A 3-year Postoperative Effect Analysis Of Laparoscopic Sleeve Gastrectomy For Obesity And Metabolic Diseases

Background:Laparoscopic sleeve gastrectomy(LSG)is widely recognized for its safety and efficacy in the treatment of obesity and type 2 diabetes mellitus(T2DM).However,the long-term efficacy of LSG still varies greatly among different Bariatric and metabolic surgery institutions.This study aims to evaluate the efficacy and safety of LSG for obesity and metabolic diseases 3 years after LSG.Methods:A total of 54 patients treated successfully with LSG at the department of Bariatric and Metabolic Surgery in China-Japan Union Hospital of Ji Lin university from September 2014 to September 2016 were included in this study.Body weight,waist circumference,body mass index(BMI),fasting blood glucose,glycated hemoglobin(Hb A1c),blood pressure,blood lipid,uric acid and trace elements were recorded at 1month,3 months,6 months,1 year,2 years and 3 years after operation by outpatient service or electronic communication.All the statistical analyses were performed using SPSS version 23.0.Normality of the data was tested with a matched t test or independent t test.Mann–Whitney test was used to examine skewed data.P values <0.05 were accepted as statistically significant.Results:All the 54 patients(22 males and 32 females)underwent LSG successfully,without conversion to laparotomy or death.Preoperative weight,BMI,waist circumference,fasting blood glucose(FBG),Hb A1 c,systolic blood pressure diastolic blood pressure,uric acid and triglyceride were(98.10±20.32)kg,(33.94±5.46)kg/m2,(110.12±13.23)cm,(9.40±2.70)mmol/L,(8.11±1.92)%,(138.70±16.96)mm Hg,(85.59±11.43)mm Hg,(2.23±1.10)mmol/L,(392.34±97.02)umol/L,respectively.At 3years after operation,weight,BMI,waist circumference,FBG,Hb A1 c,systolic blood pressure,diastolic blood pressure,uric acid and triglyceride were(71.95±9.62)kg,(25.32±2.87)kg/m2,(86.28±7.79)cm,(6.07±1.80)mmol/L,(6.13±0.87)%,(120.02±11.63)mm Hg,(76.33±6.98)mm Hg,(1.21±0.49)mmol/L,(296.06±107.41)umol/L,respectively.Compared with preoperation,these indicators were significant improvement(P<0.05).EWL% at 3 months,6 months,1 year,2 years and 3 years were(65.94±28.69)%,(80.22±24.74)%,(84.64±22.93)%,(86.41±37.69)%,(81.71±36.76)%,respectively.There was no significant difference in EWL% between groups 1 year,2 years and 3 years after operation(P>0.05),and the weight loss effect tended to be stable.The complete remission rates of T2 DM were 47.22%,50.00%,63.89%,52.78% and 55.56% at 3 months,6 months,1 year,2 years and 3 years,respectively.There was no significant difference in hemoglobin,calcium ion,iron,vitamin B12,25-hydroxyvitamin D and folic acid 3 years after operation compared with normal values.Conclusion:LSG is a safe and effective method for the treatment of obesity,T2 DM,hypertension,hyperlipidemia and hyperuricemia,with good long-term therapeutic effect.LSG has a low incidence of postoperative complications and no long-term nutrition-related complications.It is a safe and reliable surgery for weight loss and metabolism.