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ANZMOSS - ANZGOSA 2020 Virtual Conference
ANZMOSS – ANZGOSA 2020 Virtual Conference
ANZMOSS - ANZGOSA 2020 Virtual Conference
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Long-term outcomes of sleeve gastrectomy

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Description
BACKGROUND
Primary laparoscopic sleeve gastrectomy (LSG) has emerged as the most commonly performed bariatric operation across the world. The rapid uptake of LSG has preceded complete understanding of the long-term outcomes from this procedure. Initial reports of long-term outcomes have suggested high rates of weight regain, reflux and re-operation. Developments in surgical technique and attention to follow-up may result in improved outcomes, although comprehensive data are lacking. 

OBJECTIVE
To determine both short and long-term outcomes following primary LSG from a single bariatric unit.

METHODS
Analysis of prospectively maintained databases for 2489 patients who underwent primary LSG between 2006 and 2019 by surgeons in our department. Data cross linkages with The National Bariatric Surgery Registry were performed to identify: outcome domains, demographics, complications and follow up.

RESULTS
There were 2489 primary LSG performed. Patients were mostly female (79%), had a mean age of 41  10 and a mean baseline BMI of 45  8 (126 kg  27). Mean length of stay was two nights.

Maximal weight loss was achieved at two year follow up (%TWL 34  14). Long term follow-up (mean 8 years) demonstrated an average %TWL of 29  12.

77 patients (3.1%) experienced a complication, 30 (1.2%) greater than Clavien-Dindo Grade III. 
There were 30 sleeve leaks (1.2%). Other perioperative complications were classified as: bleeding (0.4%), sepsis (0.3%), venous thrombosis (0.4%), wound problems (0.9%), fistula formation (0.2%), other organ system dysfunction (0.8%). Long term reflux and stricture rates were also recorded. There were six deaths (0.2%) during follow-up, but none occurred in the peri-operative period.

18 patients (0.7%) underwent a second bariatric operation, on average 2 years after primary LSG. 

CONCLUSIONS
We have comprehensively analysed outcomes of primary LSG utilising data cross linkage. Our results demonstrate high follow up rates, sustained long term weight loss and a low rate of re-intervention and a low rate of complications. 
Authors
Professor Wendy Brown - Monash University, Department of Surgery, Melbourne, Australia and Oesophagogastric and Bariatric Surgical Unit, Alfred Health, Mr Paul Burton - Monash University, Department of Surgery, Melbourne, Australia and Oesophagogastric and Bariatric Surgical Unit, Alfred Health, Professor Peter Nottle - , Kalai Shaw - Monash University, Department of Surgery, Melbourne, Australia , and Mr. Prem Chana - Oesophagogastric and Bariatric Surgical Unit, Alfred Health, Melbourne, Australia
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