Our experience in laparoscopic sleeve gastrectomy
Nurkan Törer, Yahya Ekici, Tarık Zafer Nursal
Başkent Üniversitesi, Tıp Fakültesi, Genel Cerrahi AD., ADANA
Keywords: Morbid obesity, laparoscopic sleeve gastrectomy, complication
Objective: Obesity is the major health problem of our era. We have evaluated patients who underwent Laparoscopic Sleeve Gastrectomy (LSG) in our hospital and shared our experience. The risks and benefits, treatment success and complication rates of LSG were analyzed.
Methods: The records of all patients undergoing LSG in our hospital were screened retrospectively. Demographic characteristics as well as the size (m), body weight (BW, kg), Body Mass Index (BMI), ASA (American Society of Anesthesiology) score, co-morbidities, previous surgery, length of hospital stay (in days), and complications were recorded. All of the patients were called by phone, and asked for their last BW, existence of gastro-esophageal reflux symptoms, if they are satisfied with the surgery or not, if they would recommend this surgery to their friends in the same situation. The patients weight lost, ideally BW, Body Weight Excess (Excess Body Weight) (EBW), Excess Body Weight Loss (EBWL), final BMI were calculated.
Results: The mean BW and BMI on admission were 132.1 ± 23.2 kg and 46.6 ± 6.3 kg/m2 respectively. The median postoperative hospital stay was 5 days (2-9 days). We have converted to open surgery due to the closure problem of the staples in one patient. In one patient, Veress needle injury with mesenteric bleeding controlled without conversion. There was no mortality. Seven patients (12.9%) had complication (5 surgical site infections (9.2%), 1 gastro-cutaneous fistula, 1 stricture). Weight and male gender was found to increase the risk of surgical site infection (p = 0.002 and p = 0.001 respectively).
The median follow-up period of our patients was 10.5 months (range 1-33 months). 42 patients were reached by telephone. 39 of them (92.8) were satisfied with the surgery, while 3 patients were not satisfied. Patients' final mean BW and BMI were 96.1 ± 16.7 kg, 34.6 ± 5.5 BMI.
Conclusion: LSG is an effective and safe procedure with low complication and high patient satisfaction rates. We recommend taking extra care during removal of surgical specimen of male patients with excessive BW.