Laparoscopic Sleeve Gastrectomy for Morbid Obesity in 3003 patients Asnat Raziel Nasser Sakran Amir Szold David Goitein Assia Medical Group Assuta Medical Center Tel Aviv, Israel
Background • We report the results of a cohort of 3003 consecutive patients who underwent LSG over 9 years 2006-2014 Number of LSG per Year 700 595
600 500
605
634
461
400 307
300 217
200 100
116 11
57
0 2006 2007 2008 2009 2010 2011 2012 2013 2014
Methods Operative time, hospital stay, weight loss, comorbidity resolution, re-operation, and 30-day morbidity rates are shown
Results Gender
1102, 37% Male
Female
1901, 63%
Results Mean
Range
Age
43
14-76
Weight
120.5
75.4-220
BMI
42.8
35-73
There were 451 Patients with BMI>50 (15%)
Results Age Distribution 1011
No Of Patients
1200 1000
726
627
800 600
339 244
400 200
56
0 14-18
19-29
30-39
40-49 Age
50-59
Over 60
Results
Median
Range
Operative Time
50 min
32-94
Hospital Stay
2.2 days
1-38
Results Primary versus Revisional LSG 177, 6%
Primary Surgery Revisional Surgery
2826, 94%
Results Previous Bariatric Surgery Gastric Banding
Number 158
SRVG
7
Sleeve Gastrectomy
12
Total
177 (6%)
Comments 113 - LSG + Band Removal 45 - LSG after Band Removal
Leak Total 25 (0.83%) No difference in gender, mostly at the angle of his, mostly 7 days
7
Bleeding Total 63 (2.1%) 13 (21.3%) of them needed revisions for hemostasis and control of Bleeding 3 intra operative bleeding - two needed conversion to open surgery (1 splenectomy, 1 hemostasis in omentum)
Site of Bleeding
No
%
Omentum
4
6.35
Spleen
3
4.76
Stapler Line
3
4.76
Intra Gastric
4
6.35
Gallblader Bed
1
1.59
Unknowm Origin
48
76.2
Total
63
100
Revisions
Total
44
Leak
22
Bleeding
13
Obstruction of Sleeve
3
Intra abdominal hematoma
2
Abdominal wall Hematoma
1
Abdominal Abscess
1
Mesenteric Thrombosis and Small Bowel Necrosis
2
Results Excess Body Weight Loss % 80.0 70.0
72.3
67.0 59.4
60.0
63.8 57.1
50.0 40.0
EBWL%
30.0 20.0 10.0 0.0 12
24
36
Months
48
60
Prevalence of Comorbidities
HTN
DM
Hyperlipidemia
OSA
862
832
1,357
476
28.70%
27.70%
45.20%
15.90%
Resolution and Improvement of Comorbidities
1.3
1.7 14.3
12.2
29.8
30.7
100% 90%
80% 36.4
No Change
70%
41.5
Improved
60%
Resolved
50% 68.9
67.6 44.2
40% 30%
51.4
20% 10% 0% DM
HTN
Hyperlipidemia
OSA
Conclusions • LSG is an effective and safe bariatric surgery • High volume centers can lower complication rates
