Sleeve gastrectomy – still popular bariatric method

Czech version

Authors: M. Kasalický ^1,2; E. Koblihová ¹; R. Pohnán ¹
Authors‘ workplace: Chirurgická klinika 2. lékařské fakulty Univerzity Karlovy a Ústřední vojenská nemocnice – Vojenská fakultní nemocnice Praha, Česká republika ¹; Fakulta zdravotníctva a sociálnej práce Trnavská univerzita, Slovenská republika ²
Published in: Rozhl. Chir., 2024, roč. 103, č. 1, s. 6-12.
doi: https://doi.org/10.33699/PIS.2024.103.1.6–12

Overview

Introduction: Obesity is currently the most common multifactorial disease affecting almost all social strata of the population. Conservative therapy of obesity usually succeeds in reducing excess weight by an average of 10–15%. After surgical treatment of severe obesity (bariatric surgery), the average decrease in excess weight is several times greater and, in most cases, has a long-term positive effect on the overall clinical condition of the patients.

Methods: Sleeve gastrectomy (SG) is the most used bariatric method of treating severe obesity today. The principle of SG is a vertical resection of a major portion of the gastric greater curvature. After the resection, the residual stomach has the shape of a sleeve with a remaining volume of about 120–150 ml. The effect of the method is both restrictive and hormonal, because after SG, the plasma level of active ghrelin decreases in the long term, among other things.

Conclusion: Obesity is considered one of the most serious global health problems today. In 2018 a total of 696,191 bariatric procedures were performed worldwide. Sleeve gastrectomy was originally used in high-risk severely obese patients as the first stage of a duodenal switch (DS) or gastric bypass. Since 2003, this method has been used independently because for most of the patients, SG had a sufficient effect on weight reduction and improvement of comorbidities, and that is why since 2015, SG has become the most frequently used bariatric method.

Keywords:

sleeve gastrectomy – bariatric surgery – severe obesity

Sources

Gu L, Huang X, Li S, et al. A meta-analysis of the medium – and longterm effects of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. BMC Surg. 2020 Feb 12;20(1):30. doi:10.1186/ s12893-020-00695-x.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2014. Obes Surg. 2015 Oct;25(10):1822–1832. doi:10.1007/s11695-015-1657-z.
Pavone G, Tartaglia N, Porfido A, et al. The new onset of GERD after sleeve gastrectomy: A systematic review. Ann Med Surg. (Lond) 2022 Apr 5;77:103584. doi:10.1016/j.amsu.2022.103584.
Frühbeck G. Bariatric and metabolic surgery: a shift in eligibility and success criteria. Nat Rev Endocrinol. 2015 Aug;11(8):465–477. doi:10.1038/nrendo. 2015.84.
Kasalicky M. Bariatrie – chirurgická léčba obezity a cukrovky. Praha, Maxdorf Jessenius 2018. ISBN 978-80-7345-593-4.
Angrisani A, Santonicola A, Iovino P, et al. Bariatric surgery survey 2018: Similarities and disparities among the 5 IFSO chapters. Obes Surg. 2021 May;31(5):1937– 1948. doi:10.1007/s11695-020-05207-7.
Gagner M, Hutchinson C, Rosenthal R. Fifth international consensus conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016 May;12(4):750– 756. doi:10.1016/j. soard. 2016.01.022.
Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery. Obes Surg. 2023 Jan;33(1):3–14. doi:10.1007/s11695-022-06332-1.
Syn NL, Cummings DE, Wang LZ, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants. Lancet 2021 May 15;397(10287):1830–1841. doi:10.1016/ S0140-6736(21)00591-2.
Gagner M. The future of sleeve gastrectomy. Eur Endocrinol. 2016 Mar;12(1):37–38. doi:10.17925/EE.2016.12.01.37.
Anderson B, Switzer NJ, Almamar A, et al. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg. 2013 Sep;23(9): 1476–1480. doi:10.1007/s11695-013-0999-7.
McCarty TR, Jirapinyo P, Thompson CC. Effect of sleeve gastrectomy on ghrelin, GLP-1, PYY, and GIP gut hormones: A systematic review and meta-analysis. Ann Surg. 2020 Jul;272(1):72–80. doi:10.1097/ SLA.0000000000003614.
Müllerová D a kol. Obezita – prevence a léčba. Mladá fronta 2009:42–51,81–84. ISBN 978-80-204-2146-3.
Ruiz-Tovar J, Sanchez-Santos R, MartínGarcía-Almenta E, et al. Enhanced recovery after bariatric surgery. Cir Esp. (Engl Ed). 2019 Dec;97(10):551–559.doi:10.1016/j.ciresp.2019.05.003.
Montastier E, Chalret du Rieu M, Tuyeras G, et al. Long-term nutritional follow-up post bariatric surgery. Curr Opin Clin Nutr Metab Care 2018 Sep;21(5):388–393. doi:10.1097/ MCO.0000000000000490.
Phillips BT, Shikora SA. The history of metabolic and bariatric surgery: Development of standards for patient safety and efficacy. Metabolism 2018 Feb;79:97–107. doi:10.1016/j.metabol.2017.12.010.
https://asmbs.org/resources/estimateof-bariatric-surgery-numbers.
Mahawar KK, Omar I, Singhal R, et al. The first modified Delphi consensus statement on sleeve gastrectomy. Surg Endosc. 2021 Dec;35(12):7027–7033. doi: 10.1007/s00464-020-08216-w.
Hutch ChR, Sandoval D. The role of GLP-1 in the metabolic success of bariatric surgery. Endocrinology 2017 Dec 1;158(12):4139–4151. doi:10.1210/en. 2017-00564.
Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5(4): 469–475. doi:10.1016/j.soard.2009.05.011.
Gill RS, Birch DW, Shi X, et al. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis. 2010;6(6):707–713. doi:10.1016/j. soard.2010.07.011.
Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes – 5-year outcomes. N Engl J Med. 2017 Feb 16;376(7):641–651. doi:10.1056/NEJ-Moa 1600869.
Wang GF, Yan YX, Xu N, et al. Predictive factors of type 2 diabetes mellitus remission following bariatric surgery: a meta-analysis. Obes Surg. 2015;25(2):199–208. doi:10.1007/s11695-014-1391-y.
Li F, Sheng Ch, Song K, et al. Preventative sleeve gastrectomy contributes to maintaining β cell function in db/db diabetic mouse. Obes Surg. 2016;26:2402−2410. doi:10.1007/s11695-016-2112-5.
Franken RJ, Sluiter NR, Franken J, et al. Treatment options for weight regain or insufficient weight loss after sleeve gastrectomy: a systematic review and meta-analysis. Obes Surg. 2022 Jun;32(6):2035–2046. doi:10.1007/ s11695-022-06020-0.
Emile SH, Mahdy T, Schou C, et al. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg. 2021 Aug;92:106024. doi:10.1016/j. ijsu.2021.106024.
Salama AF, Baazaoui J, Shahid F, et al. Comparative analysis of 5-year efficacy and outcomes of single anastomosis procedures as revisional surgery for weight regain following sleeve gastrectomy. Surg Endosc. 2023 Jul 11. doi:10.1007/ s00464-023-10234-3.
Sucandy I, Chrestiana D, Bonanni F, et al. Gastroesophageal reflux symptoms after laparoscopic sleeve gastrectomy for morbid obesity. The importance of preoperative evaluation and selection. N Am J Med Sci. 2015 May;7(5):189–193. doi:10.4103/1947-2714.157624.

prof. MUDr. Mojmír Kasalický, CSc.
Chirurgická klinika 2. LF UK Praha a ÚVN Praha
U Vojenské nemocnice 1200
169 02 Praha 6
e-mail: mojmir.kasalicky@uvn.cz
ORCID: 0000-0002-1940-0253

Labels

Surgery Orthopaedics Trauma surgery

Bariatrics

Single anastomosis sleeve ileal bypass a single anastomosis sleeve jejunal bypass in the surgical treatment of severe obesity

Gastric bypass − 10 years’ results

Successful treatment of gastrosplenic fistula after sleeve gastrectomy

From adjustable gastric banding to Roux-en-Y gastric bypass – case report

Article was published in

Perspectives in Surgery

2024 Issue 1