Canadian Surgery Forum.

摘要: Laparoscopic sleeve gastrectomy (LSG) has been designed as a first-stage procedure for high-risk or superobese patients (BMI> 50 kg/m2) to decrease perioperative complications following laparoscopic Roux-en-Y gastric bypass (LRYGB) or duodenal switch (DS). Its short-and midterm weight loss results are reportedly similar to those of LRYGB, stimulating surgeons to perform LSG as a primary procedure. The aim of this study was to evaluate its safety, efficacy with short-and midterm results of excess weight loss (% EWL) and to identify variables for reinterventions. We retrospectively evaluated 242 patients who underwent LSG between March 2007 and March 2010. Their mean preoperative weight was 138.6 kg, with a mean BMI of 49.0 kg/m2; 38% were superobese (n= 93). The major morbidity encountered was staple line leaks in 15 of 242 patients (6.2%), with 6 following revisional procedures. The perioperative mortality rate was 1.6%(4 patients). In terms of weight loss,% EWL for patients at 6 months was 46%, 60% at 12 months, 61% at 18 months and 62% at 24 months. Eighty-seven patients were evaluated at 12 months: 44 were morbidly obese (BMI< 50 kg/m2) and 43 were superobese (BMI> 50 kg/m2). Failures were assessed as% EWL less than 50 or BMI greater than 35 kg/m2. The failure rate was 4.5%(2/44 patients) for morbidly obese patients (p< 0.05) and 32.6%(14/43 patients) for superobese patients; these were scheduled for a second stage procedure. In all, 76.4% of superobese patients had an% EWL greater than 50%. Given our encouraging results with LSG, we believe that LSG gives similar midterm weight loss results as …