Literature DB >> 18506548

Staged laparoscopic sleeve gastrectomy followed by Roux-en-Y gastric bypass for morbidly obese patients: a risk reduction strategy.

Owen Ou Yang1, Ken Loi, Victor Liew, Michael Talbot, John Jorgensen.   

Abstract

BACKGROUND: In our centre laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the most effective weight loss surgical procedure performed. However, LRYGBP may be associated with higher risk of peri- and postoperative complications in contrast to a purely restrictive procedure to justify this procedure on all comers. Laparoscopic sleeve gastrectomy (LSG) as a staged procedure may be an alternate risk reduction strategy. The aim of this study is to report on the short-term outcomes of LSG, the effect on operative risk reduction and resolution of comorbidities.
METHODS: A prospective review of 138 patients who underwent consecutive LSG from November 2004 to November 2006 was performed. Data were collected on all patients who attended the three to six monthly clinical follow-up and/or the patient questionnaire. Data collection included demographics, degree of weight reduction, postoperative complications, and changes in comorbidities.
RESULTS: Median BMI was 50.60 kg/m(2) (33-82). Of the patients, 46.38% had a BMI >or=50 kg/m(2). The overall median postoperative excess weight loss (EWL) was 43.26%, 31.08% at 6 months, 54.50% at 12 months, 51.47% at 18 months and 46.05% at 24 months. Of the patients, 39% had resolution of type 2 diabetes mellitus, 48% had resolution of dyslipidemia, 29% in hypertension, 52% in obstructive sleep apnea. Complication rate was 5.07% and four patients needed further surgical intervention. The mortality rate was zero.
CONCLUSION: LSG does minimize postoperative complication rates significantly on high-risk patients and achieves effective short-term weight loss with resolutions in comorbidities. Additional studies are required to evaluate LSG as a stand-lone procedure.

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Year:  2008        PMID: 18506548     DOI: 10.1007/s11695-008-9554-3

Source DB:  PubMed          Journal:  Obes Surg        ISSN: 0960-8923            Impact factor:   4.129


  19 in total

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2.  Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome.

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3.  Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients.

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4.  Cost-effectiveness of gastric bypass for severe obesity.

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5.  Sleeve gastrectomy in the high-risk patient.

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6.  A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years.

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7.  Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50).

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  13 in total

Review 1.  Metabolic Surgery in Type 2 Diabetes: Roux-en-Y Gastric Bypass or Sleeve Gastrectomy as Procedure of Choice?

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Review 4.  Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association.

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5.  Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass--indications and outcome.

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Review 6.  Excessive weight loss after sleeve gastrectomy: a systematic review.

Authors:  Lars Fischer; Caroline Hildebrandt; Thomas Bruckner; Hannes Kenngott; Georg R Linke; Tobias Gehrig; Markus W Büchler; Beat P Müller-Stich
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7.  Changes in lipid profiles in morbidly obese patients after laparoscopic sleeve gastrectomy (LSG).

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9.  Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin.

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10.  Laparoscopic sleeve gastrectomy as a step approach for morbidly obese patients with early stage malignancies requiring rapid weight loss for a final curative procedure.

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