Jsmc-10379

SHORT AND MID-TERM MEDICAL OUTCOMES OF SLEEVE GASTRECTOMY IN OBESITY IN SULAIMANI CITY. AN ANALYTICAL CROSS-SECTIONAL STUDY

Syamand Awrahman Ahmed a, Karzan Seerwan Abdullah b, and Mohammed Ibrahim Mohialdeen Gubarii c

a  KBMS Candidate in GIT Surgery, Kurdistan Region, Iraq.

b Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

c Department of Family and Community Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 27/5/2022; Accepted: 21/10/2022; Published: 21/12/2022

DOI Link: https://doi.org/10.17656/jsmc.10379 

ABSTRACT 

Background 

The laparoscopic sleeve gastrectomy (LSG) is a frequently performed bariatric procedure. Studies indicate that LSG can facilitate successful and sustainable weight loss.

Objectives 

To examine the short-term (weight reduction) and mid-term (weight maintenance, quality of life, and medical conditions) outcomes following sleeve gastrectomy in Sulaimani.

Patients and Methods

A cross-sectional study was conducted on 114 participants from both high-quality and Zhyan hospitals in Sulaimani. From Feb 3, 2020, to Jul 22, 2021, data was gathered by evaluating the patient data records of 114 patients. Data included patients’ demographics, preoperative BMI& comorbidities, complications, and weight loss in the first week, second,4th, sixth months, and sixth months. Also, after the sixth month, complications were recorded and analyzed by SPSS software (IBM, version 25), including frequency and percentage, mean, and standard deviation, also obtained for parametric data. The associations between the variables were tested at a P value <0.05.

Results

The study consists of 114 patients (71.9% female and 28.1% male), with an average age of 34.0 years (range 20- 51 years). The average preoperative BMI and weight were 41.2 kg/m2 and 110.80 kg, respectively. Six months after surgery, the average ± SD of BMI was 32.8 kg/m ± 2 4.5, and the average ± SD of weight was 87.8 kg ±14.4. The prevalence of early postoperative problems (leak, upper GI bleeding, and intraperitoneal hemorrhage) among 114 patients was 0.9% for each complication, while the proportion of early postoperative nausea was 66.7%, and vomiting was 39.5%. Preoperative sleep apnea was 34.2%; after six months of surgery, the percentage was 0%; 19.3% of patients had joint pain; after six months of surgery, the percentage was 0.9%. In addition, 14 out of 114 patients (12.3%) had preoperative Hypertension, and 2 out of 114 patients (1.75%) had diabetes; after six months, 50% of both groups discontinued medical treatment. The incidence of gallstone development six months after surgery was 13.2%. Six months following LSG, 68.4% of individuals had hair loss. 

Conclusion

laparoscopic sleeve gastrectomy can considerably reduce BMI six months following surgery and may help improve or eliminate obesity-related comorbidities such as Hypertension and type 2 diabetes. A laparoscopic sleeve gastrectomy is an effective option for obese adults, resulting in significant weight loss with a low incidence of postoperative complications. LSG could be recommended as a valuable single intervention therapy for patients who typically fail to achieve and obtain real benefits from a structured weight loss program.

KEYWORDS

Obesity, sleeve gastrectomy, medical outcomes.

References 

1. Obesity [Internet]. Who. int. [cited 2021 Sep 25]. Available from: https://www.who.int/health-topics/obesity.

2. Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of family medicine and primary care. 2015 Apr;4(2):187.

3.  Obesity [Internet]. NHS.uk. [cited 2021 Sep 25]. Available from: https://www.nhs.uk/conditions/obesity/.

4. Garcia Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD. Cochrane review: Interventions for treating obesity in children. Evidence-Based Child Health: A Cochrane Review Journal. 2009 Dec;4(4):1571–729.

5. García Díaz E, Martín Folgueras T (2011). A systematic review of the clinical efficacy of sibutramine and orlistat in weight loss, quality of life, and adverse effects in obese adolescents. Nutr Hosp. 26(3):451-7.

6. Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C. Effects of bariatric surgery on mortality in Swedish obese subjects. New England journal of medicine. 2007 Aug 23;357(8):741-52.

7. Elder KA, Wolfe BM. Bariatric surgery: a review of procedures and outcomes. Gastroenterology. 2007 May 1;132(6):2253-71.

8. Fielding GA, Ren CJ. Laparoscopic adjustable gastric band. Surgical Clinics. 2005 Feb 1;85(1):129-40.

9. Treadwell JR, Sun F, Schoelles K. Systematic review and meta-analysis of bariatric surgery for pediatric obesity. Annals of surgery. 2008 Nov 1;248(5):763-76.

10. Jaruvongvanich V, Wongjarupong N, Vantanasiri K, Samakkarnthai P, Ungprasert P. Midterm outcome of laparoscopic sleeve gastrectomy in Asians: a systematic review and meta-analysis. Obesity Surgery. 2020 Apr;30(4):1459–67.

11. Sofianos C, Sofianos C. Outcomes of laparoscopic sleeve gastrectomy at a bariatric unit in South Africa. Annals of medicine and surgery. 2016 Dec 1;12:37-42.

12. Singla V, Aggarwal S, Singh B, Tharun G, Katiyar V, Bhambri A. Outcomes in super obese patients undergoing one anastomosis gastric bypass or laparoscopic sleeve gastrectomy. Obesity Surgery. 2019 Apr;29(4):1242–7.

13. Felberbauer FX, Langer F, Shakeri-Manesch S, Schmaldienst E, Kees M, Kriwanek S, Prager M, Prager G. Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obesity surgery. 2008 Jul;18(7):814–8.

14. Arias E, Martínez PR, Ka Ming Li V, Szomstein S, Rosenthal RJ. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obesity surgery. 2009 May;19(5):544-8.

15. Al Zabadi H, Daqour A, Hawari A, Hasouni J. Short-term outcomes of laparoscopic sleeve gastrectomy among obese patients in the Northern West Bank: a retrospective records review. BMC Research Notes. 2014 Dec;7(1):1-9.

16. Zhang F, Strain GW, Lei W, Dakin GF, Gagner M, Pomp A. Changes in lipid profiles in morbidly obese patients after laparoscopic sleeve gastrectomy (LSG). Obesity surgery. 2011 Mar;21(3):305–9.

17. Perathoner A, Weißenbacher A, Sucher R, Laimer E, Pratschke J, Mittermair R. Significant weight loss and rapid resolution of diabetes and dyslipidemia during short-term follow-up after laparoscopic sleeve gastrectomy. Obesity surgery. 2013 Dec;23(12):1966-72.

18. Fischer L, Hildebrandt C, Bruckner T, Kenngott H, Linke GR, Gehrig T, Büchler MW, Müller-Stich BP. Excessive weight loss after sleeve gastrectomy: a systematic review. Obesity surgery. 2012 May;22(5):721-31.

19. Yu J, Zhou X, Li L, Li S, Tan J, Li Y, Sun X. The long-term effects of bariatric surgery for type 2 diabetes: systematic review and meta-analysis of randomized and non-randomized evidence. Obesity surgery. 2015 Jan;25(1):143-58.

20. Yin X, Qian J, Wang Y, Yang C, Jia B, Cheng Y, Yu G, Wang Y. Short-term outcome and early effect on blood pressure of laparoscopic sleeve gastrectomy in morbidly obese patients. Clinical and Experimental Hypertension. 2019 Oct 3;41(7):622–6. Michael

21. Goldenshluger M, Goldenshluger A, Keinan-Boker L, Cohen MJ, Ben-Porat T, Gerasi H, Amun M, Abu-Gazala M, Khalaileh A, Mintz Y, Elazary R. Postoperative outcomes, weight loss predictors, and late gastrointestinal symptoms following laparoscopic sleeve gastrectomy. Journal of Gastrointestinal Surgery. 2017 Dec;21(12):2009-15.

22. Ruiz-Tovar J, Oller I, Llavero C, Zubiaga L, Diez M, Arroyo A, Calero A, Calpena R. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. The American Surgeon. 2014 May;80(5):466–71.

23. Şen O, Türkçapar A.G. Hair loss after sleeve gastrectomy and effect of biotin supplements. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2021 Mar 1;31(3):296–300.

24. Yousef A.A, Zedan A.M, Zayed M.E, Elmoghazy MA. Incidence and Aetiology of Gallstones Formation after Laparoscopic Sleeve Gastrectomy (Retrospective Study). Benha Journal of Applied Sciences. 2020 Aug 1;5(5 part (2)):313-8.

25. Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999 Sep 1;117(3):632-9.

26. Warschkow R, Tarantino I, Ukegjini K, Beutner U, Güller U, Schmied BM, Müller SA, Schultes B, Thurnheer M. Concomitant cholecystectomy during laparoscopic Roux-en-Y gastric bypass in obese patients is not justified: a meta-analysis. Obesity surgery. 2013 Mar;23(3):397–407.

27. Manatsathit W, Leelasinjaroen P, Al-Hamid H, Szpunar S, Hawasli A. The incidence of cholelithiasis after sleeve gastrectomy and its association with weight loss: a two-center retrospective cohort study. International Journal of Surgery. 2016 Jun 1;30:13-8. Outcomes of laparoscopic sleeve gastrectomy at a bariatric unit in South Africa. Annals of medicine and surgery.

28. Nedelcu M, Manos T, Cotirlet A, Noel P, Gagner M. Outcome of leaks after sleeve gastrectomy based on a new algorithm addressing leak size and gastric stenosis. Obesity surgery. 2015 Mar;25(3):559–63.

29. Dang JT, Shelton J, Mocanu V, Sun W, Birch DW, Karmali S, Switzer NJ. Trends and outcomes of laparoscopic sleeve gastrectomy between 2015 and 2018 in the USA and Canada. Obesity Surgery. 2021 Feb;31(2):675-81.

30. Gill RS, Lai M, Birch DW, Karmali S. Sleeve gastrectomy: procedure, outcomes, and complications. Current Obesity Reports. 2012 Jun;1(2):75–9.

31. Bashah M, Khidir N, El-Matbouly M. Management of leak after sleeve gastrectomy: outcomes of 73 cases, treatment algorithm and predictors of resolution. Obesity Surgery. 2020 Feb;30(2):515-20.

32. Moy J, Pomp A, Dakin G, Parikh M, Gagner M. Laparoscopic sleeve gastrectomy for morbid obesity. The American Journal of Surgery. 2008 Nov 1;196(5):e56-9.

Full Text

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.