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Prof. Ashraf Mahmoud Abdelkader Mohamed :: Publications:

Title:
Impact of Laparoscopic Sleeve Gastrectomy on Obesity-associated co-morbidities: A two-year follow-up prospective study
Authors: Nabeel Shdeed MD, Mohamed A. Mansour MD, Ahmed Zeidan MD, Hussein G. El-Gohary MD, Ashraf M. Abd elkader MD & Ayman M. Elbdawy MD*
Year: 2015
Keywords: Laparoscopic sleeve gastrectomy, Obesity, Co-morbidities, Insulin resistance
Journal: Not Available
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: International
Paper Link: Not Available
Full paper Not Available
Supplementary materials Not Available
Abstract:

Abstract 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 (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 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 %EWL and %EBMIL. BMI 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.

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