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Laparoscopic Sleeve Gastrectomy: Comorbidity Outcomes

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Obesity, Bariatric and Metabolic Surgery

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Abstract

Obesity is one of the commonest diseases worldwide and tends to increase year by year. Several obesity-related comorbidities are typical conditions of the “metabolic syndrome”: type-2 diabetes mellitus (T2DM), arterial hypertension, hyperlipidemia, obstructive sleep apnea (OSA), nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH), and diseases of bones and joints. Various carcinomas are also associated with obesity. Metabolic surgery, as the most effective therapy for permanent weight loss, has a major part in the improvement and remission of the abovementioned comorbidities. This chapter will discuss the outcomes of comorbidities in short-, mid-, and long-term follow-up periods after sleeve gastrectomy (SG).

The available data regarding T2DM remission after SG seems valid due to a number of existing randomized controlled trails. Overall, the remission rate ranges from 30% to 70% in the existing studies. Also, studies focusing on the remission of arterial hypertension, hyperlipidemia, and OSA after SG report constant results from short-, over mid-, to long-term studies.

SG also helps to rapidly improve NAFLD, NASH, and even fibrosis; however, bariatric surgery (especially strong malabsorptive procedures) in patients with progressed liver disease (e.g., fibrosis) may induce further liver damage with severe liver failure in rare cases. Symptoms related to the bones and joints, such as pain or constrained movement, improve after SG; nevertheless, once damaged, joints cannot regenerate. Some studies have reported that hormone-related cancers as well as some other types of cancer may decrease with SG.

Only a small number of studies are available with a follow-up of >10 years; thus, further results on long-term outcomes must be awaited.

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Authors and Affiliations

  1. Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria

    Daniel Moritz Felsenreich & Gerhard Prager

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  1. Daniel Moritz Felsenreich
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  2. Gerhard Prager
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Correspondence to Gerhard Prager .

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  1. Homerton University Hospital, London, UK

    Sanjay Agrawal

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  1. Department of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    Sandeep Aggarwal MBBS, MS, FACS

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Felsenreich, D.M., Prager, G. (2023). Laparoscopic Sleeve Gastrectomy: Comorbidity Outcomes. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-60596-4_86

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  • DOI: https://doi.org/10.1007/978-3-030-60596-4_86

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