VSG Long Term WLS Report in PubMed

Here is a recent VSG report that I saw online recently posted on PubMed.

 

Surg Endosc. 2011 Feb 27.

Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss.

 

Department of Digestive Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium, [email protected].

Abstract

BACKGROUND: This retrospective study evaluated long-term weight loss, resolution of comorbidities, quality of life (QoL), and food tolerance after laparoscopic sleeve gastrectomy (LSG).

METHODS: Between January 2003 and July 2008, 102 patients underwent LSG as a sole bariatric operation. A retrospective review of a prospectively collected database was performed. Demographics, complications, and percentage of excess weight loss (%EWL) were determined. Quality of life was measured using Medical Outcomes Survey Short Form 36 (SF-36) and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaires, which were sent to all patients. The food tolerance score (FTS) was determined and compared with that of nonobese subjects.

RESULTS: A total of 83 patients (81.4%) were eligible for follow-up evaluation. Their mean initial body mass index (BMI) was 39.3 kg/m(2). No major complications occurred. At a median follow-up point of 49 months (range, 17-80 months), the mean %EWL was 72.3% ± 29.3%. For the 23 patients *****ached the 6-year follow-up point, the mean %EWL was 55.9% ± 25.55%. The mean BAROS score was 6.5 ± 2.1, and a “good" to “excellent" score was observed for 75 patients (90.4%). In the comparison of patients with a %EWL greater than 50% and those with a %EWL of 50% or less, the SF-36 scores were statistically different only for “physical functioning" and “general health perception." The mean FTS was 23.8, and 95.2% of the patients described their food tolerance as acceptable to excellent.

CONCLUSION: Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure, although a tendency for weight regain is noted after 5 years of follow-up evaluation. Resolution of comorbidity is comparable with that reported in the literature. The LSG procedure results in good to excellent health-related QoL. Food tolerance is lower for patients after LSG than for nonobese patients who had no surgery, but 95.2% described food tolerance as acceptable to excellent.

 

Although I find the percentage of regain a little concerning, it still has a much better outcome than long term Lap Band studies, as indicated in the ASMBS recent report at their annual conference that I posted on my WLS blog.

How many long term VSG’ers have read this? How successful have you been with the VSG???

I have friends that have had lap band and gastric - some have kept it off and some have gained all their weight back and then some....I had the sleeve 4 weeks ago.  In my opinion - it's just a tool - you still have to do your part - with all three surgeries.....I'm not scared...not now anyway! Lol! I'm lucky to eat 1/4 of a cup of food. 

Kris I wish 1/4 cup did it for me. Unfortunately I got the CRAP BAND. :-(

Enjoy your VSG!

I just have to be questionable about the weight gain at 5 years out.... By than your sleeve is set and you should have adjusted to your eating habits.
It will be interesting to hear from all the 5 year sleeve people. I hope some reply.

 It is a scary thought of how we could regain eating such a small amount of food.  Is the stomach actually stretching?  Does the fact we take in so few calories set our metabolism to such a point that any extra calorie makes us gain back?  Yes, please long term sleeves, we need you!!!  

People *****gain are probably making bad food choices.  You can eat a lot more ice cream than you can dense steak.  You can eat more potato chips, crackers, bread, potatoes, etc.  Those foods are "slider" foods.  They slide into and out of your stomach pretty fast, so you don't feel full and you can keep putting them in your mouth.  This is why the one consistent instruction after VSG is PROTEIN FIRST, preferably dense protein, then veggies/fruit, then (only if you have room) starch and carbs.  Dense protein will stay in your stomach longer and make you feel full longer.

The sleeve matures, so it has a little more capacity then when you first had surgery.  But the really stretchy part of the stomach is removed, so there's not a lot of stretch left.  My doc said that to really stretch it out, you'd have to grossly overeat, to the point of vomiting, over and over and over and over and over again.  It would have to be intentional.

Well, I'm 3 1/2+ years out, and I would have to say, yes, you absolutely can regain, and I don't know ANYONE who was sleeved in my time frame who would disagree. Does that mean we WILL regain? No, absolutely not.

Aintstoppin, I don't think that our metabolisms get screwed up by the low calories you are currently eating. Your stomach is still swollen now, and so you will be able to eat quite a bit more after a while, though usually by a year or so, it's set. My restriction is still excellent, though I can eat a lot more than I could when I was newly sleeved. However, I do find that I get hungrier sooner than I did earlier--perhaps it's the return of the ghrelin hormone?--and so I have a tendency to eat more frequently. Also, old habits creep back in and tastes revert. A lot of people feel like they will never want sweets or carbs or whatever again when they're newly sleeved because their tastes change. But, in my experience, that's temporary. So, I think what may happen over time is you start to eat a bit more, even healthy food, because your capacity is greater and you get hungrier, and little treats start making their way in more freqently, you snack more..a bite of this or that...etc., etc. So, yes, you will be able to gain. That's why it's so important to change your eating habits and work on the mental game because the further out you get, the more important that will become. The sleeve will alway be there to help A LOT but it does get more challenging!

Lizanne

 Thank you ThinLizzy for your great incite.  

Lizanne. was there ever a time where you did not experience hunger.  And when did you notice it coming back.  I'm 26 months out and still no hunger, but I didn't have crazy hunger before surgery either.  My eating was more from boredom or emotional type eating.

Laura

No, mine never went away completely, but it hasn't come back completely either. I would say that it's been gradual. I think I started noticing that I don't stay satisfied as long at about 3 years out. I don't know whether that's because my stomach is emptying more quickly or because of the return of ghrelin or what. It's manageable, certainly, and it's not as big a potential problem as boredom/emotional eating was/is. I still feel full on the same small portion, but I notice that I'm hungry and/or have a strong "head" desire to eat after 2-3 hours, where before I could go for a long time between meals.

Lizanne