Five-year results of laparoscopic sleeve gastrectomy: effects on gastroesophageal reflux disease symptoms and co-morbidities

Background: Laparoscopic sleeve gastrectomy (LSG) is becoming the most performed bariatric procedure; however, data available on long-term follow-up are scanty. Objectives: The aim of the present study was to evaluate the 5-year efficacy of LSG on weight loss, gastroesophageal reflux disease (GERD) symptoms, and obesity-associated co-morbidities. Setting: Tertiary-care referral hospital. Methods: This study retrospectively analyzed 105 obese patients undergoing LSG from January 2006 to December 2009. The preoperative evaluation included demographic characteristics, evaluation of co-morbidities, a double-contrast barium swallow, and an upper-gastrointestinal endoscopy. The following data were collected at 1, 3, and 5 years after surgery: weight, improvement/remission of co-morbidities, complications, and revisional surgery. Results: According to preoperative body mass index (BMI), patients were divided into Group 1 (n = 61) with BMI <= 50 kg/m(2) and Group 2 (n = 44) with BMI >50 kg/m(2). The follow-up rate was 94% after 5 years (n = 99). Delta BMI (BMI at follow-up preoperative BMI) was significantly higher in Group 2 than in Group 1 at 1-3 years and 5 years (P <.001). Furthermore, at 5 years, Group 2 showed a significantly higher percentage total weight loss (%TWL) (26.6% +/- 18.3% versus 33.5% +/- 12.9%, P =.006) than Group 1, whereas percentage excess weight loss was similar (58.4% +/- 21.8% versus 55.3% +/- 19.5%, P =.5).Younger age at surgery and absence of postoperative GERD were associated with a better %TWL at 5 years (P <.001 and P =.03). Conclusion: LSG is an effective procedure at long-term, with good weight loss outcomes and with a considerable improvement of obesity-associated co-morbidities. Younger age at surgery and absence of postoperative GERD were associated with a better %TWL at 5 years. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.