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 of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). All patients
underwent LSG; operative time, hospital stay, and intraoperative and postoperative (P0)
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 HOMA-IR index
was evaluated at 6, 12 and 24 months after surgery.
Results: Mean operative time was 157.8±17 minutes and mean duration of hospital stay was
5.5±0.9 days. No conversion to open surgery. All patients showed progressive weight loss
throughout the follow-up period with progressively increasing VOEWL and %EBMIL. BM1 strata
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 of follow-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
of follow-up in various combinations in the 7 non-responders. Preoperatively, all patients were
insulin resistant; however, at the end of follow-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. |
