Review articleSystematic review of sleeve gastrectomy as staging and primary bariatric procedure
Section snippets
Methods
The present review was conducted according to published recommendations, and the reports were selected using 2 levels of study screening [1]. PubMed was searched for citations that included SG using the keywords “bariatric surgery,” “sleeve gastrectomy,” “vertical gastrectomy,” and “Magenstrasse and Mill.” English language citations for human studies reported from 1996 to January 31, 2009 were included in the search. After an initial review of titles and abstracts, a review of 103 reports was
Data retrieval
Fig. 1 shows the flow process for study selection. After the initial screening of titles and abstracts, 2968 citations were excluded, and 130 studies were reviewed to determine whether they the met inclusion criteria. Of the 130 studies, 92 were excluded during this phase of the review. Of the 92 excluded studies, 13 were kin studies, substudies of larger series, or duplicate patient groups from the same institution or group. After removing the Magenstrasse and Mill citations, 36 SG studies,
Discussion
SG has increasingly gained acceptance among bariatric surgeons during the past 5 years. The initial reports of SG included high-risk patients who underwent laparoscopic SG (LSG) as a staged approach to bariatric surgery. Of the 36 published series included in the present analysis, 13 included patients who were considered by the investigators to be at high risk or who underwent LSG as a planned staged procedure before Roux-en-Y gastric bypass (RYGB) or biliopancreatic diversion/duodenal switch.
Conclusion
From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis, and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reduction that exceeds, or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been
Disclosures
Dr. Brethauer receives educational and research support from Ethicon, and teaching honoraria from Covidien. Dr. Schauer receives educational and research support, and teaching and consulting honoraria from Ethicon and Covidien. Dr. Hammel claims no commercial associations that might be a conflict of interest in relation to this article.
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