Five-Year Outcomes of Laparoscopic Sleeve Gastrectomy in Japanese Patients with Class I Obesity
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ORIGINAL CONTRIBUTIONS
Five-Year Outcomes of Laparoscopic Sleeve Gastrectomy in Japanese Patients with Class I Obesity Yosuke Seki 1 & Kazunori Kasama 1 & Eri Kikkawa 1 & Renzo Yokoyama 1 & Taiki Nabekura 1 & Akihiko Sano 1 & Manabu Amiki 1,2 & Yoshimochi Kurokawa 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Bariatric surgery is being recognized increasingly as an effective treatment for obesity and related comorbidities. In Japan, the cost of laparoscopic sleeve gastrectomy (LSG) is covered by the national health insurance for adults with a body mass index (BMI) ≥ 35 kg/m2 and specific comorbidities (type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), and obstructive sleep apnea syndrome (OSAS)). However, only 0.6% of the adult population have a BMI ≥ 35 kg/m2. In contrast, 4.3% have class I obesity (a BMI of 30–34.9 kg/m2). The BMI of Asians with central obesity-induced diabetes and other metabolic disorders is much lower than that of Westerners. Objectives To evaluate the medium-term (up to 5 years) outcomes of LSG performed in Japanese patients with class I obesity. Methods One hundred eighteen consecutive patients with class I obesity treated by LSG at our center between August 2007 and December 2018 were included in a retrospective study. Mean preoperative body weight (BW) and BMI were 88.6 ± 10.3 kg and 32.8 ± 1.6 kg/m2, respectively. Weight loss, comorbidity status, and adverse events were assessed. Results Mean BW/BMI at 1, 3, and 5 years after LSG decreased significantly to 66.6 ± 11.2 kg/24.6 ± 2.8 kg/m2, 68.0 ± 14.0 kg/ 25.4 ± 4.0 kg/m2, and 69.1 ± 12.9 kg/26.5 ± 3.0 kg/m2, respectively. Mean total weight loss at 1, 3, and 5 years was 24.7 ± 8.2%, 21.8 ± 12.1%, and 18.5 ± 9.7%, respectively. Metabolic disorders such as T2DM, HT, and DL improved significantly. There was no mortality. Conclusion LSG is safe, yields excellent weight loss, and improves obesity-related comorbidities in Japanese patients with class I obesity. Keywords LSG . Sleeve gastrectomy . Mild obesity . Class I obesity . Japanese
Introduction Bariatric surgery is an effective treatment for obesity and obesity-related comorbidities. Of the various types of bariatric surgeries, laparoscopic sleeve gastrectomy (LSG) has become the most commonly performed due to its simplicity, effectiveness, and safety [1]. Out of the 1991 National Institutes of
* Yosuke Seki [email protected] 1
Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo 102-0084, Japan
2
Department of Surgery, Kawasaki Saiwai Hospital, 31-27 Omiyacho, Saiwai-ku, Kawasaki-shi, Kanagawa, Japan
3
Department of Surgery, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo 102-0084, Japan
Health Consensus Conference came the recommendation that bariatric surgery be considered for patients with class II or class III obesity (body mass index (BMI) ≥ 35 kg/m2) [2], and this guideline stands, after nearly 30 years, as the most widely adopted, especially in Western countri
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