One of the biggest question marks about the sleeve gastrectomy operation has been the lack of long term follow-up data.
Many patients have expressed concerned about having this irreversible procedure without any data showing results over 5 years down the track. Compare several studies have now been published looking at 10 year results after sleeve gastrectomy.
At the 2017 national meeting of the ANZMOSS in Adelaide Mr Clough presented some of the latest data regarding long term outcomes up to ten years after sleeve gastrectomy.
Some of the key findings presented were as follows:
1. Sleeve gastrectomy on average may allow a patient to achieve 60% loss of their excess weight. As an example, a 120kg individual of average height might lose 30kg in the long term. Typically a sleeve patient's best weight loss is at the 12-24 month mark post op and most will slowly regain a little weight over the years following.
2. To achieve a long term weight loss average of around 60% excess weight loss, around one fifth of sleeve patients may need a revisional procedure (such as gastric bypass or duodenal switch) along the way
3. At least 5% of patients may need conversion to gastric bypass to treat severe reflux symptoms after sleeve.
4. Many patients (up to 15%?) may develop Barrett's oesophagus after sleeve gastrectomy over many years. Barrett's is a condition where the lining of the lower oesophagus changes to adapt to an environment where acid or bile reflux is occurring. Barrett's is a known potential pre-cancerous condition, although actually cancer development is quite uncommon. It may be necessary for sleeve patients to undergo periodic gastroscopy to monitor this potential condition.
A summary Flowchart of the long term sleeve gastrectomy experience may look something like this:
NB: “Failure” of the operation for the purposes of this chart is defined by not achieving sustained Excess Weight Loss of at least 50% from baseline.