Udai S Sibia, MD, Raquel Redondo, MD, Adam S Weltz, MD, Olmos Holmatova, MD, Paxton Paganelli, Hamid R Zahiri, DO, Timothy R Turner, PhD, Alejandro Gandsas, MD. Anne Arundel Medical Center
Background: Laparoscopic Sleeve Gastrectomy (LSG) is a safe and effective operative treatment for morbid obesity. The purpose of this study was to analyze trends in biochemical parameters and pharmacologic dependence in morbidly obese patients to quantify the impact of LSG on obesity related comorbidities.
Methods: A retrospective review was conducted analyzing a consecutive series LSGs performed between January and April of 2015 at Anne Arundel Medical Center. Analyzed outcomes included patient demographics, intra-operative data, and 30-day wound and non-wound related complications. In addition, post-operative biochemical trends and pharmacologic dependence related to obesity-associated comorbidities were assessed after one year.
Results: One-hundred seventeen patients (85% female) with mean age, BMI, and ASA of 46.5 years, 45.9 kg/m2 and 2.9 were included. Common comorbidities included hypertension (HTN, 81.2%), hyperlipidemia (HLD, 45.3%), gastroesophageal reflux disease (GERD, 41.9%) and diabetes mellitus (DM, 35.0%). Operative data included mean time (66.3 min), blood loss (18 ml) and length of stay (2.0 days). Thirty day wound and non-wound related complications were 0.9% and 2.6%. At one year follow-up, pharmacologic independence or reduction was seen in 93.3% of diabetics, 72.4% of hypertensives, 64.3% of refluxers and 71.4% of hyperlipidemics. Additional decreases were BMI by 76.0% (p<0.0001), hemoglobin A1c by 0.8 mg/dL (p<0.001), blood glucose by 24.9mmHg (p<0.001), systolic blood pressure by 8.7 mmHg (p<0.0001), diastolic blood pressure by 8.6 mmHg (p<.0001) and triglycerides by 42.0 mg/dL (p<0.01). Increases included mean HDL levels by 10.3 mg/dL (p<.001). Overall, mean excess weight loss (EWL) was 52.2% after one year.
Conclusion: The potential of LSG to treat morbid obesity and alleviate its most commonly associated ailments is significant as shown by major weight loss, improved biochemical parameters and independence from pharmacologic therapy. Consideration of LSG in less obese patients with DM, HTN, HLD and/or GERD refractory to medical management may serve as a valuable therapeutic strategy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80323
Program Number: P484
Presentation Session: Poster (Non CME)
Presentation Type: Poster