Early results of a Canadian laparoscopic sleeve gastrectomy experience

Abstract

Background: Sleeve gastrectomy (SG) is a relatively new bariatric procedure with a number of advantages compared with Roux-en-Y gastric bypass. However, SG also has a number of disadvantages and associated risks. We sought to examine perioperative complications and outcomes of laparoscopic SG (LSG) in a single major Canadian bariatric surgery centre (Victoria, BC). Methods: Since June 2008, LSG has been performed at our centre and we reviewed the cases of all patients. We conducted a retrospective chart review in April 2010. Results: Thirty-four patients had LSG, and none was lost to follow-up. Indications for LSG over other bariatric procedures were patient preference (n = 28), severe obes - ity with a body mass index (BMI) greater than 60 kg/m2 (n = 5) and severe upper abdominal adhesions (n = 1). All but 1 of the cohort were women, and the average age was 48 (standard deviation [SD] 11) years. Preoperatively, the average BMI was 50.3 (SD 7.7) kg/m2. Preoperative obesity-related comorbidity rates were 56% (n = 19) for type 2 diabetes mellitus (T2DM), 50% (n = 17) for hypertension, 32% (n = 11) for dys lipidemia, 62% (n = 21) for obstructive sleep apnea (OSA), 62% (n = 21) for knee and/or hip pain and 44% (n = 15) for depression and/or anxiety. The mean duration of surgery was 74 (SD 21) minutes. There were 2 major perioperative complications: 1 staple line leak and 1 staple line hemorrhage. The median stay in hospital was 1 day. Postoperative upper gastrointestinal imaging studies were conducted in 11 patients; 1 was positive for staple line leak. Histopathology on the excised gastric segments revealed chronic helicobacter pylori gastritis in 2 patients and small gastrointestinal stromal tumours in 1 patient. The mean postoperative follow-up interval was 10 months. Weight loss averaged 27.4 (SD 9.0) kg. Overall weight loss was 3.3 (SD 1.8) kg/month. Resolution occurred in 74% of patients with T2DM, 53% with hypertension, 45% with dyslipidemia, 76% with OSA, 38% with joint pain and 20% with depression/anxiety. Overall satisfaction was rated as excellent by 68% of patients, good by 29% and poor by 3% of patients. Conclusion: Preliminary analysis of our experience with LSG indicates that this is an effective and safe procedure for the treatment of obesity.©2011 Association médicale canadienne.