VSG 5 year results

Question
Hi Karla,
I saw your previous answer to a question about VSG and I was incredibly impressed with your thoroughness.

I know some 5 year data was presented this year.

Five Year Weight loss outcome.
Rudolf Weiner, MD
Review of Sleeve Gastrectomy: 3000 cases with up to 5 year follow up.
Phillip Schauer, MD
The Second International Consensus Summit on Sleeve Gastrectomy
http://www.obesityeducation.com/icssg/agenda.htm

Sleeve Gastrectomy: 2,000 Cases - 5-Year Follow-up.
Stacy Brethauer, MD
The Ninth Annual Minimally Invasive Surgery Symposium
http://www.miss-cme.org/pages.asp?id=24

I have had no success in getting copies of these presentations.  Do you have any sources who might share this information with you?

Thanks

Answer
Hi Teri:

Thanks so much for the compliment. :)

I haven't seen those articles, but I'll try and get copies over the next week.  If I can get copies, I'll send you an updated answer to this question.

Thanks for the heads-up on the 5-year data.  Hopefully, this will make it easier for more people to get insurance coverage for the Sleeve.  Personally, I highly doubt that the results will be any worse than the Band...and as that's covered, so should the Sleeve be as well.

Kind Regards,
Karla

Revising answer to include this which was just published...

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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