Outcomes and Complications of Sleeve Gastrectomy
Sherif Hassanien Garhy Hassanien;
Abstract
Summary and Conclusion
O
besity now represents a public global health problem. The World Health Organization estimates the number of obese people in the World (Body Mass Index (BMI) over 30 kg/m²), to be over 500 million people
Severe obesity increases the mortality rate, especially from cardiovascular disease. Other cardiovascular problems include hypertension, thrombophlebitis, and venous stasis ulcers. Obstructive sleep apnoea and obesity hypoventilation syndrome are severe complications of obesity. Arthritis in weight-bearing joints. Obesity is a major and treatable cause of type II diabetes mellitus. Hyperlipidaemia is common in the obese and contributes to the risk of vascular disease. Abnormal liver function and cholelithiasis are common complications of obesity. Increased intra-abdominal pressure contributes to reflux oesophagitis, stress incontinence, and benign intracranial hypertension. Depression may contribute to abnormal eating and obesity, but often results from obesity.
Laparoscopic Sleeve Gastrectomy (LSG), also known as longitudinal or vertical gastrectomy, is a relatively new and effective surgical option for the management of morbid obesity it was initially introduced in 1990 as an alternative to distal gastrectomy with the duodenal switch procedure to reduce the rate of complications, Sleeve Gastrectomy was first performed laparoscopically by Ren 1999.
The effect of SG on Weight loss is partly based on a gastric restrictive mechanism tubulisation which reduces the size of the new stomach. The SG has also a hormonal effect. By removing the gastric fundus, the secretion of ghrelin, a hormone that stimulates appetite secreted by fundic parietal cells, is almost stopped, causing loss of appetite. A recent large series of about 1000 SG reported an excess weight loss of 86.6% at 1 year, 84.2% at 2 years and 84.5% at 3 years from the intervention.
There are several inherent risks associated with LSG. These risks include staple line disruption and subsequent leak, bleeding requiring reoperation or transfusion; and postoperative strictures requiring endoscopic or surgical intervention. In a systematic review of SG, Brethauer et al. identified studies with detailed complication data. In these studies, there were leaks (2.2%), bleeding episodes (1.2%), and postoperative strictures (0.6%). Nonetheless, LSG is still considered a low morbidity procedure, with a mortality rate < 1%.
LSG has emerged as an effective stand-alone procedure in the thriving world of bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) has been proven to be safe and effective, causing significant weight loss and improving an expressive number of metabolic conditions, including diabetes.
Owing to an increase in the number of bariatric surgical procedures, general surgeons should have an understanding of the complications associated with LSG and an approach for dealing with them.
O
besity now represents a public global health problem. The World Health Organization estimates the number of obese people in the World (Body Mass Index (BMI) over 30 kg/m²), to be over 500 million people
Severe obesity increases the mortality rate, especially from cardiovascular disease. Other cardiovascular problems include hypertension, thrombophlebitis, and venous stasis ulcers. Obstructive sleep apnoea and obesity hypoventilation syndrome are severe complications of obesity. Arthritis in weight-bearing joints. Obesity is a major and treatable cause of type II diabetes mellitus. Hyperlipidaemia is common in the obese and contributes to the risk of vascular disease. Abnormal liver function and cholelithiasis are common complications of obesity. Increased intra-abdominal pressure contributes to reflux oesophagitis, stress incontinence, and benign intracranial hypertension. Depression may contribute to abnormal eating and obesity, but often results from obesity.
Laparoscopic Sleeve Gastrectomy (LSG), also known as longitudinal or vertical gastrectomy, is a relatively new and effective surgical option for the management of morbid obesity it was initially introduced in 1990 as an alternative to distal gastrectomy with the duodenal switch procedure to reduce the rate of complications, Sleeve Gastrectomy was first performed laparoscopically by Ren 1999.
The effect of SG on Weight loss is partly based on a gastric restrictive mechanism tubulisation which reduces the size of the new stomach. The SG has also a hormonal effect. By removing the gastric fundus, the secretion of ghrelin, a hormone that stimulates appetite secreted by fundic parietal cells, is almost stopped, causing loss of appetite. A recent large series of about 1000 SG reported an excess weight loss of 86.6% at 1 year, 84.2% at 2 years and 84.5% at 3 years from the intervention.
There are several inherent risks associated with LSG. These risks include staple line disruption and subsequent leak, bleeding requiring reoperation or transfusion; and postoperative strictures requiring endoscopic or surgical intervention. In a systematic review of SG, Brethauer et al. identified studies with detailed complication data. In these studies, there were leaks (2.2%), bleeding episodes (1.2%), and postoperative strictures (0.6%). Nonetheless, LSG is still considered a low morbidity procedure, with a mortality rate < 1%.
LSG has emerged as an effective stand-alone procedure in the thriving world of bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) has been proven to be safe and effective, causing significant weight loss and improving an expressive number of metabolic conditions, including diabetes.
Owing to an increase in the number of bariatric surgical procedures, general surgeons should have an understanding of the complications associated with LSG and an approach for dealing with them.
Other data
| Title | Outcomes and Complications of Sleeve Gastrectomy | Other Titles | النتائج والمضاعفات المصاحبة لعملية استئصال المعدة الكمي | Authors | Sherif Hassanien Garhy Hassanien | Issue Date | 2015 |
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