Jaime Ruiz-Tovar1, Rosana Martínez2, José María Bonete2, José María Rico2, Lorea Zubiaga3, Maria Diez3, Carolina Llavero4. 1. Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain. jruiztovar@gmail.com. 2. Department of Psychiatry, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain. 3. Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, Alicante, Spain. 4. Department of Surgical Nursery, Hospital Sureste, Madrid, Spain.
Abstract
BACKGROUND: Most surgeons calibrate the sleeve with 32-French (Fr) to 40-Fr bougies hypothesizing that smaller bougies are associated with greater weight loss and long-term lower weight regain. The purpose of this study was to assess the weight loss results and resolution of comorbidities 5 years after laparoscopic sleeve gastrectomy (LSG). METHODS: A prospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy calibrated with a 50-Fr bougie between October 2007 and February 2010 was performed. Excess weight loss (EWL) and remission of comorbidities were investigated at 1, 2, and 5 years after surgery. RESULTS: Fifty patients were included for the analysis. One year after surgery, mean excess weight loss (EWL) of 81.8 % was achieved, type 2 diabetes mellitus (T2DM) resolution rate was 76.9 %, hypertension resolution was observed in 73.3 %, sleep apnea hypopnea syndrome (SAHS) resolution in 100 % hypertriglyceridemia was normalized in all the cases, and hypercholesterolemia in 21.4 %. Two years after surgery, mean EWL was 84.4 % and comorbidity resolution rate similar to that obtained after the first postoperative year. Five years after surgery, mean EWL was 78.7 %, T2DM resolution 69.2 %, hypertension 66.7 %, SAHS 100 %, hypertriglyceridemia 100 %, and hypercholesterolemia 14.3 %. CONCLUSIONS: LSG calibrated with a 50-Fr bougie obtained excellent results in weight loss and resolution comorbidities and their maintenance in the long-term follow-up in our series. In our opinion, the results depend more on a preoperative correct selection of candidates and a close postoperative follow-up, rather than using a narrow calibration bougie.
BACKGROUND: Most surgeons calibrate the sleeve with 32-French (Fr) to 40-Fr bougies hypothesizing that smaller bougies are associated with greater weight loss and long-term lower weight regain. The purpose of this study was to assess the weight loss results and resolution of comorbidities 5 years after laparoscopic sleeve gastrectomy (LSG). METHODS: A prospective study of all the morbidly obesepatients undergoing laparoscopic sleeve gastrectomy calibrated with a 50-Fr bougie between October 2007 and February 2010 was performed. Excess weight loss (EWL) and remission of comorbidities were investigated at 1, 2, and 5 years after surgery. RESULTS: Fifty patients were included for the analysis. One year after surgery, mean excess weight loss (EWL) of 81.8 % was achieved, type 2 diabetes mellitus (T2DM) resolution rate was 76.9 %, hypertension resolution was observed in 73.3 %, sleep apnea hypopnea syndrome (SAHS) resolution in 100 % hypertriglyceridemia was normalized in all the cases, and hypercholesterolemia in 21.4 %. Two years after surgery, mean EWL was 84.4 % and comorbidity resolution rate similar to that obtained after the first postoperative year. Five years after surgery, mean EWL was 78.7 %, T2DM resolution 69.2 %, hypertension 66.7 %, SAHS 100 %, hypertriglyceridemia 100 %, and hypercholesterolemia 14.3 %. CONCLUSIONS: LSG calibrated with a 50-Fr bougie obtained excellent results in weight loss and resolution comorbidities and their maintenance in the long-term follow-up in our series. In our opinion, the results depend more on a preoperative correct selection of candidates and a close postoperative follow-up, rather than using a narrow calibration bougie.
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