The success rates of gastric sleeve surgery can be assessed based on the underlying aim of doing the surgery. Most surgeries are done to either correct an abnormality or to prevent a defect from occurring. In the case of gastric sleeve surgery, the procedure is done to correct abnormalities. These abnormalities are obesity and its associated disease conditions.
Gastric sleeve surgery is one of the restrictive bariatric surgeries that reduce calorie intake by reducing the stomach capacity. This is done by resecting 4/5th of the stomach leaving the remaining to function as the small capacity stomach with the expectation of early sensation of fullness during a meal.
Weight loss is expected to reduce, and the comorbid conditions such as diabetes, sleep apnea, hypertension, osteoarthritis, and dyslipidemia are expected to resolve or improve. These are believed to improve the patient’s quality of life and overall survival.
Gastric Sleeve Life Expectancy
Fontaine et al. showed in their study that when compared with an average weight individual; the reduction in life expectancy is 22% in a morbidly obese man of 25 years of age. This represents a 12-year reduction in life expectancy. This implies that a 25year old morbidly obese man will likely die 12 years earlier than his counterpart with a healthy weight.
In another study by Adams et al., involving over 500, 000 Americans between the ages of 50-71 years, it was revealed that those who were overweight (BMI 25-29.9kg/m2) had 20-40% increase in mortality and this figure tripled in those who are obese (BMI ≥30kg/m2). This implies that an obese person (50-71years) has more than three folds chance of dying as compared to someone of similar age with a healthy weight.
Thus, the gastric sleeve success rates can only be appreciated by the assessment of the degree of weight loss after surgery, the reversal/improvement of comorbid conditions, the improvement in the quality of life and overall increase in lifespan.
Gastric Sleeve Weight Loss Results
Hoyuela conducted a study where the 5-year outcome of obese patients who had a gastric sleeve as the primary procedure for morbid obesity was analyzed. In a total of 156 patients, the average preoperative body mass index (BMI) was 41.5kg/m2 (33.6-49.4kg/m2). No death was recorded. The average percentage excess weight loss at 1year after surgery was 82% and 60.3% at 5 years. The average percentage of excess BMI loss was 94.9% at 1 year and 74.8% at 5 years.
In a review of various studies by Shabbir and Dargan where the success of gastric sleeve surgery in the management of metabolic syndrome and obesity was analyzed, the percentage excess weight loss at 1 year was 59% and 50% at 6 years post-surgery in 46, 133 patients that had gastric sleeve surgeries in New York in 2012.
Although there were variable reductions in percentage excess weight loss and the percentage excess BMI loss over a 5year period, this could be attributed to the ability of the individual patient to sustain the dietary and lifestyle changes following surgery.
The above clearly showed that significant weight loss can be achieved and maintained over a long period of time in patients that undergo gastric sleeve surgery for the treatment of obesity. Based on weight loss alone, one can say that gastric sleeve surgery has a high success rate.
Reduction in Co-Morbidities
In Hoyuela study, the total resolution of diabetes mellitus was recorded in 75% of patients after 1year as evidenced by the blood sugar below 120mg/dL (6.6mmol/L) after discontinuation of anti-diabetic drugs. The other patients had significant improvement while one of the patients was able to convert from insulin to anti-diabetic drugs. Not less than 71.7% of those with hypertension had remission/improvement while those with obstructive sleep apnea had CPAP (Continuous Positive Airway Pressure ventilation) withdrawn.
Shabbir and Dargan also reported the findings of the STAMPEDE trial at Cleveland clinic where 42% of those with obesity and diabetes who had gastric sleeve surgery had their HbA1C (a measure of blood sugar control) reduced to 6.0%. At 6 years after surgery, 77% of these patients have recorded remission/improvement of diabetes. They also reported another study where hypertension reduced in 75% of the patients and resolution occurred in 58%. These are clear demonstrations of improvements in the comorbid conditions which will subsequently result in the reduction in cardiovascular risks, improved quality of life and prolonged survival.
Quality of Life after Gastric Sleeve
Fezzi et al. conducted a study on the quality of life in patients after gastric sleeve surgery. They reported a significant improvement in the quality of life in patients who had gastric sleeve surgery. This was found to be independent of the degree of weight loss.
In conclusion, looking at the degree of weight loss that is achievable after gastric sleeve surgery, the resolution/improvement of associated disease conditions with their positive effects on the quality of life and overall survival, one can confidently say that gastric sleeve surgery has recorded a high success rate.
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