Objectives: To determine the effects imposed by laparoscopic sleeve gastrectomy (LSG) on
obesity-associated co-morbidities.
Patients & methods: The study included 40 patients; 13 morbid obese and 27 obese patients.
All patients were evaluated preoperatively for existence and severity of co-morbidities and
determination ofHomeostasis Model Assessment of Insulin Resistance (HOMA-IR). All patients
underwent LSG; operative time, hospital stay, and intraoperative and postoperative (PO)
complications were registered. Postoperative monitoring included evaluation of the percentage
of excess weight loss (%EWL)and the percentage of excess body mass index loss (%EBMIL)
at 3, 6, 12 and 24 months after surgery; the frequency of associated co-morbidities and HOMAIR
index was evaluated at 6, 12 and 24 months after surgery.
Results: Mean operative time was 157.817 minutes and mean duration of hospital stay was
5.50.9 days. No conversion to open surgery. All patients showed progressive weight loss
throughout the follow-up period with progressively increasing %EWL and %EBMIL. BMIstrata
showed significant progressive change throughout follow-up period; 27 women were overweight
and only 13 women were obese. All obesity-associated co-morbidities showed progressive
improvement or resolution. At end off ollow-up, 7 patients still had co-morbidities, 9 patients
had improved co-morbidities and 24 patients had resolved co-morbidities with an improvement
and resolution rates of 22.5% and 60%, respectively and only 11 co-morbidities were recorded
at end off ollow-up in various combinations in the 7 non-responders. Preoperatively, all patients
were insulin resistant; however, at the end off ollow-up period HOMA-IR index of all patients
was within the non-resistant range.
Conclusion: Bariatric surgery effectively improves obesity-associated co-morbidities and
could be considered as non-pharmacological therapeutic modality for these co-morbidities.
Laparoscopic gastric sleeve is a safe and effective appropriate surgical procedure for morbidly
obese patients with associated co-morbidities. |
