Beyond the Decade: Unveiling Long-Term Weight and Co-Morbidity Outcomes More Than 10 Years Post Laparoscopic Sleeve Gastrectomy

Abstract Introduction Despite its effectiveness, long-term outcomes of the safety and effectiveness of laparoscopic sleeve gastrectomy(LSG) for morbid obesity are still lacking. Methods We utilized phone interviews and hospital chart data for patients who underwent LSG, analyzing weight outcomes, comorbidities, and complications. Results The study included 2982 patients (72% female) with a maximum follow-up of 13 years. Mean pre-operative age and body mass index(BMI) were 34.7±11.3 years and 45.5±7.7 kg/m2. The prevalence of obesity classes were as follows: Class I, 3.1%; Class II, 19.2%; and Class III, 75.9%. BMI at nadir was 32.35 Kg/m2 equating to a mean nadir excess weight loss(EWL) of 67.03%. Weight outcomes at 13 years post-LSG showed a mean BMI of 31.83 kg/m2 and total weight loss(TWL) percentage of 31.43%. The highest excess weight loss and total weight loss were observed at 4 years and 18 months post-LSG, respectively. Weight loss outcomes varied according to pre-operative obesity class, with class I achieving the highest percentage EWL and class III observing the highest TWL at the end of one year. Weight regain occurred in 1.3% of the patient population, with class III experiencing the highest weight regain at 13 years. Significant reductions in comorbidities were observed, with a remission rate of 12.9% for type-1 DM. Complication rates were low, with 0.4% bleed, 0.5% leak, and 7.9% GERD. Conclusion LSG demonstrates sustained weight loss and comorbidity resolution, with low complication rates. The influence of initial obesity class on weight loss was significant only in the first 18 months post-LSG.