Quality of long-term follow up and results of sleeve gastrectomy: 5-year prospective observational cohort study. 114 cases

Abstract

Introduction Sleeve gastrectomy (SG) is the most used procedure worldwide for the treatment of morbid obesity. Despite sustained weight loss and improvement of comorbidities in most patients, it can also be associated with late complications and weight regain. International guidelines therefore recommend multidisciplinary long-term follow-up. The aim of this study was to examine the quality of 5-year follow-up and weight loss of patients who underwent SG in our center in 2013. Patients and methods A total of 111 patients were analyzed in this study. Follow-up was considered consistent when the patient complied with the procedures of our bariatric center, and with international and national guidelines, and attended at least one biologic assessment and follow-up clinic every year in the postoperative period. Follow-up was considered intermediate if there was a proof of regular follow-up by a general practitioner (GP). Follow-up was otherwise considered inconsistent. Results Forty-two of the 111 patients (39%) had regular follow-up by the bariatric center and 37 (33%) by their GP. No follow-up could be traced for 32 (29%) patients. Mean (±SD) difference between body mass index (BMI) at the time of surgery and at 5-year follow-up was 12.6 ± 6.0 kg/m² for patients who were followed in the bariatric center vs. 11.8 ± 5.1 kg/m² for those followed by their GP (p=0.38). Mean Total Weigh Lost % (%TWL) was 29.9 ± 11.1% for the first group and 29.1 ± 14.2% for the second group (p = 0.4). Conclusion The rate of patients lost to follow-up is concerning. However, those patients who attended regular follow-up visits had a real long-term benefit of SG and follow-up by a GP only seemed to be effective.