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Erschienen in: Obesity Surgery 5/2014

01.05.2014 | Original Contributions

Lifestyle Modification Parallels to Sleeve Success

verfasst von: Dean Keren, Ibrahim Matter, Alexandra Lavy

Erschienen in: Obesity Surgery | Ausgabe 5/2014

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Abstract

Background

The role of laparoscopic sleeve gastrectomy (LSG) has increased over the past 10 years. We present our results of patients who were 5 years out from surgery with regard to safety and long-term efficacy.

Methods

Retrospective analysis was carried out from prospectively collected data of patients who underwent LSG for morbid obesity. Bariatric Analysis and Reporting Outcome System (BAROS) and Food Tolerance Scores (FTS) were assessed. At 5 years, two lifestyle modification questions (regarding nutrition habits and physical fitness) were separately assessed.

Results

One hundred fourteen patients underwent LSG and were available for postoperative visits. Mean excess weight loss (EWL) was >65 % during the initial 3 years and declined to 45.3 % in 5 years. Of the patients, 71.92 % did not reach 50 % EWL at 60 months and were considered objective failures. BAROS and FTS scores were 7.15 and 4.32, and 23.5 and 22.5 at 30 and 60 months, respectively. Analyzing the 32 patients with EWL >50 % in the 5-year group, 26 (81.25 %) of them had scored ≥0.5 on the two lifestyle modification questions compared with 6 (18.75 %) that scored <0.5 (P < 0.001).

Conclusion

LSG is an effective bariatric surgical procedure with significant long-term (5 year) weight loss, resolution of comorbid medical conditions and significant improvement in the quality of life. The basis for this success, which must be always emphasized preoperatively by the bariatric team, is knowledge and implementation of better nutritional habits and increasing physical fitness or, in other words, in significant lifestyle modification.
Literatur
1.
Zurück zum Zitat James PT, Rigby N, Leach R. International Obesity Task Force—the obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil. 2004;11(1):3–8.PubMedCrossRef James PT, Rigby N, Leach R. International Obesity Task Force—the obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil. 2004;11(1):3–8.PubMedCrossRef
2.
Zurück zum Zitat Dymek MP, Le Grange D, Neven K, et al. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg. 2001;11(1):32–9.PubMedCrossRef Dymek MP, Le Grange D, Neven K, et al. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg. 2001;11(1):32–9.PubMedCrossRef
3.
Zurück zum Zitat Keren D, Matter I, Rainis T, et al. Getting the most from the sleeve: the importance of post operative follow-up. Obes Surg. 2011;21:1887–93.PubMedCrossRef Keren D, Matter I, Rainis T, et al. Getting the most from the sleeve: the importance of post operative follow-up. Obes Surg. 2011;21:1887–93.PubMedCrossRef
5.
Zurück zum Zitat Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.PubMedCrossRef Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.PubMedCrossRef
6.
Zurück zum Zitat Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic. Ann Surg. 2010;252:319–24.PubMedCrossRef Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic. Ann Surg. 2010;252:319–24.PubMedCrossRef
7.
Zurück zum Zitat Suter M, Calmes JM, Paroz A, et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg. 2007;17:2–8.PubMedCrossRef Suter M, Calmes JM, Paroz A, et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg. 2007;17:2–8.PubMedCrossRef
8.
Zurück zum Zitat Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155:385–94.PubMed Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155:385–94.PubMed
9.
Zurück zum Zitat Heath V. Laparoscopic sleeve gastrectomy as the first-line surgical option for morbid obesity. Nat Rev Endocrinol. 2010;6(10):534.PubMedCrossRef Heath V. Laparoscopic sleeve gastrectomy as the first-line surgical option for morbid obesity. Nat Rev Endocrinol. 2010;6(10):534.PubMedCrossRef
10.
Zurück zum Zitat Strain GW, Saif T, Gagner M, et al. Cross-sectional review of effects of laparoscopic sleeve gastrectomy at 1, 3, and 5 years. Surg Obes Relat Dis. 2011;7(6):714–9.PubMedCrossRef Strain GW, Saif T, Gagner M, et al. Cross-sectional review of effects of laparoscopic sleeve gastrectomy at 1, 3, and 5 years. Surg Obes Relat Dis. 2011;7(6):714–9.PubMedCrossRef
11.
Zurück zum Zitat Kehagias I, Spyropoulos C, Karamanakos S, et al. Efficacy of sleeve gastrectomy as sole procedure in patients with clinically severe obesity (BMI ≤50 kg/m(2)). Surg Obes Relat Dis. 2013;9(3):363–9.PubMedCrossRef Kehagias I, Spyropoulos C, Karamanakos S, et al. Efficacy of sleeve gastrectomy as sole procedure in patients with clinically severe obesity (BMI ≤50 kg/m(2)). Surg Obes Relat Dis. 2013;9(3):363–9.PubMedCrossRef
12.
Zurück zum Zitat Deitel M, Gagner M, Erickson AL, et al. Third International Summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749–59.PubMedCrossRef Deitel M, Gagner M, Erickson AL, et al. Third International Summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749–59.PubMedCrossRef
13.
Zurück zum Zitat Zachariah SK, Chang PC, Ooi AS, et al. Laparoscopic sleeve gastrectomy for morbid obesity: 5 years experience from an Asian center of excellence. Obes Surg. 2013;23(7):939–46.PubMedCrossRef Zachariah SK, Chang PC, Ooi AS, et al. Laparoscopic sleeve gastrectomy for morbid obesity: 5 years experience from an Asian center of excellence. Obes Surg. 2013;23(7):939–46.PubMedCrossRef
14.
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(2):166–71.PubMedCrossRef 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(2):166–71.PubMedCrossRef
15.
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.PubMedCrossRef 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.PubMedCrossRef
16.
Zurück zum Zitat Wang Y, Liu J. Plasma ghrelin modulation in gastric band operation. Obes Surg. 2009;19:357–62.PubMedCrossRef Wang Y, Liu J. Plasma ghrelin modulation in gastric band operation. Obes Surg. 2009;19:357–62.PubMedCrossRef
17.
Zurück zum Zitat Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.PubMedCrossRef Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.PubMedCrossRef
18.
Zurück zum Zitat Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today. 2008;38(6):481–3.PubMedCrossRef Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today. 2008;38(6):481–3.PubMedCrossRef
19.
Zurück zum Zitat Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.PubMedCrossRef Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.PubMedCrossRef
20.
Zurück zum Zitat Melissas J. IFSO Guidelines for safety, quality, and excellence in bariatric surgery. Obes Surg. 2008;18:497–500.PubMedCrossRef Melissas J. IFSO Guidelines for safety, quality, and excellence in bariatric surgery. Obes Surg. 2008;18:497–500.PubMedCrossRef
21.
Zurück zum Zitat Kafri N, Valfer R, Nativ O, et al. Health behavior, food tolerance, and satisfaction after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(1):82–8.PubMedCrossRef Kafri N, Valfer R, Nativ O, et al. Health behavior, food tolerance, and satisfaction after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(1):82–8.PubMedCrossRef
22.
Zurück zum Zitat Sarela AI, Dexter SP, O’Kane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results. Surg Obes Relat Dis. 2012;8(6):679–84.PubMedCrossRef Sarela AI, Dexter SP, O’Kane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results. Surg Obes Relat Dis. 2012;8(6):679–84.PubMedCrossRef
23.
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(5):535–40.PubMedCrossRef 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(5):535–40.PubMedCrossRef
Metadaten
Titel
Lifestyle Modification Parallels to Sleeve Success
verfasst von
Dean Keren
Ibrahim Matter
Alexandra Lavy
Publikationsdatum
01.05.2014
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 5/2014
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-1145-2

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