| Abstract [eng] |
Background Laparoscopic sleeve gastrectomy (LSG) has become one of the most performed bariatric/obesity operations. Short and mid-term outcomes display remarkable weight loss and comorbidity improvement, but, long term outcomes of LSG need more evidence, safety and effectiveness. Concerns such as weight regain, gastroesophageal reflux disease (GERD), and nutritional deficiencies highlight the need for a critical evaluation of its durability. Objective This study aims to assess the long-term effectiveness of LSG in weight loss, quality of life, and complication rates over a 10-year period. This also includes comparing LSG to other bariatric procedures, particularly laparoscopic Roux-en-Y gastric bypass (LRYGB), as well as conservative treatments, therefore providing evidence based suggestions for clinical practice. Methods A systematic literature review was conducted using Medline (PubMed) to identify human studies published between August 2014 and August 2024. The search was conducted on August 01, 2024, using the search terms (long-term results of sleeve gastrectomy for obesity) AND (10 years[title]) and only studies with “10 years” in the title. After excluding studies that did not compare sleeve gastrectomy with no treatment, other forms of obesity treatment, or other bariatric surgery methods, eight studies met the criteria and were included into the literature selection. Results LSG demonstrated moderate long-term effectiveness in sustained weight loss and quality of life improvements. Concerns were raised part because of high rates of GERD, re-operation and slow, steady weight gain. Compared to LRYGB, LSG often yielded inferior outcomes in patients with severe obesity, treatment-resistant type 2 diabetes, and pre-existing GERD. A notable lack of long-term follow-up data was attributed to limited physician compensation and patient noncompliance. Conclusion Although LSG can provide lasting benefits for selected patients, it should not be considered the default surgical option for all cases of obesity. Its long-term success depends on patient selection, comprehensive education about postoperative expectations, and sustained lifestyle changes. LRYGB may be a more appropriate option for patients with specific risk profiles. Healthcare system incentives should be in place that encourage long-term follow up and multi-disciplinary support to achieve best possible outcomes. |
