Beyond the decade: unveiling long-term weight and co-morbidity outcomes up to 10 years post laparoscopic sleeve gastrectomy.

Abstract

Introduction: Despite its effectiveness, long-term data on the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for morbid obesity are sparce.

Methods: We collected data through phone interviews and hospital records for patients who had LSG, including those that then underwent revisional bariatric surgery, assessing their weight outcomes, associated health conditions, and complications.

Results: 2982 patients (72% female) were included in the study, with a maximum follow-up reached of 13 years. The mean pre-operative age and body mass index (BMI) were 34.7 ± 11.3 years and 45.5 ± 7.7 kg/m2, respectively. The prevalence of obesity classes were as follows: Class I, 3.1%; Class II, 19.2%; and Class III, 75.9%. BMI at nadir was 32.35 Kg/m2 equating to a mean nadir excess weight loss (EWL) of 67.03%. Weight outcomes at 13 years post-LSG showed a mean BMI of 31.83 kg/m² and total weight loss (TWL) percentage of 31.43%. Weight loss outcomes varied according to pre-operative obesity class, with class I achieving the highest percentage EWL and class III observing the highest TWL at the end of one year. Weight regain occurred in 1.3% of the patient population, with class III experiencing the highest weight regain at 13 years. Significant reductions in comorbidities were observed, while complication rates were low, with 0.4% bleed, 0.5% leak, and 7.9% GERD.

Conclusion: LSG demonstrates sustained weight loss and resolution of comorbidities with low complication rates. The influence of initial obesity class on weight loss was found to be significant in the first 18 months post-LSG.