Outcomes in Super Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Background: Super obese patients remain a challenge for management because of large liver size resulting in decreased work space and associated comorbidities. Objectives: To study outcomes in super obese patients undergoing Laparoscopic sleeve gastrectomy (LSG). Methods: Retrospective data of 123 patients undergoing LSG from January 2008 to March 2015 were analyzed prospectively. Results: Mean age and body mass index (BMI) of 123 patients (± 2 standard deviation [SD]) were 39.9 ± 23.3 years and 55.6 ± 10.54 kg/m2, respectively. Mean percentage excess weight loss (%EWL) (± 2 SD) at 1, 3, 5, and 7 years was 63% ± 36.7%, 62.3% ± 29.0%, 56.5% ± 35.8%, and 58.6% ± 40.3%, respectively. The preoperative BMI correlated with %EWL at 1 year (r2 = 0.0397, P = .044). Staple line leak, bleeding, deep venous thrombosis, and 30-day mortality occurred in 1.6%, 0%, 0.8%, and 0% of the patients, respectively. Stricture formation and new onset gastroesophageal reflux disease (GERD) occurred in 0.8% patients each. Of the diabetic patients, 72.2% had remission and the rest required decreased dosage of oral hypoglycemic medications. Hypertension, obstructive sleep apnea, and GERD improved in 68.2%, 100%, and 25% of the patients, respectively. However, 25% of patients had worsening in GERD symptoms. Conclusions: Super obese patients undergoing LSG as the primary procedure have reasonable weight loss of 62% and 56% at 3 and 5 years, respectively, with significant resolution of comorbidities.