ABSTRACT
OBJECTIVE: To analyze pregnancy outcomes after laparoscopic sleeve gastrectomy (LSG) according to body mass index (BMI) at conception and the interval between LSG and pregnancy. METHODS: In a retrospective study, data were obtained for all women who became pregnant after LSG at a center in France between December 2001 and December 2011. Frequencies of perinatal events according to BMI at conception and the interval between LSG and pregnancy were compared. RESULTS: A total of 63 pregnancies occurring in 54 patients were included, among which 52 (83%) occurred after the first postoperative year and 26 (41%) in women who remained obese. Compared with women who were no longer obese at conception, women who were still obese delivered neonates of significantly lower gestational age at birth (P=0.02) and birth weight (P=0.001). Odds of preterm delivery were also increased (odds ratio 4.37, 95% confidence interval 1.17-16.27; P=0.03). Maternal and neonatal outcomes according to the interval between LSG and pregnancy did not differ significantly. CONCLUSION: Women who remain obese following LSG are at increased risk of adverse outcomes, including low gestational age at birth, low birth weight, and preterm delivery, and should be regarded as a risk group.
Subject(s)
Gastrectomy/methods , Obesity/surgery , Pregnancy Complications/epidemiology , Pregnancy Outcome , Adult , Birth Weight , Body Mass Index , Female , France , Gestational Age , Humans , Infant, Newborn , Laparoscopy/methods , Male , Middle Aged , Obesity/complications , Pregnancy , Premature Birth/epidemiology , Retrospective Studies , Young AdultABSTRACT
Laparoscopic sleeve gastrectomy (LSG) has been described as the first step of a two-step laparoscopic Roux-en-Y gastric bypass (LRYGB) or biliopancreatic diversion with duodenal switch (BPD-DS) in extremely obese patients. It has also been used as an independent bariatric procedure. Recently a banded sleeve gastrectomy using human dermis was published. Gastric sleeve dilatation is one of the unfavorable postoperative courses that may limit weight loss. Our technique of a banded sleeve gastrectomy using the GaBP Ring Autolock(TM) System to calibrate the sleeve and prevent distal sleeve dilatation is described in this article.
Subject(s)
Gastrectomy/instrumentation , Gastrectomy/methods , Obesity, Morbid/surgery , Gastric Dilatation/epidemiology , Gastric Dilatation/etiology , Humans , Treatment OutcomeABSTRACT
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has been rapidly accepted as a valuable bariatric procedure before its effectiveness on weight loss in the long-term is clearly demonstrated. We report a feasibility study including 13 patients undergoing a redo LSG for either progressive weight regain after initial weight loss of insufficient weight loss. METHODS: From October 2005 to April 2010, 13 patients underwent a re-sleeve gastrectomy procedure for progressive weight regain or insufficient weight loss (<50% of excess weight (EW)) associated with the persistence of the gastric fundus on upper gastrointestinal series. RESULTS: Mean initial body mass index (BMI) and EW were 44.6 (37-52.9) kg/m(2) and 61.8 (38.2-93.9) kg, respectively. There were ten comorbid conditions in five out of the 13 patients. The revision resulted in a mean BMI, percent of excess weight loss (%EWL), and percentage of excess BMI loss (%EBL) of 32.3 kg/m(2), 50.3%, and 57% at 1 month; 32 kg/m(2), 47.9%, and 54.5 at 6 months; and 27.5 kg/m(2), 71.4%, and 82.8% at 12 months, respectively. There was no morbidity. CONCLUSIONS: Laparoscopic revision of LSG is safe and effective in the short term to obtain substantial loss of weight and improvement in comorbidities.
