Short- and Mid-term Outcomes of Sleeve Gastrectomy for Morbid Obesity: The Experience of the Spanish National Registry

Abstract

Background Reports on laparoscopic sleeve gastrectomy (LSG) communicate very good short-term results on very high-risk morbid obese patients. However, mid- and longterm results are still unknown. A National Registry has been created in Spain to achieve information on the outcomes of this bariatric procedure. Methods Data were obtained from 17 centers and collected in a database. Technical issues, preoperative comorbid conditions, hospital stay, early and late complications, and short- and mid-term weight loss were analyzed. Results Five hundred forty patients were included; 76% were women. Mean BMI was 48.1±10. Mean age was 44.1±11.8. Morbidity rate was 5.2% and mortality rate 0.36%. Complications presented more frequently in superobese patients (OR, 2.8 (1.18–6.65)), male (OR, 2.98 (1.26–7.0)), and patients >55 years old (OR, 2.8 (1.14–6.8)). Staple-line reinforcement was related to a lower complication rate (3.7 vs 8.8%; p=0.039). Mean hospital stay was 4.8±8.2 days. Mean follow-up was 16.5±10.6 months (1–73). Mean percent excess BMI loss (EBL) at 3 months was 38.8±22, 55.6±8 at 6 months, 68.1±28 at 12 months, and 72.4±31 at 24 months. %EBL was superior in patients with lower initial BMI and lower age. Bougie caliber was an inverse predictive factor of%EBL at 12 and 24months (RR, 23.3 (11.4–35.2)). DMis remitted in 81% of the patients and HTA improved in 63.2% of them. A second-stage surgery was performed in 18 patients (3.2%). Conclusions LSG provides good short- and mid-term results with a low morbid-mortality rate. Better results are obtained in younger patients with lowest BMI. Staple-line reinforcement and a thinner bougie are recommended to improve outcome.