5 y Results sleeve gastrectomy

Question
Hi Karla
i've read that you were looking for copies of 5 year results of sleeve
gastrectomy. I'm also very interested in these datas. If you find them i would
be very grateful to you if you could also forward them to me.
Thanks a lot
Daniel

Answer
Hi Daniel:

I definitely will.  So far, the closest data is the 5 year Magenstrasse & Mill info (60% EWL maintained for five years) as well as Santoro's DAIR results (sleeve gastrectomy, omentectomy, and enterectomy (shortening of small intestine)).  My best guess is that the Sleeve will lead to 5 year results around the 55-60% EWL mark... but I'll definitely post data/studies when I find it, as well as email you a copy.

Karla


Revising answer... here's some longer data from the Second International Consensus on Sleeve Gastrectomy.  Greater than 4 years post-op is 48.5 %EWL.

Surg Obes Relat Dis. 2009 Jul-Aug;5(4):476-85. Epub 2009 Jun 13.
   The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009.
   Gagner M, Deitel M, Kalberer TL, Erickson AL, Crosby RD.

   Department of Surgery, Mount Sinai Medical Center, Miami Beach, Florida 33140, USA. [email protected]

   BACKGROUND: Sleeve gastrectomy (SG) is a rapid and comparatively simple bariatric operation, which thus far shows good resolution of co-morbidities and good weight loss. The potential peri-operative complications must be recognized and treated promptly. Like other bariatric operations, there are variations in technique. Laparoscopic SG was initially performed for high-risk patients to increase the safety of a second operation. However, indications for SG have been increasing. Interaction among those performing this procedure is necessary, and the Second International Consensus Summit for SG (ICSSG) was held to evaluate techniques and results. METHODS: A questionnaire was filled out by attendees at the Second ICSSG, held March 19-22, 2009, in Miami Beach, and rapid responses were recorded during the consensus part. RESULTS: Findings are based on 106 questionnaires representing a total of 14,776 SGs. In 86.3%, SG was intended as the sole operation. A total of 81.9% of the surgeons reported no conversions from a laparoscopic to an open SG. Mean +/- SD percent excess weight loss was as follows: 1 year, 60.7 +/- 15.6; 2 years, 64.7 +/- 12.9; 3 years, 61.7 +/- 11.4; 4 years 64.6 +/- 10.5; >4 years, 48.5 +/- 8.7. Bougie size was 35.6F +/- 4.9F (median 34.0F, range 16F-60F). The dissection commenced 5.0 +/- 1.4 cm (median 5.0 cm, range 1-10 cm) proximal to the pylorus. Staple-line was reinforced by 65.1% of the responders; of these, 50.9% over-sew, 42.1% buttress, and 7% do both. Estimated percent of fundus removed was 95.8 +/- 12%; many expressed caution to avoid involving the esophagus. Post-operatively, a high leak occurred in 1.5%, a lower leak in 0.5%, hemorrhage in 1.1%, splenic injury in 0.1%, and later stenosis in 0.9%. Post-operative gastroesophageal reflux ( approximately 3 mo) was reported in 6.5% (range 0-83%). Mortality was 0.2 +/- 0.9% (total 30 deaths in 14,776 patients). During the consensus part, the audience responded that there was enough evidence published to support the use of SG as a primary procedure to treat morbid obesity and indicated that it is on par with adjustable gastric banding and Roux-en-Y gastric bypass, with a yes vote at 77%. CONCLUSION: SG for morbid obesity is very promising as a primary operation.

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