https://scholars.lib.ntu.edu.tw/handle/123456789/572915
標題: | Thirteen-Year Experience of Laparoscopic Sleeve Gastrectomy: Surgical Risk, Weight Loss, and Revision Procedures | 作者: | Chang D.-M Lee W.-J JEN-CHIH CHEN Ser K.-H Tsai P.-L Lee Y.-C. |
關鍵字: | proton pump inhibitor; adolescent; adult; aged; anastomosis; Article; body mass; body weight; body weight gain; body weight loss; controlled study; dyslipidemia; female; follow up; gastropexy; heart failure; hernia; hiatus hernia; hospitalization; human; hypertension; hyperuricemia; intestine injury; laparoscopic sleeve gastrectomy; long term care; major clinical study; male; morbid obesity; multidisciplinary team; nutritional status; operation duration; operative blood loss; postoperative complication; postoperative hemorrhage; priority journal; reflux esophagitis; remission; retrospective study; Roux-en-Y gastric bypass; sleep disordered breathing; surgical risk; telephone interview; treatment outcome; adverse event; body weight loss; gastrectomy; laparoscopy; middle aged; physiology; postoperative complication; reoperation; Adult; Female; Gastrectomy; Humans; Laparoscopy; Male; Middle Aged; Obesity, Morbid; Postoperative Complications; Reoperation; Retrospective Studies; Weight Loss | 公開日期: | 2018 | 卷: | 28 | 期: | 10 | 起(迄)頁: | 2991-2997 | 來源出版物: | Obesity Surgery | 摘要: | Background: Laparoscopic sleeve gastrectomy (LSG) has been validated as a safe and effective treatment for morbid obesity. However, data of the long-term outcome remains lacking. Methods: A total of 1759 LSG was performed as primary bariatric procedure from 2005 to 2017 with mean age of 35.2 ± 10.3?years old (14–71), female 69.7%, mean body mass index (BMI) 37.9 ± 7.7?kg/m 2 , and mean waist width 113.7 ± 17.9?cm. All patients were evaluated and managed under a strict multidisciplinary team approach. A retrospective analysis of a prospective bariatric database and telephone interview of patients who defaulted clinic follow-up at 10?years was conducted. Results: The mean operating time, intraoperative blood, and hospital stay of LSG were 121.5 ± 36.5?min, 40.8 ± 69.7?ml, and 2.8 ± 2.7?days, respectively. The 30-day postoperative major complication occurred in 25 (1.4%) patients. The major complication rate was 15% at first year and 0% at the last year. The follow-up rate at 1, 5 and 10?years were 89.3%, 52.1 and 64.4%. At postoperative 1, 5, and 10?years, the mean percentage of total weight loss (%TWL) and excess weight loss (EWL%) of LSG patients were 33.4, 28.3, and 26.6% and 92.2, 80.1, and 70.5%, respectively. The mean BMI became 27, 26.2, and 27.1?kg/m 2 at postoperative 1, 5, and 10?years. At follow-up, a total 69 patients needed surgical revision due to reflux disease (n = 45), weight regain (n = 19), persistent diabetes (n = 2), and chronic fistula (n = 3). The type of revision procedures were hiatal repair and gastropexy (n = 29), Roux-en Y gastric bypass (RYGB) (n = 23), and single anastomosis bypass (n = 17) with median time to revision 33?months (range 3–62). At 10?years, the overall revision rate was 21.5% (14/65) and 11(16.9%) of 65 patients were converted to RYGB. The other 54 patients remained at LSG anatomy, but 45% of them required proton pump inhibitor for reflux symptoms. Conclusions: Our results showed that primary LSG is a durable primary bariatric procedure with sustained weight loss and a high resolution of comorbidities at 10?years, but about half the patients had de novo GERD. The need for conversion to RYGB was 16.9% at 10?years. ? 2018, Springer Science+Business Media, LLC, part of Springer Nature. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85048787496&doi=10.1007%2fs11695-018-3344-3&partnerID=40&md5=7e1e82c7268dbbc7128a316951f43f1d https://scholars.lib.ntu.edu.tw/handle/123456789/572915 |
ISSN: | 9608923 | DOI: | 10.1007/s11695-018-3344-3 |
顯示於: | 生物科技研究所 |
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