Obesity Surgery

, Volume 29, Issue 1, pp 191–196 | Cite as

Seven-Year Outcomes of Laproscopic Sleeve Gastectomy in Indian Patients with Different Classes of Obesity

  • Mohamed IsmailEmail author
  • Dileep Nagaraj
  • Mahesh Rajagopal
  • Hafiz Ansari
  • Megha Nair
  • Aparna Hegde
  • P. D. RekhaEmail author
Original Contributions



The aim of the study was to assess the long-term outcome in terms of weight loss and remission of comorbidities among the patients who had undergone LSG in an Indian setting.


This is a retrospective observational study of patients (BMI > 30 kg/m2) who underwent LSG having a minimum 6 months of follow-up data. Based on preoperative BMI, patients were grouped as class 1, 30 < BMI < 35 kg/m2; class 2, 35 < BMI < 40 kg/m2; and class 3, BMI > 40 kg/m2. Data on BMI and %EWL between three classes and among genders at different follow-up points for 7 years were compared.


Study included 95 patients (mean age of 33.7 ± 11 years), and the preoperative mean BMI was 40.2 ± 5.1 kg/m2. At one year of surgery, 85.5% patients achieved > 50%EWL. The highest mean %EWL was found in class 1 (66.19%), followed by class 2 (56.73%) and class 3 (46.59%) at the sixth month follow-up. At the seventh year, %EWLs were 85.11% (class 1), 76.69% (class 2), and 62.98% (class 3) and the mean BMIs were 25.13 ± 3.09 kg/m2 (class 1), 26.86 ± 2.12 kg/m2 (class 2), and 31.07 ± 3.39 kg/m2 (class 3) and were significantly different (p < 0.05). At the last follow-up, though, the males showed slight weight regain; however, there were no statistical differences between the genders (p = 0.065).


Outcome from LSG was better in patients with BMI < 40 kg/m2 compared to the patients with BMI > 40 kg/m2. Remission of obesity-related comorbidities was observed with LSG in all groups and gender did not influence the outcome significantly.


Obesity Sleeve gastrectomy Diabetes BMI Bariatric surgery 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Human and Animal Rights

This study was performed in accordance with the principles of Declaration of Helsinki and was approved by the institutional ethical committee.


  1. 1.
    Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefGoogle Scholar
  2. 2.
    Feng JJ, Gagner M. Laparoscopic biliopancreatic diversion with duodenal switch. Semin Laparosc Surg. 2002;9:125–9.CrossRefGoogle Scholar
  3. 3.
    Ejaz A, Patel P, Gonzalez-Heredia R, et al. Laparoscopic sleeve gastrectomy as first-line surgical treatment for morbid obesity among adolescents. J Ped Surg. 2017;52(4):544–8.CrossRefGoogle Scholar
  4. 4.
    Deitel M, Gagner M, Erickson AL, et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749–59.CrossRefGoogle Scholar
  5. 5.
    Sánchez-Santos R, Masdevall C, Baltasar A, et al. Short- and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg. 2009;19:1203–10.CrossRefGoogle Scholar
  6. 6.
    Rosenthal RJ, Diaz AA, Arvidsson D, et al. International Sleeve Gastrectomy Expert Panel Consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8:8–19.CrossRefGoogle Scholar
  7. 7.
    Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg. 2010;20:447–53.CrossRefGoogle Scholar
  8. 8.
    Gagner M, Buchwald JN. Comparison of laparoscopic sleeve gastrectomy leak rates in four staple-line reinforcement options: a systematic review. Surg Obes Relat Dis. 2014;10:713–23.CrossRefGoogle Scholar
  9. 9.
    Li JF, Lai DD, Lin ZH, et al. Comparison of the long-term results of Roux-en-Y gastric bypass and sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis of randomized and nonrandomized trials. Surg Laparosc Endosc Percutan Tech. 2014;24:1–11.CrossRefGoogle Scholar
  10. 10.
    Peterli R, Borbély Y, Kern B, et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258:690–4.CrossRefGoogle Scholar
  11. 11.
    Jiménez A, Casamitjana R, Flores L, et al. Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256:1023–19.CrossRefGoogle Scholar
  12. 12.
    Hoyuela C. Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: a prospective study. World J Gastrointest Surg. 2017;9(4):109–17.CrossRefGoogle Scholar
  13. 13.
    Agrawal P, Voller L, Wulfovich S, et al. Are there gender disparities in cardiac outcomes following bariatric surgery? Surg Obes Relat Dis. 2016;12(7 suppl):S29.CrossRefGoogle Scholar
  14. 14.
    Blum A, Tamir S, Hazzen D, et al. Gender effect on vascular responsiveness after bariatric surgery. Cent Eur J Med. 2013;8(5):531–8.Google Scholar
  15. 15.
    Park JY, Kim YJ. Laparoscopic sleeve gastrectomy in obese Korean patients: up to 4-year follow-up in a single center. Ann Surg Treat Res Online. 2015;88(5):246–52.CrossRefGoogle Scholar
  16. 16.
    Chou JJ, Lee WJ, Almalki O, et al. Dietary intake and weight changes 5 years after laparoscopic sleeve gastrectomy. Obes Surg. 2017;27(12):3240–6.CrossRefGoogle Scholar
  17. 17.
    Garg H, Aggarwal S, Misra MC, et al. Mid to long term outcomes of laparoscopic sleeve gastrectomy in Indian population: 3–7 year results—a retrospective cohort study. Int J Surg. 2017;48:201–9.CrossRefGoogle Scholar
  18. 18.
    Melissas J, Braghetto I, Molina JC, et al. Gastroesophageal reflux disease and sleeve gastrectomy. Obes Surg. 2015;25(12):2430–5.CrossRefGoogle Scholar
  19. 19.
    Dakour Aridi H, Asali M, Fouani T, et al. Gastroesophageal reflux disease after laparoscopic sleeve gastrectomy with concomitant hiatal hernia repair: an unresolved question. Obes Surg. 2017;27(11):2898–904.CrossRefGoogle Scholar
  20. 20.
    Noel P, Nedelcu M, Edbali I, et al. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis. 2017;13(7):1110–5.CrossRefGoogle Scholar
  21. 21.
    Nedelcu M, Loureiro M, Skalli M, et al. Laparoscopic sleeve gasterctomy: effect on long term remission for morbidly obese patients with type 2 diabetes at 5-year follow up. Surgery. 2017;162(4):857–62.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General, Laparoscopic and Bariatric SurgeryMoulana HospitalPerinthalmannaIndia
  2. 2.Yenepoya Research CentreYenepoya UniversityMangaloreIndia

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