Obes Surg. 2025 Dec 18. doi: 10.1007/s11695-025-08428-w. Online ahead of print.
ABSTRACT
BACKGROUND: Sleeve gastrectomy (SG) is the most commonly performed metabolic and bariatric surgery, yet literature on long-term outcomes, including weight loss durability and safety, remains limited.
METHODS: This retrospective cohort study examined patients from 3 bariatric centers of excellence undergoing SG from 2010 to 2014 to allow for 10 years of follow-up period. Baseline characteristics, annual weight and body mass index (BMI), obesity-related medical conditions resolution and recurrence, and complications were documented. Statistical methods included paired t-test, Kaplan-Meier curve, and multivariate regression.
RESULTS: A total of 830 patients (73.3% female, mean age 45.6 ± 11.6, mean preoperative BMI 45.6 ± 7.8 kg/m2 ) were included, with a median follow-up period of 9.8 years. Patients achieved a maximum percentage total weight loss (%TWL) of 29.0 ± 9.7 at 24 months postoperatively (p < 0.001). Resolution rates for type 2 diabetes (T2DM), hypertension (HTN), hyperlipidemia (HLD), and obstructive sleep apnea (OSA) were 58.7%, 45.0%, 41.4%, and 65.8%, respectively, with recurrence rates of 5.4%, 10.4%, 6.9%, and 1.4%. Suboptimal clinical response (< 20% TWL) occurred in 15.8% of patients. 63.9% and 57.5% of the cohort experienced recurrent weight gain of > 10% and > 20% from postoperative nadir weight; T2DM (p = 0.02) and adherence to follow-up (≥ 5 postoperative visits) (p < 0.001) were significantly associated with weight gain of > 20%. Complications occurred in 10.0% (early) and 19.8% (late) of patients. 10.1% of the cohort required revisional surgery by the end of the study period.
CONCLUSION: Overall, SG demonstrates relatively favorable long-term outcomes, but the notable rates of recurrent weight gain raise concern regarding its durability.
KEY POINTS: Sleeve gastrectomy resulted in significant weight loss, with a peak at 24 months. 57.5-63.9% of the cohort had recurrent weight gain; 10.1% required revision surgery. SG counseling must include long-term outcomes and potential need for revision.
PMID:41410827 | DOI:10.1007/s11695-025-08428-w
