4.4 Article

Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asian cohort

Journal

SURGERY FOR OBESITY AND RELATED DISEASES
Volume 12, Issue 2, Pages 330-337

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.soard.2015.05.009

Keywords

Laparoscopic sleeve gastrectomy; Bariatric surgery; Remission of obesity-related co-morbidities; Multiethnic cohort; Asian

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Background: Laparoscopic sleeve gastrectomy (LSG) has become a popular bariatric operation worldwide. Objectives: To report early outcomes of patients with LSG performed. Settings: University hospital and a restructured hospital, Singapore. Methods: Data of patients who underwent LSG as a primary procedure from 2008 to 2013 were analyzed for change in body mass index (BMI), percentage of weight loss (%WL), and percentage of excess weight loss (%EWL). The remission of obesity-related co-morbidities after LSG was analyzed. Logistic regression analyses were performed to determine predictive factors for perioperative complication and suboptimal EWL. Results: Two hundred operations were performed on a cohort that consisted of 74 Chinese, 57 Malay, and 52 Indian patients and 17 patients from other ethnic groups. Mean preoperative weight and BMI were 118.1 +/- 26.8 kg and 43.0 +/- 8.0 kg/m(2), respectively. Mean follow-up duration was 16.7 +/- 9.4 months. At 6, 12, 24 and 36 months, the percentage of patients followed-up were 79.5%, 75.7%, 50.0%, and 50.0%, and the mean %EWL were 51.2%, 61.2%, 60.9%, and 51.0%, respectively. Postoperative complications occurred in 9 patients (4.5%), 5 of whom (2.5%) required reoperation. There was no mortality in our series. Remission of type 2 diabetes mellitus (T2DM) was significantly associated with achieving >50% EWL (P = .009). Patients >50 years of age and higher preoperative BMI were significant factors for failure to achieve >50% EWL at 1 year after LSG. Conclusion: LSG is a safe and effective operation for achieving significant weight loss and improvement of co-morbidities in multiethnic Asian population. Adequate EWL is important to achieve remission of T2DM. Older patients and higher preoperative BMI are predictive factors for suboptimal EWL. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.

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