Prognostic factors of weight loss after sleeve gastrectomy: Multi centre study in Spain and Portugal.
Sanchez Santos R (1), Corcelles R (2), Vilallonga Puy R (3), Delgado Rivilla S (4), Ferrer JV (5), Foncillas Corvinos J (6), Masdevall Noguera C (7), Socas Macias M (8), Gomes P (9), Balague Ponz C (10), de Tomas Palacios J (11), Ortiz Sebastian S (12), Sanchez Pernaute A (13), Puche Pla JJ (14), Sabench Pereferrer F (15), Abasolo Vega J (16), Suñol Sala X (17), Garcia Navarro A (18), Duran Escribano C (19), Cassinello Fernandez N (20), Perez N (21), Gracia Solanas JA (22), Garcia-Moreno Nisa F (23), Hernández Matias A (24), Valentí Azcarate V (25), Perez Folques JE (26), Navarro Garcia I (27), Dominguez-Adame Lanuza E (28), Martinez Cortijo S (29), González Fernández J (30).
Sleeve gastrectomy (SG) has become a technique in its own right although a selective or global indication remains controversial. The weight loss data at 5 years are heterogeneous. The aim of the study is to identify possible prognostic factors of insufficient weight loss after SG.
A SG retrospective multicenter study of more than one year follow-up was performed. Failure is considered if EWL>50%. Univariate and multivariate study of Cox regression were performed to identify prognostic factors of failure of weight loss at 1, 2 and 3 years of follow up.
A total of 1,565 patients treated in 29 hospitals are included. PSP per year: 70.58±24.7; 3 years 69.39±29.2; 5 years 68.46±23.1. Patients with EWL<50 (considered failure): 17.1% in the first year, 20.1% at 3 years, 20.8% at 5 years.
Variables with influence on the weight loss failure in univariate analysis were: BMI>50kg/m2, age>50years, DM2, hypertension, OSA, heart disease, multiple comorbidities, distance to pylorus> 4cm, bougie>40F, treatment with antiplatelet agents. The reinforcement of the suture improved results. In multivariate study DM2 and BMI are independent factors of failure.
The SG associates a satisfactory weight loss in 79% of patients in the first 5 years; however, some variables such as BMI>50, age>50, the presence of several comorbidities, more than 5cm section of the pylorus or bougie>40F can increase the risk of weight loss failure.