Multiple studies outline safety, efficacy of laparoscopic sleeve gastrectomy

Laparoscopic sleeve gastrectomy was highlighted as a safe and effective bariatric surgical procedure by several studies presented recently at the American Society for Metabolic & Bariatric Surgery Annual Meeting in San Diego.

In a study conducted by the Cleveland Clinic Florida in Weston, Fla., researchers evaluated 1,492 Roux-en-Y gastric bypass (RYGB), 602 laparoscopic sleeve gastrectomy (LSG) and 339 laparoscopic adjustable gastric band (LAGB) procedures performed on morbidly obese patients between 2005 and 2011. Readmission rates were comparable across all three procedures (1.7 incidents for RYGB patients, 1.3 for LSG and 1.5 for LAGB), and the number of necessary reoperations because of failure or complications was 1.5% in the LSG group compared with 7.7% in the RYGB group and 15.3% among LAGB patients.

Similarly, a study conducted by researchers at Stanford University evaluated data from 268,898 patients who received LSG (n=15,964), LAGB (n=116,898) and RYGB (n=136,036) between 2007 and 2010. LSG fell between the two other procedures regarding rates of postoperative outcomes including serious complications (0.96% compared with 1.25% in RYGB and 0.25% LAGB), mortality (0.08% compared with 0.14% RYGB and 0.03% LAGB) and readmission rates (3.61% compared with 4.62% RYGB and 1.38% LAGB), among others.

A retrospective review performed at the University of California, San Francisco evaluated 26 morbidly obese patients who underwent LSG between 2006 and 2011 before organ transplantation. Six adverse events occurred in the cohort, including two superficial wound infections, one staple line leak, one case of transient encephalopathy, one incident of postoperative bleeding and one case of temporary renal insufficiency. Excess weight loss was 17% at 1 month (24 patients), 26% at 3 months (22 patients) and 50% at 12 months (16 patients). Six patients received liver transplants and one received a combined liver and kidney transplant following surgery, and no patients had abnormal nutritional parameters after transplantation.

In a fourth study, a retrospective analysis performed at the Naval Medical Center in San Diego, researchers reviewed 486 patients from 2005 to 2011. Patients included 238 who underwent laparoscopic gastric bypass (LGB) and 248 who received laparoscopic vertical gastrectomy (LVG). LGB led to significantly more excessive weight loss than LVG at 1 year (72.3% compared with 63.7%, P=.002). The findings were not statistically significant at 2 years (70.2% vs. 65.6%, P=.113) and 5 years (57.1% vs. 54.5%, P=.252). BMI reduction also was significantly greater at 1 year after surgery but not at later follow-ups.

“Sleeve gastrectomy has proven itself to be a safe and effective option in patients with morbid obesity and this procedure should be considered a primary procedure for weight loss and obesity-related disease improvement and resolution,” Robin Blackstone, MD, president of the American Society for Metabolic & Bariatric Surgery, said in a press release.

For more information:

Fridman A. #PL-133: Procedure Related Morbidity Comparing Roux-en-y Gastric Bypass, Sleeve Gastrectomy and Laparoscopic Adjustable Gastric Band: A Retrospective Long Term Follow-Up. Presented at: the American Society for Metabolic & Bariatric Surgery Annual Meeting; June 17-22, San Diego.
Morton J. #PL-104: National Comparisons of Bariatric Surgery Safety and Efficacy: Findings from the BOLD Database 2007-2010. Presented at: the American Society for Metabolic & Bariatric Surgery Annual Meeting; June 17-22, San Diego.
Lin MY. #PL-117: Laparoscopic Sleeve Gastrectomy Is Safe and Efficacious for Pre-Transplant Candidates. Presented at: the American Society for Metabolic & Bariatric Surgery Annual Meeting; June 17-22, San Diego.

Lim DM. #PL-102: Laparoscopic Gastric Bypass versus Laparoscopic Vertical Gastrectomy for Morbid Obesity: 5 Year Results in a Military Institution. Presented at: the American Society for Metabolic & Bariatric Surgery Annual Meeting; June 17-22