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Results of Sleeve Gastrectomy in Germany—Data on Nationwide Survey on Quality Assurance in Bariatric Surgery in Germany

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DOI: 10.4236/ss.2012.34033    3,792 Downloads   6,507 Views   Citations

ABSTRACT

Background: Since January 1st of 2005, the situation of bariatric surgery is being analyzed in Germany. The data is registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. Methods: The data is registered through an online database which includes all information for primary and revision bariatric procedures as well as yearly follow-up. Participation in the quality assurance study is optional. All certificated centers have to participate at the survey. Results: From January 2006 to December 2009, 1478 sleeve gastrectomies (SG) were performed at 45 hospitals. The number of procedures has increased from 126 in 2007 to 933 in 2009. The main complication is leakage of the staple-line. Initial leakage rate was 7% in 2007. Leakage rate dropped down to 2.3% in 2008 and 2.5% in 2009. Mean age of patients was 43.1 years and mean BMI was 52.83 kg/m2. Age and BMI were significantly higher in patients with SG than in all other patients undergoing bariatric surgery. Conclusion: SG is a common and hype bariatric procedure in Germany, but postoperative complication rate is high. Data on the long-term effect of SG on weight loss and amelioration of comorbidities need to be evaluated. More detailed analyzes are necessary to establish the position of SG in the bariatric surgery. Further studies should also include examinations on long-term complications and redo-procedure after SG.

Conflicts of Interest

The authors declare no conflicts of interest.

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C. Stroh, R. Weiner, T. Horbach, K. Ludwig, M. Dressler, S. Wolff, H. Lippert, M. Büsing, U. Schmidt and T. Manger, "Results of Sleeve Gastrectomy in Germany—Data on Nationwide Survey on Quality Assurance in Bariatric Surgery in Germany," Surgical Science, Vol. 3 No. 4, 2012, pp. 169-176. doi: 10.4236/ss.2012.34033.

References

[1] Statistisches-Bundesamt. Mikrozensus. 2009 Wiesbaden: Statistisches Bundesamt. Federal Statistical Office. 2010 Microcensus. 2009 Wiesbaden: Federal Statistical Office.
[2] K. R. Fontaine, D. T. Redden, C. Wang, A. O. Westfall and D. B. Allison, “Years of Life Lost Due to Obesity,” The Journal of the America Medical Association (JAMA), Vol. 289, No. 2, 2003, pp. 187-193. doi:10.1001/jama.289.2.187
[3] L. Sj?str?m, K. Narbro, C. D. Sj?str?m, K. Karason, B. Larsson, H. Wedel, T. Lystig, M. Sullivan, C. Bouchard, B. Bengtsson, S. Dahlgren, A. Gummesson, P. Jacobsen, J. Karlsson, A. K. Lindross, H. L?nroth, I. Naslund, T. Olbers, K. Stenlof, J. Torgerson, J. Agren and L. Carlsson, “Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects,” The New England Journal of Medicine, Vol. 357, No. 8, 2007, pp. 741-752. doi:10.1056/NEJMoa066254
[4] C. Stroh, D. Birk, R. Flade-Kuthe, M. Frenken, B. Herbig, S. H?hne, H. K?hler, K. Ludwig, P. Pick, Th. Horbach, S. Krause, L. Sch?fer, R. Weiner, S. Wolff, A. M. Wolf, U. Schmidt and Th. Manger, “Arbeitsgruppe Adipositaschirurgie. Quality Assurance in Bariatric Surgery in Germany—Results of the German Multicentre Trial 2005 and 2006,” Zentralblatt fur Chirurgie, Vol. 133, No. 5, 2008, pp. 473-478. doi:10.1055/s-2008-1077002
[5] M. Fried, V. Hainer, A. Basdevant, H. Buchwald, M. Deitel, N. Finer, J. W. Greve, F. Horber, E. Mathus-Vliegen, N. Scopinaro, R. Steffen, C. Tsigos, R. Weiner, K. Widhalm and Bariatric Scientific Collaborative Group Expert Panel, “Interdisciplinary European Guidelines for Surgery for Severe (Morbid) Obesity,” Obesity Surgery, Vol. 17, Vol. 2, 2007, pp. 260-270. doi:10.1007/s11695-007-9025-2
[6] E. J. DeMaria, V. Pate, M. Warthen, et al., “Baseline Data from American Society for Metabolic and Bariatric Surgery-Designated Bariatric Surgery Centers of Excellence Using the Bariatric Outcomes Longitudinal Database,” Surgery for Obesity and Related Diseases, Vol. 6, No. 4, 2011, pp. 347-355.
[7] M. Deitel, M. Gagner, A. L. Erickson and R. D. Crosby, “Third International Summit: Current Status of Sleeve Gastrectomy,” Surgery for Obesity and Related Diseases, Vol. 7, No. 6, 2011, pp. 749-759.
[8] C. Serra, A. Baltasar, N. Pérez, R. Bou and M. Bengochea, “Total Gastrectomy for Complications of the Duodenal Switch, with Reversal,” Obesity Surgery, Vol. 16, No. 8, 2006, pp. 1082-1086. doi:10.1381/096089206778026271
[9] C. Serra, A. Baltasar, L. Andreo, N. Pérez, R. Bou, M. Bengochea and J. J. Chisbert, “Treatment of Gastric Leaks with Coated Self-Expanding Stents after Sleeve Gastrectomy,” Obesity Surgery, Vol. 17, No. 7, 2007, pp. 866-872. doi:10.1007/s11695-007-9161-8
[10] S. Agarwal, S. U. Kini and D. M. Herron, “Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Review,” Surgery for Obesity and Related Diseases, Vol. 3, No. 2, 2007, pp. 189-194. doi:10.1016/j.soard.2006.10.013
[11] P. F. Lalor, O. N. Tucker, S. Szomstein and R. J. Rosenthal, “Complications after Laparoscopic Sleeve Gastrectomy,” Surgery for Obesity and Related Diseases, Vol. 4, No. 1, 2007, pp. 33-38.
[12] Clinical Issues Committee of American Society for Metabolic and Bariatric Surgery, “Sleeve Gastrectomy as a Bariatric Procedure,” Surgery for Obesity and Related Diseases, Vol. 3, No. 6, 2007, pp. 573-576.
[13] A. Assalia, K. Ueda, R. Matteotti, F. Cuenca-Abente, T. Rogula and M. Gagner, “Staple-Line Reinforcement with Bovine Pericardium in Laparoscopic Sleeve Gastrectomy: Experimental Comparative Study in Pigs,” Obesity Surgery, Vol. 17, No. 2, 2007, pp. 222-228.
[14] E. C. Consten, M. Gagner, A. Pomp and W. B. Inabnet, “Decreased Bleeding after Laparoscopic Sleeve Gastrectomy with or without Duodenal Switch for Morbid Obesity Using a Stapled Buttressed Absorbable Polymer Membrane,” Obesity Surgery, Vol. 14, No. 10, 2004, pp. 1360-1366. doi:10.1381/0960892042583905
[15] K. M. Stamou, E. Menenakos, D. Dardamanis, C. Arabatzi, L. Alevizos, K. Albanopoulos, E. Leandros and G. Zografos, “Prospective Comparative Study of the Efficacy of Staple-Line Reinforcement in Laparoscopic Sleeve Gastrectomy,” Surgical Endoscopy, Vol. 25, No. 11, 2011, pp. 3526-3520.
[16] A. Baltasar, C. Serra, N. Pérez, R. Bou, M. Bengochea and L. Ferri, “Laparoscopic Sleeve Gastrectomy: A Multi-Purpose Bariatric Operation,” Obesity Surgery, Vol. 15, No. 8, 2005, pp. 1124-1128. doi:10.1381/0960892055002248
[17] D. Bellanger and F. L. Greenway, “Laparoscopic Sleeve Gastrectomy, 529 Cases without Leak: Short-Term Results and Technical Considerations,” Obesity Surgery, Vol. 21, No. 2, 2011, pp. 146-150. doi:10.1007/s11695-010-0320-y
[18] S. A. Brethauer, J. P. Hammel and P. R. Schauer, “Systematic Review of Sleeve Gastrectomy as Staging and Primary Bariatric Procedure,” Surgery for Obesity and Related Diseases, Vol. 5, No. 4, 2009, pp. 469-475.
[19] R. A. Weiner, S. Weiner, I. Pomhoff, C. Jacobi, W. Makarewicz and G. Weigand, “Laparoscopic Sleeve Gastrectomy—Influence of Sleeve Size and Resected Gastric Volume,” Obesity Surgery, Vol. 17, No. 10, 2007, pp. 1297-1305. doi:10.1007/s11695-007-9232-x
[20] M. Gagner and C. Boza, “Laparoscopic Duodenal Switch for Morbid Obesity,” Expert Review of Medical Devices, Vol. 3, No. 1, 2006, pp. 105-112. doi:10.1586/17434440.3.1.105
[21] E. E. Frezza, “Laparoscopic Vertical Sleeve Gastrectomy for Morbid Obesity. The Future Procedure of Choice?” Surgery Today, Vol. 37, No. 4, 2007, pp. 275-281. doi:10.1007/s00595-006-3407-2
[22] C. Stroh, D. Birk, R. Flade-Kuthe, M. Frenken, B. Herbig, S. H?hne, H. K?hler, V. Lange, K. Ludwig, R. Matkowitz, G. Meyer, F. Meyer, P. Pick, T. Horbach, S. Krause, L. Sch?fer, M. Schlensak, E. Shang, T. Sonnenberg, M. Susewind, H. Voigt, R. Weiner, S. Wolff, H. Lippert, A. M. Wolf, U. Schmidt, T. Manger and Bariatric Surgery Working Group, “A Nationwide Survey on Bariatric Surgery in Germany-Results 2005-2007,” Obesity Surgery, Vol. 19, No. 1, 2009, pp. 105-112. doi:10.1007/s11695-008-9736-z
[23] J. Himpens, G. Dapri and G. B. Cadière, “A Prospective Randomized Study between Laparoscopic Gastric Banding and Laparoscopic Isolated Sleeve Gastrectomy: Results after 1 and 3 Years,” Obesity Surgery, Vol. 16, No. 11, 2006, pp. 1450-1456. doi:10.1381/096089206778869933
[24] J. Himpens, J. Dobbeleir and G. Peeters, “Long-Term Results of Laparoscopic Sleeve Gastrectomy for Obesity,” Annals of Surgery, Vol. 252, No. 2, 2010, pp. 319-314. doi:10.1097/SLA.0b013e3181e90b31
[25] J. P. Regan, W. B. Inabnet, M. Gagner and A. Pomp, “Early Experience with Two-Stage Laparoscopic Rouxen-Y Gastric Bypass as an Alternative in the Super-Super Obese Patient,” Obesity Surgery, Vol. 13, No. 6, 2003, pp. 861-864. doi:10.1381/096089203322618669
[26] G. Almogy, P. F. Crookes and G. J. Anthone, “Longitudinal Gastrectomy as a Treatment for the High-Risk Super-Obese Patient,” Obesity Surgery, Vol. 14, No. 4, 2004, pp. 492-497. doi:10.1381/096089204323013479
[27] F. B. Langer, M. A. Reza-Hoda, A. Bohdjalian, F. X. Felberbauer, J. Zacherl, E. Wenzl, K. Schindler, A. Luger, B. Ludvik and G. Prager, “Sleeve Gastrectomy and Gastric Banding: Effects on Plasma Ghrelin Levels,” Obesity Surgery, Vol. 15, No. 7, 2005, pp. 1024-1029. doi:10.1381/0960892054621125
[28] L. Milone, V. Strong and M. Gagner, “Laparoscopic Sleeve Gastrectomy Is Superior to Endoscopic Intragastric Balloon as a First Stage Procedure for Super-Obese Patients (BMI > or = 50),” Obesity Surgery, Vol. 15, No. 5, 2005, pp. 612-617. doi:10.1381/0960892053923833
[29] P. Mognol, D. Chosidow and J. P. Marmuse, “Laparoscopic Sleeve Gastrectomy (LSG): Review of a New Bariatric Procedure and Initial Results,” Surgical Technology International, Vol. 15, 2006, pp. 47-52.
[30] S. Moon-Han, W. W. Kim and J. H. Oh, “Results of Laparoscopic Sleeve Gastrectomy (LSG) at 1 Year in Morbidly Obese Korean Patients,“ Obesity Surgery, Vol. 15, No. 10, 2005, pp. 1469-1475. doi:10.1381/096089205774859227
[31] D. Cottam, F. G. Qureshi, S. G. Mattar, S. Sharma, S. Holover, G. Bonanomi, R. Ramanathan and P. Schauer, “Laparoscopic Sleeve Gastrectomy as an Initial Weight-Loss Procedure for High-Risk Patients with Morbid Obesity,” Surgical Endoscopy, Vol. 20, No. 6, 2006, pp. 859-863. doi:10.1007/s00464-005-0134-5
[32] N. Hamoui, G. J. Anthone, H. S. Kaufman and P. F. Crookes, “Sleeve Gastrectomy in the High-Risk Patient,” Obesity Surgery, Vol. 16, No. 11, 2006, pp. 1445-1449. doi:10.1381/096089206778870157
[33] F. B. Langer, A. Bohdjalian, F. X. Felberbauer, E. Fleischmann, M. A. Reza-Hoda, B. Ludvik, J. Zacherl, R. Jakesz and G. Prager, “Does Gastric Dilatation Limit the Success of Sleeve Gastrectomy as a Sole Operation for Morbid Obesity?” Obesity Surgery, Vol. 16, No. 2, 2006, pp. 166-171. doi:10.1381/096089206775565276
[34] P. E. Roa, O. Kaidar-Person, D. Pinto, M. Cho, S. Szomstein and R. J. Rosenthal, “Laparoscopic Sleeve Gastrectomy as Treatment for Morbid Obesity: Technique and Short-Term Outcome,” Obesity Surgery, Vol. 16, No. 10, 2006, pp. 1323-1326. doi:10.1381/096089206778663869
[35] G. Silecchia, C. Boru, A. Pecchia, M. Rizzello, G. Casella, F. Leonetti and N. Basso, “Effectiveness of Laparoscopic Sleeve Gastrectomy (First Stage of Biliopancreatic Diversion with Duodenal Switch) on Co-Morbidities in Super-Obese High-Risk Patients,” Obesity Surgery, Vol. 16, No. 9, 2006, pp. 1138-1144. doi:10.1381/096089206778392275
[36] I. Braghetto, O. Korn, H. Valladares, L. Gutiérrez, A. Csendes, A. Debandi, J. Castillo, A. Rodríguez, A. M. Burgos and L. Brunet, “Laparoscopic Sleeve Gastrectomy: Surgical Technique, Indications and Clinical Results,” Obesity Surgery, Vol. 17, No. 11, 2007, pp. 1442-1450. doi:10.1007/s11695-008-9421-2
[37] G. Dapri, C. Vaz, G. B. Cadière and J. Himpens, “A Prospective Randomized Study Comparing Two Different Techniques for Laparoscopic Sleeve Gastrectomy,” Obesity Surgery, Vol. 17, No. 11, 2007, pp. 1435-1441. doi:10.1007/s11695-008-9420-3
[38] O. Givon-Madhala, R. Spector, N. Wasserberg, N. Beglaibter, H. Lustigman, M. Stein, N. Arar and M. Rubin, “Technical Aspects of Laparoscopic Sleeve Gastrectomy in 25 Morbidly Obese Patients,” Obesity Surgery, Vol. 17, No. 6, 2007, pp. 722-727. doi:10.1007/s11695-007-9133-z
[39] C. M. Lee, P. T. Cirangle and G. H. Jossart, “Vertical Gastrectomy for Morbid Obesity in 216 Patients: Report of Two-Year Results,” Surgical Endoscopy, Vol. 21, No. 10, 2007, pp. 1810-1816. doi:10.1007/s00464-007-9276-y
[40] J. Melissas, S. Koukouraki, J. Askoxylakis, M. Stathaki, M. Daskalakis, K. Perisinakis and N. Karkavitsas, “Sleeve Gastrectomy: A Restrictive Procedure?” Obesity Surgery, Vol. 17, No. 1, 2007, pp. 57-62. doi:10.1007/s11695-007-9006-5
[41] O. N. Tucker, S. Szomstein and R. J. Rosenthal, “Indications for Sleeve Gastrectomy as a Primary Procedure for Weight Loss in the Morbidly Obese,” Journal of Gastrointestinal Surgery, Vol. 12, No. 4, 2008, pp. 662-667. doi:10.1007/s11605-008-0480-4
[42] M. Parikh, M. Gagner, L. Heacock, G. Strain, G. Dakin and A. Pomp, “Laparoscopic Sleeve Gastrectomy: Does Bougie Size Affect Mean %EWL? Short-Term Outcomes,” Surgery for Obesity and Related Diseases, Vol. 4, No. 4, 2008, pp. 528-533.
[43] F. X. Felberbauer, F. Langer, S. Shakeri-Manesch, E. Schmaldienst, M. Kees, S. Kriwanek, M. Prager and G. Prager, “Laparoscopic Sleeve Gastrectomy as an Isolated Bariatric Procedure: Intermediate-Term Results from a Large Series in Three Austrian Centers,” Obesity Surgery, Vol. 18, No. 7, 2008, pp. 814-818. doi:10.1007/s11695-008-9483-1
[44] M. Rubin, R. T. Yehoshua, M. Stein, D. Lederfein, S. Fichman, H. Bernstine and L. A. Eidelman, “Laparoscopic Sleeve Gastrectomy with Minimal Morbidity. Early Results in 120 Morbidly Obese Patients,” Obesity Surgery, Vol. 18, No. 12, 2008, pp. 1567-1570. doi:10.1007/s11695-008-9652-2
[45] G. Skrekas, D. Lapatsanis, V. Stafyla and A. Papalambros, “One Year after Laparoscopic ‘tight’ Sleeve Gastrectomy: Technique and Outcome,” Obesity Surgery, Vol. 18, No. 7, 2008, pp. 810-813. doi:10.1007/s11695-008-9440-z
[46] W. L. Mui, E. K. Ng, B. Y. Tsung, C. C. Lam and M. Y. Yung, “Laparoscopic Sleeve Gastrectomy in Ethnic Obese Chinese,” Obesity Surgery, Vol. 18, No. 12, 2008, pp. 1571-1574. doi:10.1007/s11695-008-9538-3
[47] M. Gagner, A. A. Gumbs, L. Milone, E. Yung, L. Goldenberg and A. Pomp, “Laparoscopic Sleeve Gastrectomy for the Super-Super-Obese (Body Mass Index >60 kg/m (2)),” Surgery Today, Vol. 38, No. 5, 2008, pp. 399-403. doi:10.1007/s00595-007-3645-y
[48] M. Kasalicky, D. Michalsky, J. Housova, M. Haluzik, D. Housa, D. Haluzikova and M. Fried, “Laparoscopic Sleeve Gastrectomy without an Over-Sewing of the Staple Line,” Obesity Surgery, Vol. 18, No. 10, 2008, pp. 1257-1262. doi:10.1007/s11695-008-9635-3
[49] E. E. Frezza, S. Reddy, L. L. Gee and M. S. Wachtel, “Complications after Sleeve Gastrectomy for Morbid Obesity,” Obesity Surgery, Vol. 19, No. 6, 2009, pp. 684-687. doi:10.1007/s11695-008-9677-6
[50] B. Uglioni, B. W?lnerhanssen and T. Peters, C. Christoffel-Courtin, B. Kern and R. Peterli, “Midterm Results of Primary vs Secondary Laparoscopic Sleeve Gastrectomy (LSG) as an Isolated Operation,” Obesity Surgery, Vol. 19, No. 4, 2009, pp. 401-406. doi:10.1007/s11695-009-9804-z
[51] D. Fuks, P. Verhaeghe, O. Brehant, C. Sabbagh, F. Dumont, M. Riboulot, R. Delcenserie and J. M. Regimbeau, “Results of Laparoscopic Sleeve Gastrectomy: A Prospective Study in 135 Patients with Morbid Obesity,” Surgery, Vol. 145, No. 1, 2009, pp. 106-113. doi:10.1016/j.surg.2008.07.013

  
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