Gastric bypass has better outcomes than gastric b and procedures for long-term weight loss , type 2 diabetes control and remission , hypertension , and hyperlipidemia .
Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections
IMPORTANCE Bariatric surgery is an accepted treatment for obesity .
Despite extensive literature , few studies report long-term follow-up in cohorts with adequate retention rates .
OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss , type 2 diabetes , hypertension , and hyperlipidemia in severely obese adults .
Laparoscopic Sleeve Gastrectomy — Influence of Sleeve Size and Resected Gastric Volume
Background Although the efficacy of laparoscopic sleeve gastrectomy ( LSG ) for morbidly obese patients with a BMI of < 50 kg/m2 , the incidence of weight gain by change of eating behaviors , and gastric dilatation following LSG have not been investigated thus far , LSG is becoming more common as a single-stage operation for the treatment morbid obesity . Methods This is a prospect i ve study of the initial 120 patients who underwent isolated LSG .  Initially , the LSG was performed without a calibration tube and result ed in high sleeve volumes ( group 1 : n=25 ) . In group 2 ( n=32 ) , a calibration tube of 44 Fr and in group 3 ( n=63 ) a calibration tube of 32 Fr were used . The study group consists of 101 patients with high BMI who were scheduled for a two-step LBPD-DS , but rejected the second step after 1 year . Study endpoints include estimated sleeve volume , volume of removed stomach , operative time , complication rates , length of hospital stay , changes in co-morbidity , percentage of excess BMI loss ( % EBL ) and changes in BMI ( kg/m2 ) . Results All 3 groups were comparable regarding age , gender , and co-morbidities . There was no hospital mortality , but there was one case of late mortality ( 0.8 % ) . 2 early leaks ( 1.7 % ) were seen . % excess BMI loss was significantly higher for patients who underwent LSG with tube calibrations . LSG with large sleeve volume showed a slight weight gain during 5 years of observation . A total of 16 patients ( 13.3 % ) underwent a second stage procedure within a period of 5 years ( 2 redo-sleeves , 7 LBPD-DS , 3 LRYGBP ) . Conclusion Early weight loss results were not different between the groups , but after 2 years the more restrictive LSG ( groups 2 , 3 ) results were significantly better than in patients without calibration . A removed gastric volume of < 500 cc seems to be a predictor of failure in treatment or early weight regain . A statistically significant improved health status and quality of life were registered for all groups . The general introduction of LSG as a one-stage restrictive procedure in the bariatric field can be considered only if the procedure is st and ardized and long-term results are available
Gastric bypass has better outcomes than gastric b and procedures for long-term weight loss , type 2 diabetes control and remission , hypertension , and hyperlipidemia .
Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections
IMPORTANCE Bariatric surgery is an accepted treatment for obesity .
Despite extensive literature , few studies report long-term follow-up in cohorts with adequate retention rates .
OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss , type 2 diabetes , hypertension , and hyperlipidemia in severely obese adults .