Analysis of efficacy of laparoscopic sleeve gastrectomy in treatment of simple obesity with different degrees of obesity_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Pei , LIU Pengpeng , HOU Dongsheng , YAO Libin , LI Chao , MENG Song , WANG Hui , HONG Jian , ZHU Xiaocheng ,  SHAO Yong

Department of Gastrointestinal Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, P. R. China;

Corresponding author：

SHAO Yong, Email: shaoyutong1975@163.com

Keywords：

simple obesity; weight loss surgery; laparoscopic sleeve gastrectomy; weight loss; weight regaining

DOI：

10.7507/1007-9424.202005119

Video：

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Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with different degrees of obesity.Methods The clinicopathologic data of patients received LSG in this hospital from October 2016 to October 2018 were analyzed retrospectively. The effect of LSG on postoperative weight loss in patients with different degrees of obesity were analyzed too.Results ① A total of 161 patients with simple obesity were included in this study, including 40 cases of degree Ⅰ obesity, 41 cases of degree Ⅱ obesity, 61 cases of degree Ⅲ obesity, and 19 cases of super obesity. All operations were successfully completed, there was no conversion to laparotomy or mortality. The postoperative bleeding occurred in 4 (2.5%) cases, nausea and vomiting occurred in 97 (60.2%) cases during hospitalization, and 143, 130, and 122 cases were followed up in 1-, 2-, and 3-year after operation. The body mass indexes (BMIs) were decreased significantly in postoperative 1-, 2-, and 3-year (P<0.05) as compared with their preoperative values, respectively. The excess BMI loss percentage(EBMIL%) in postoperative 1-, 2-, and 3-year were (87.4±25.7)%, (84.6±30.5)%, and (88.8±20.4)%, respectively. The rates of weight regaining were 3.8% (5/130) and 4.9% (6/122) in 2- and 3-year following-up, respectively. ② There were no remarkable changes in the trend of BMI in patients with degree Ⅰ and Ⅱ obesity [the EBMIL% changes from postoperative year-1 to year-3 were (–2.3±1.1)% and (3.3±1.5)%, respectively]. Conversely, there were remarkable changes in the trend of BMI in patients with degree Ⅲ obesity and super obesity [the EBMIL% changes from postoperative year-1 to year-3 were (–7.1±1.9)% and (–11.6±5.3)%, respectively].Conclusions From the results of this study, LSG has a good effect on weight loss in the treatment of patients withdegree Ⅰ and Ⅱ obesity. The long-term efficacy of LSG in patients with degree Ⅲ and super obesity, whether to take other bariatric procedures, whether to perform the second operation, and the timing of the second operation need to be further explored.

Citation： GUO Pei, LIU Pengpeng, HOU Dongsheng, YAO Libin, LI Chao, MENG Song, WANG Hui, HONG Jian, ZHU Xiaocheng, SHAO Yong. Analysis of efficacy of laparoscopic sleeve gastrectomy in treatment of simple obesity with different degrees of obesity. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(2): 208-211. doi: 10.7507/1007-9424.202005119 Copy

1.	Zhang X, Zhang M, Zhao Z, et al. Geographic variation in prevalence of adult obesity in China: Results from the 2013–2014 National Chronic Disease and Risk Factor Surveillance. Ann Intern Med, 2020, 172(4): 291-293.
2.	Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med, 2014, 370(21): 2002-2013.
3.	Hsu CC, Almulaifi A, Chen JC, et al. Effect of bariatric surgery vs medical treatment on type 2 diabetes in patients with body mass index lower than 35: five-year outcomes. JAMA Surg, 2015, 150(12): 1117-1124.
4.	Arterburn DE, Bogart A, Sherwood NE, et al. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg, 2013, 23(1): 93-102.
5.	Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg, 2013, 258(4): 628-636.
6.	Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg, 2018, 28(12): 3783-3794.
7.	ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis, 2012, 8(3): e21-e26.
8.	O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg, 2019, 29(1): 3-14.
9.	Clapp B, Wynn M, Martyn C, et al. Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis. Surg Obes Relat Dis, 2018, 14(6): 741-747.
10.	Pagidipati NJ, Zheng Y, Green JB, et al. Association of obesity with cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease: Insights from TECOS. Am Heart J, 2020, 219: 47-57.
11.	Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis, 2015, 11(3): 489-506.
12.	朱江帆. 腹腔镜胃袖状切除几个细节问题的探讨. 中华腔镜外科杂志(电子版), 2019, 12(6): 324-325.
13.	Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution. Surg Obes Relat Dis, 2019, 15(2): 245-252.
14.	Shoar S, Poliakin L, Rubenstein R, et al. Single anastomosis duodeno-ileal switch (SADIS): a systematic review of efficacy and safety. Obes Surg, 2018, 28(1): 104-113.
15.	Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg, 2012, 256(1): 104-110.
16.	Santoro S, Mota FC, Aquino CG. Treating severe GERD and obesity with a sleeve gastrectomy with cardioplication and a transit bipartition. Obes Surg, 2019, 29(4): 1439-1441.
17.	Azevedo FR, Santoro S, Correa-Giannella ML, et al. A prospective randomized controlled trial of the metabolic effects of sleeve gastrectomy with transit bipartition. Obes Surg, 2018, 28(10): 3012-3019.
18.	Ser KH, Lee WJ, Chen JC, et al. Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): Surgical risk and long-term results. Surg Obes Relat Dis, 2019, 15(2): 236-243.

1. Zhang X, Zhang M, Zhao Z, et al. Geographic variation in prevalence of adult obesity in China: Results from the 2013–2014 National Chronic Disease and Risk Factor Surveillance. Ann Intern Med, 2020, 172(4): 291-293.
2. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med, 2014, 370(21): 2002-2013.
3. Hsu CC, Almulaifi A, Chen JC, et al. Effect of bariatric surgery vs medical treatment on type 2 diabetes in patients with body mass index lower than 35: five-year outcomes. JAMA Surg, 2015, 150(12): 1117-1124.
4. Arterburn DE, Bogart A, Sherwood NE, et al. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg, 2013, 23(1): 93-102.
5. Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg, 2013, 258(4): 628-636.
6. Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg, 2018, 28(12): 3783-3794.
7. ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis, 2012, 8(3): e21-e26.
8. O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg, 2019, 29(1): 3-14.
9. Clapp B, Wynn M, Martyn C, et al. Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis. Surg Obes Relat Dis, 2018, 14(6): 741-747.
10. Pagidipati NJ, Zheng Y, Green JB, et al. Association of obesity with cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease: Insights from TECOS. Am Heart J, 2020, 219: 47-57.
11. Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis, 2015, 11(3): 489-506.
12. 朱江帆. 腹腔镜胃袖状切除几个细节问题的探讨. 中华腔镜外科杂志(电子版), 2019, 12(6): 324-325.
13. Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution. Surg Obes Relat Dis, 2019, 15(2): 245-252.
14. Shoar S, Poliakin L, Rubenstein R, et al. Single anastomosis duodeno-ileal switch (SADIS): a systematic review of efficacy and safety. Obes Surg, 2018, 28(1): 104-113.
15. Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg, 2012, 256(1): 104-110.
16. Santoro S, Mota FC, Aquino CG. Treating severe GERD and obesity with a sleeve gastrectomy with cardioplication and a transit bipartition. Obes Surg, 2019, 29(4): 1439-1441.
17. Azevedo FR, Santoro S, Correa-Giannella ML, et al. A prospective randomized controlled trial of the metabolic effects of sleeve gastrectomy with transit bipartition. Obes Surg, 2018, 28(10): 3012-3019.
18. Ser KH, Lee WJ, Chen JC, et al. Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): Surgical risk and long-term results. Surg Obes Relat Dis, 2019, 15(2): 236-243.

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Analysis of efficacy of laparoscopic sleeve gastrectomy in treatment of simple obesity with different degrees of obesity

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