<35 kg/m2 was associated with better %EWL but not with %TWL (P = 0.003). Four leaks (2.7%) and no mortalities were reported.


CONCLUSIONS
LSG is an acceptable surgical technique for weight loss, but in this series, up to one third of the patients fail at the fifth year and half fail in the seventh year. %EWL is better in patients with BMI<35 kg/m2, but this difference disappears when we express outcomes with %TWL.
['Sepúlveda|Matías|M|', 'Alamo|Munir|M|', 'Saba|Jorge|J|', 'Astorga|Cristián|C|', 'Lynch|Raúl|R|', 'Guzmán|Hernán|H|']
D000293:Adolescent D000328:Adult D050110:Bariatric Surgery D015992:Body Mass Index D061887:Conversion to Open Surgery D005260:Female D005500:Follow-Up Studies D005743:Gastrectomy D006801:Humans D010535:Laparoscopy D007902:Length of Stay D008297:Male D008875:Middle Aged D009767:Obesity, Morbid D061646:Operative Time D011183:Postoperative Complications D012189:Retrospective Studies D016896:Treatment Outcome D015431:Weight Loss D055815:Young Adult
Weight loss Sleeve gastrectomy Long-term outcomes Weight regain, Bariatric surgery