Sleeve gastrectomy in patients Sleeve gastrectomy in patients with BMI between 30 and 35 with BMI between 30 and 35

Sleeve gastrectomy in patients Sleeve gastrectomy in patients with BMI between 30 and 35 with BMI between 30 and 35

M. Berry MD, P. Lamoza MD, L. Urrutia MD, A. Molina MD, E. Luna MD, F. Parra MD

Unit of Bariatric & Metabolic Surgery

Clinica Las Condes

Santiago – Chile

SAGES 2015

Nashville, TN, USA

DisclosureDisclosureDisclosureDisclosure

• Covidien: Fellowship grant

IntroductionIntroductionIntroductionIntroduction

• The laparoscopic sleeve gastrectomy (LSG) 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.

• We try to demonstrate that LSG can be performed safely in patients with BMI between 30-35 obtaining comparable results to severe and morbidly obese patients, with resolution of their comorbidities.

LSGLSGLSGLSG

• LSG became the most widespread procedure in our country with excellent results in weight loss and acceptable morbimortality

Methods and ProceduresMethods and ProceduresMethods and ProceduresMethods and Procedures

• 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.)

ResultsResultsResultsResults

BMI

33,57

27,00 27,02

0

5

10

15

20

25

30

35

40

Preoperative 24 months postop. 36 months postop.

Kg/

Mts

2

ResultsResultsResultsResults

• Mean Weight: 89,8(68 – 114) kg

• Surgical time: 86,1(40 – 120)min

Comorbidities and RemissionComorbidities and RemissionComorbidities and RemissionComorbidities and Remission

0

50

100

150

200

250

300

350

400

Insulin Resistence Dyslipidemia Fatty Liver Disease Hypertension Obstructive Sleep

Apnea

Hyperuricemia Hypothyroidism Type 2 Diabetes

(T2DM)

Comorbiditites Remission

93%

90%

70%

70%

72%

82%*

* Improvement T2DM 18% (n:6)

MorbidityMorbidityMorbidityMorbidity

Morbidity n rate

Hemoperitoneum 5 1,0

Portal Vein Thrombosis 1 0,2

Bile Peritonitis (Lushka -cholecystectomy) 1 0,2

Leaks 0 0,0

Total Cases 7 1,4

ConclusionsConclusionsConclusionsConclusions

• Clearly, BMI is not the only indicator to consider bariatric and metabolic surgery; there are other variables to consider in a complete preoperative evaluation.

• Our results have shown that performing LSG in patients with BMI between 30 and 35 is safe

• The results are comparable or even better than those obtained in patients with severe or morbid obesity in terms of resolution of comorbidities and weight loss

• It will require further studies and longer follow-up.

• Thank you for your attention!!