Note: 32 French bougie used - VERY small!  Yes, only 20 patients in starting group, but there you go.

Surg Obes Relat Dis. 2011 Jul 20. [Epub ahead of print]

Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results.

Sarela AI, Dexter SP, O'Kane M, Menon A, McMahon MJ.

Source

Department of Upper Gastrointestinal and Bariatric Surgery, St. James's University Hospital, Leeds, United Kingdom; Bariatric Surgical Service, Nuffield Hospital, Leeds, United Kingdom.

Abstract

BACKGROUND:

Laparoscopic sleeve gastrectomy (LSG) has rapidly gained popularity as a definitive bariatric procedure despite the sparse long-term follow-up data. On the basis of extensive experience with the open Magenstrasse and Mill operation, we began practice of LSG in 2000. The objective of the present study was to analyze 8-9 years of our follow-up data for LSG at a university hospital in the United Kingdom.

METHODS:

From January 2000 to December 2001, 20 patients underwent LSG. A 32F bougie was used for calibration in all cases.

RESULTS:

The preoperative median body mass index was 45.8 kg/m(2) (range 35.8-63.7), and 9 patients (45%) were superobese (body mass index ≥50 kg/m(2)). For LSG as a definitive bariatric procedure, 8-9-year follow-up data were available for 13 patients. Of the remainder, 4 patients underwent revision surgery and 3 were lost to follow-up after 2 years. For the entire cohort, the median excess weight loss (EWL) was 73% (range 13-105%) at 1 year, 78% (range 22-98%) at 2 years, 73% (range 28-90%) at 3 years, and 68% (range 18-85%) at 8 or 9 years (P = .074). Of the 13 LSG-only patients with 8-9 years of follow-up, 11 (55% of the starting cohort) had >50% EWL at 8 or 9 years. No significant difference was found in the initial body mass index between the LSG-only patients with >50% EWL and others (45.9 kg/m(2), range 35.8-59.4 versus 45.7 kg/m(2), range 38.9-63.7, respectively; P = .70). The LSG-only patients with >50% EWL had a marginally significantly greater EWL at 1 year compared with the others (76%, range 48-103% versus 45%, range 13-99%, respectively; P = .058).

CONCLUSION:

At 8-9 years of follow-up, 55% of patients had >50% EWL from LSG as a definitive bariatric procedure.

Compare to the 92% of DSers who have > 50% EWL, including a HUGE number of people with a starting BMI >50.  And those stats DON'T include the 20% of patients who had revisions (presumably to a DS, which they probably should have had in the first place).

These results are better than typical RnY results. But if you want to label that as "not so good," that's your perogative. I think it shows that you are hell-bent on dismissing the VSG as a viable WLS option, myself.

I think the conclusion is actually quite misleading. Yes, 11 of the original 20 had >50% EWL, but not all 20 were followed for the full 8-9 years, so I think it's really more accurate to say 11 of the remaining 13 patients had >50% EWL at 8-9 years follow-up, which is nearly 85%. Although, it can be assumed that the 4 who underwent revision had less success as well, so maybe 11 out of 17 is more accurate? Which would be almost 65% of patients.

Generally, yes, LESS successful than the DS. But, hey, still more successful than just diet & exercise, so it's not a horrible option (and, I assume without looking it up, still wildly more successful than a band for those seeking restriction only), especially for those who know they can't/won't follow what they would need to with the DS (supplements, lab tracking, etc., although I personally think these things are also VERY lacking in other procedure groups because they seem to think it isn't as necessary - you know, until a senior-aged MALE ends up neding iron infusions at 3+ years out from a VSG...).

Lord knows my surgeon didn't get so much as ONE year of follow-up from me!  :P

Jilly bean, I just saw your ticker and huge congrats! My post op baby just started kindergarten!

Congrats Jilly!!!

 congrats on the Jiffy in the oven!  

I officially don't care about any VSG studies anymore since I am long past deciding to get one. just going to go ahead and be successful, regardless. 

but it's interesting reading.

Yes I thought that ANY study with a low number of participants was completely invalid.

At least that what has been said about other studies and they had 60 people not 20.


Hmmmm  me thinks we only like studies that say certain thinks

Pup

....

Well, it's a tiny study, but it's a start. It's still a hell of an improvement over crap bands.

According to my surgeon (and from what I have read elsewhere), the technique of the VSG has changed quite a bit since 2000-2001, beyond what size bougie is used.  Much of it has to do with how much of the stomach is left past the bougie, near the pyloric valve.  Without knowing this information, AND how close to the bougie the surgeons actually got, it is hard to judge the results of any study. 

Besides that, how is it that you can post the results of this tiny 20 person study (that only had 13 sleeve only patients with 8-9 yrs follow up) and come to a "not so good" conclusion, when you have blasted other studies (more than double this sample size) for being too small?