Laparoscopic Sleeve Gastrectomy in patients with BMI 30- 35

Marcos Berry1, Lionel Urrutia1, Patricio Lamoza, MD2, Shirley Marquina1, Alfredo Molina1. 1Clinica Las Condes, 2Hospital de Maipu

Introduction

The laparoscopic sleeve gastrectomy is a bariatric procedure that has been extended to special cases with BMI under 35. The real benefit is under investigation, but previous studies have shown beneficial results and safety.

In this paper, we try to demonstrate that LSG can be performed in patients with BMI between 30 and 35 obtaining comparable results to severe and morbidly obese patients, with resolution of their comorbidities.

Methods and Procedures

Descriptive and prospective study. We analyzed 474 patients from a universe of 1605 patients with LSG. Analyzing gender, age, comorbidities, preoperative BMI, EWL, EWL% and BMI postoperatively at 1,6,12,24 and 36 months, morbidity and mortality, between 2006 and 2014.

Results

Mean preoperative BMI 33.57 (30–34.9), mean weight 89.8 (68–114) kg, Mean postoperative BMI at 24 months 27(17-31.5),at 36 months 27.02 (21-32.5),surgical time 86.11 (40-120) min.

Comorbidities: Insulin resistance 74.3%, Dyslipidemia 66 %, Fatty liver disease 55.3%,Hypertension 35.2%, Obstructive sleep apnea 19%,Hyperuricemia 9.8%,Hypothyroidism 13.7%,Type 2 Diabetes mellitus (T2DM) 7.9%.

Remission of comorbidities: Insulin resistance 93%,Dyslipidemia 90%,Fatty liver 70%,Hypertension 70%,Obstructive sleep apnea 72%,T2DM 82% and improvement 18%.

Morbidity: 7 cases(2%);Hemoperitoneum=5,Portal vein thrombosis=1,Bile peritonitis (Lushka-cholecystectomy)=1,Leaks=0,Reoperations=1,Mortality=0.

Conclusions

LSG is a safe and reproducible technique in patients with BMI under 35, with low morbidity. In our case series this results are very encouraging with excellent weight loss in the midterm. So we believe that it should be strongly considered as a good surgical option in this group of patients.

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