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Erschienen in: Obesity Surgery 11/2016

07.04.2016 | Original Contributions

Early Weight Recidivism Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study

verfasst von: Mohamed H. A. Fahmy, Mohamed D. Sarhan, Ayman M. A. Osman, Ahmad Badran, Amr Ayad, Dalia K. Serour, Hany A. Balamoun, Mohamed E. Salim

Erschienen in: Obesity Surgery | Ausgabe 11/2016

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Abstract

Background

Although weight loss following laparoscopic sleeve gastrectomy (LSG) can be substantial, weight recidivism is still a major concern. The aim of our work is to study early weight recidivism following LSG and to evaluate the role of gastric computed tomography volumetry (GCTV) in the assessment of patients experiencing early weight regain.

Methods

One-hundred and one morbidly obese patients undergoing LSG were prospectively studied. Patients were followed up for 2 years. Those who presented with weight recidivism were counseled for dietary habits and assessed for the amount of weight regain. Patients who regained weight were scheduled for GCTV.

Results

Twelve patients were excluded from the study. Weight recidivism was reported in 9/89 patients (10.1 %) [weight loss failure (n = 1), weight regain (n = 8)] and was almost always first recognized 1½–2 years after LSG. The amount of weight regain showed negative correlations with preoperative body weight and body mass index (r = −0.643, P = 0.086 and r = −0.690, P = 0.058; respectively) and positive correlations with the distance between the pylorus and the beginning of the staple line (r = 0.869, P = 0.005), as well as with the residual gastric volume (RGV) on GCTV 2 years after LSG (r = 0.786, P = 0.021).

Conclusions

In the small group of patients who regained weight, a longer distance between the pylorus and the beginning of the staple line, as well as a higher RGV on GCTV 2 years after LSG, were both associated with increased weight regain. Gastric computed tomography volumetry with RGV measurement holds promise as a useful research tool after LSG.
Literatur
1.
Zurück zum Zitat Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2006;35:93–9.CrossRefPubMed Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2006;35:93–9.CrossRefPubMed
2.
Zurück zum Zitat Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRefPubMed Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRefPubMed
3.
Zurück zum Zitat Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37:275–81.CrossRefPubMed Frezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37:275–81.CrossRefPubMed
4.
Zurück zum Zitat Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.CrossRefPubMed Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.CrossRefPubMed
5.
Zurück zum Zitat Langer FB, Bohdjalian A, Felberbauer FX, et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16:166–71.CrossRefPubMed Langer FB, Bohdjalian A, Felberbauer FX, et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16:166–71.CrossRefPubMed
6.
Zurück zum Zitat Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.CrossRefPubMed Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.CrossRefPubMed
7.
Zurück zum Zitat Iannelli A, Schneck AS, Noel P, et al. Re-sleeve gastrectomy for failed laparoscopic sleeve gastrectomy: a feasibility study. Obes Surg. 2011;21:832–5.CrossRefPubMed Iannelli A, Schneck AS, Noel P, et al. Re-sleeve gastrectomy for failed laparoscopic sleeve gastrectomy: a feasibility study. Obes Surg. 2011;21:832–5.CrossRefPubMed
8.
Zurück zum Zitat Baltasar A, Serra C, Pérez N, et al. Re-sleeve gastrectomy. Obes Surg. 2006;16(11):1535–8.CrossRefPubMed Baltasar A, Serra C, Pérez N, et al. Re-sleeve gastrectomy. Obes Surg. 2006;16(11):1535–8.CrossRefPubMed
9.
Zurück zum Zitat Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27. Obes Surg. 2007;18:487–96.CrossRef Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27. Obes Surg. 2007;18:487–96.CrossRef
10.
Zurück zum Zitat Johnston D, Dachtler J, Sue-Ling HM, et al. The Magenstrasse and Mill operation for morbid obesity. Obes Surg. 2003;13(1):10–6.CrossRefPubMed Johnston D, Dachtler J, Sue-Ling HM, et al. The Magenstrasse and Mill operation for morbid obesity. Obes Surg. 2003;13(1):10–6.CrossRefPubMed
11.
Zurück zum Zitat Gautier T, Sarcher T, Contival N, et al. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23:212–5.CrossRefPubMed Gautier T, Sarcher T, Contival N, et al. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23:212–5.CrossRefPubMed
12.
Zurück zum Zitat Jiménez A, Casamitjana R, Flores L, et al. Longterm effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256:1023–9.CrossRefPubMed Jiménez A, Casamitjana R, Flores L, et al. Longterm effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256:1023–9.CrossRefPubMed
13.
Zurück zum Zitat Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRefPubMed Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRefPubMed
14.
Zurück zum Zitat Deguines JB, Verhaeghe P, Yzet T, et al. Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surg Obes Relat Dis. 2013;9(5):660–6.CrossRefPubMed Deguines JB, Verhaeghe P, Yzet T, et al. Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surg Obes Relat Dis. 2013;9(5):660–6.CrossRefPubMed
15.
Zurück zum Zitat Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2, CD003641.PubMed Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2, CD003641.PubMed
16.
Zurück zum Zitat Kessler RM, Eckstein B. Obesity: health insurance plans respond to a public health challenge. AHIP Cover. 2005;46(2):38–40. 42.PubMed Kessler RM, Eckstein B. Obesity: health insurance plans respond to a public health challenge. AHIP Cover. 2005;46(2):38–40. 42.PubMed
17.
Zurück zum Zitat Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.CrossRefPubMed Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.CrossRefPubMed
18.
Zurück zum Zitat Christou NV, Look D, MacLean LD. Weight gain after short and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.CrossRefPubMedPubMedCentral Christou NV, Look D, MacLean LD. Weight gain after short and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Margo DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.CrossRef Margo DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.CrossRef
20.
Zurück zum Zitat Langer FB, Bohdjalian A, Shakeri-Leidenmühler S, et al. Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass—indications and outcome. Obes Surg. 2010;20:835–40.CrossRefPubMed Langer FB, Bohdjalian A, Shakeri-Leidenmühler S, et al. Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass—indications and outcome. Obes Surg. 2010;20:835–40.CrossRefPubMed
21.
Zurück zum Zitat Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20:535–40.CrossRefPubMed Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20:535–40.CrossRefPubMed
22.
Zurück zum Zitat D’Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed D’Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed
23.
Zurück zum Zitat Greenstein AJ, Jacob BP. Placement of a laparoscopic adjustable gastric band after failed sleeve gastrectomy. Surg Obes Relat Dis. 2008;4:556–8.CrossRefPubMed Greenstein AJ, Jacob BP. Placement of a laparoscopic adjustable gastric band after failed sleeve gastrectomy. Surg Obes Relat Dis. 2008;4:556–8.CrossRefPubMed
24.
Zurück zum Zitat Switzer NJ, Karmali S. The sleeve gastrectomy and how and why it can fail? Surg Curr Res. 2014;4:3. Switzer NJ, Karmali S. The sleeve gastrectomy and how and why it can fail? Surg Curr Res. 2014;4:3.
25.
Zurück zum Zitat AbuJaish W, Rosenthal RJ. Sleeve gastrectomy: a new surgical approach for morbid obesity. Expert Rev Gasroenterol Hepatol. 2010;4(1):101–19.CrossRef AbuJaish W, Rosenthal RJ. Sleeve gastrectomy: a new surgical approach for morbid obesity. Expert Rev Gasroenterol Hepatol. 2010;4(1):101–19.CrossRef
26.
Zurück zum Zitat Myronovych A, Kirby M, Ryan KK, et al. Vertical sleeve gastrectomy reduces hepatic steatosis while increasing serum bile acids in a weight-loss-independent manner. Obesity. 2014;22(2):390–400.CrossRefPubMed Myronovych A, Kirby M, Ryan KK, et al. Vertical sleeve gastrectomy reduces hepatic steatosis while increasing serum bile acids in a weight-loss-independent manner. Obesity. 2014;22(2):390–400.CrossRefPubMed
27.
Zurück zum Zitat Kandeel AA, Sarhan MD, Hegazy T, et al. Comparative assessment of gastric emptying in obese patients before and after laparoscopic sleeve gastrectomy using radionuclide scintigraphy. Nucl Med Commun. 2015;36(8):854–62.CrossRefPubMed Kandeel AA, Sarhan MD, Hegazy T, et al. Comparative assessment of gastric emptying in obese patients before and after laparoscopic sleeve gastrectomy using radionuclide scintigraphy. Nucl Med Commun. 2015;36(8):854–62.CrossRefPubMed
28.
Zurück zum Zitat Mehran A, Koleilat A. Sleeve gastrectomy failure: just when we thought we had the perfect operation. Bariatric Times. 2010;7:16–7. Mehran A, Koleilat A. Sleeve gastrectomy failure: just when we thought we had the perfect operation. Bariatric Times. 2010;7:16–7.
29.
Zurück zum Zitat Ashrafian H, le Roux CW. Metabolic surgery and gut hormones—a review of bariatric entero-humoral modulation. Physiol Behav. 2009;97:620–31.CrossRefPubMed Ashrafian H, le Roux CW. Metabolic surgery and gut hormones—a review of bariatric entero-humoral modulation. Physiol Behav. 2009;97:620–31.CrossRefPubMed
30.
Zurück zum Zitat Zundel N, Hernandez JD. Revisional surgery after restrictive procedures for morbid obesity. Surg Laparosc Endosc Percutan Tech. 2010;20:338–43.CrossRefPubMed Zundel N, Hernandez JD. Revisional surgery after restrictive procedures for morbid obesity. Surg Laparosc Endosc Percutan Tech. 2010;20:338–43.CrossRefPubMed
31.
Zurück zum Zitat Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.CrossRefPubMed Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.CrossRefPubMed
32.
Zurück zum Zitat Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2–3 years after sleeve gastrectomy. Obes Surg. 2009;19:1262–9.CrossRefPubMed Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2–3 years after sleeve gastrectomy. Obes Surg. 2009;19:1262–9.CrossRefPubMed
33.
Zurück zum Zitat Gagner M, Rogula T. Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg. 2003;13:649–54.CrossRefPubMed Gagner M, Rogula T. Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg. 2003;13:649–54.CrossRefPubMed
34.
Zurück zum Zitat Ochner CN, Jochner MC, Caruso EA, et al. Effect of preoperative body mass index on weight loss after obesity surgery. Surg Obes Relat Dis. 2013;9(3):423–7.CrossRefPubMedPubMedCentral Ochner CN, Jochner MC, Caruso EA, et al. Effect of preoperative body mass index on weight loss after obesity surgery. Surg Obes Relat Dis. 2013;9(3):423–7.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19:1515–21.CrossRefPubMed Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19:1515–21.CrossRefPubMed
36.
Zurück zum Zitat Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18:1251–6.CrossRefPubMed Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18:1251–6.CrossRefPubMed
37.
Zurück zum Zitat Bernstine H, Tzioni-Yehoshua R, Groshar D, et al. Gastric emptying is not affected by sleeve gastrectomy—scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg. 2009;19:293–8.CrossRefPubMed Bernstine H, Tzioni-Yehoshua R, Groshar D, et al. Gastric emptying is not affected by sleeve gastrectomy—scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg. 2009;19:293–8.CrossRefPubMed
38.
Zurück zum Zitat Kim WW, Gagner M, Kini S, et al. Laparoscopic vs. open biliopancreatic diversion with duodenal switch: a comparative study. J Gastrointest Surg. 2003;7:552–7.CrossRefPubMed Kim WW, Gagner M, Kini S, et al. Laparoscopic vs. open biliopancreatic diversion with duodenal switch: a comparative study. J Gastrointest Surg. 2003;7:552–7.CrossRefPubMed
Metadaten
Titel
Early Weight Recidivism Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study
verfasst von
Mohamed H. A. Fahmy
Mohamed D. Sarhan
Ayman M. A. Osman
Ahmad Badran
Amr Ayad
Dalia K. Serour
Hany A. Balamoun
Mohamed E. Salim
Publikationsdatum
07.04.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 11/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2165-5

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