Fifteen Years After Sleeve Gastrectomy: Weight Loss, Remission of Associated Medical Problems, Quality of Life, and Conversions to Roux-en-Y Gastric Bypass—Long-Term Follow-Up in a Multicenter Study
Daniel Moritz FelsenreichEvi ArtemiouKatharina SteinlechnerNatalie VockJulia JedamzikJakob EichelterLisa GensthalerChristoph BichlerChristoph SperkerPhilipp BeckerhinnIvan KristoFelix B. LangerGerhard Prager
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Abstract:
Since 2014, sleeve gastrectomy (SG) has been the most frequently performed bariatric-metabolic operation worldwide (2018: 386,096). There are only a few studies reporting a long-term follow-up (up to 11 years) available today. The aim of this study was to evaluate the long-term outcome of SG with a follow-up of at least 15 years regarding weight loss, remission of associated medical problems (AMP), conversions, and quality of life (QOL).Multicenter cross-sectional study; university hospital.This study includes all patients who had SG before 2005 at the participating bariatric centers. History of weight, AMP, conversions, and QOL were evaluated by interview at our bariatric center.Fifty-three patients met the inclusion criteria of a minimal follow-up of 15 years. Weight and body mass index at the time of the SG were 136.8kg and 48.7kg/m2. Twenty-six patients (49.1%) were converted to Roux-en-Y gastric bypass (RYGB) for weight regain and gastroesophageal reflux within the follow-up period. Total weight loss after 15 years was 31.5% in the non-converted group and 32.9% in the converted group. Remission rates of AMP and QOL were stable over the follow-up period.Fifteen years after SG, a stable postoperative weight was observed at the cost of a high conversion rate. Patients converted to RYGB were able to achieve further weight loss and preserve good remission rates of AMP. SG in patients without the need of a conversion to another bariatric-metabolic procedure may be considered effective. Careful preoperative patient selection is mandatory when performing SG.Keywords:
Roux-en-Y anastomosis
Sleeve gastrectomy
Obesity Surgery
Gastric banding
Sleeve gastrectomy
Roux-en-Y anastomosis
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Sleeve gastrectomy
Roux-en-Y anastomosis
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Sleeve gastrectomy
Gastric banding
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Gastric banding
Sleeve gastrectomy
Adjustable gastric band
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Roux-en-Y anastomosis
Sleeve gastrectomy
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Sleeve gastrectomy
Roux-en-Y anastomosis
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Roux-en-Y anastomosis
Sleeve gastrectomy
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Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
Roux-en-Y anastomosis
Gastric banding
Obesity Surgery
Severe obesity
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ABSTRACT Objective: to compare the prevalence of micronutrient deficiencies in patients submitted to sleeve gastrectomy (SG) and Roux- en-Y gastric bypass (RYGB). Methods: this is a comparative study of 576 patients submitted to bariatric surgery, 338 to SG and 238 to RYGB, and evaluated for hemoglobin, iron, ferritin, zinc and vitamin B12 serum levels. We performed these dosages in the preoperative period and at three, six, 12 and 24 months after surgery, for analysis and comparison of micronutrient deficiencies among the techniques. Results: the SG group consisted of 48 men and 290 women, with a mean BMI of 39.4±2.6kg/m2, and a mean of age of 37.2±11 years; the group RYGB consisted of 77 men and 161 women, with mean BMI 42.7±5.9kg/m2, and a mean age of 41.9±11.1 years. After 24 months, hemoglobin deficiency was present in 24.4% of the patients submitted to SG and in 40% of the RYGB individuals (p=0.054); iron deficiency was present in 6,6% of SG patients and in 15% of RYGB ones (p=0.127); ferritin deficiency occurred in 17.8% of the SG group and in 23.7% of RYGB one (p=0.399); the Zinc deficiency incidence was 6.6% in SG and 30% in RYGB (p=0.002); and B12 deficiency took place in 6.6% the SG patients and in 8.7% of RYGB ones (p=0.844). Conclusion: patients undergoing SG had serum levels of iron and zinc superior to the ones undergoing RYGB, the prevalence of the latter micronutrient deficit being significantly higher in the RYGB group.
Sleeve gastrectomy
Roux-en-Y anastomosis
Gastric bypass surgery
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Sleeve gastrectomy
Gastric banding
Roux-en-Y anastomosis
Severe obesity
Obesity Surgery
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