10 years of sleeve gastrectomy in the Czech Republic in terms of the surgical procedure

Czech version

Authors: M. Kasalický ^1,2; A. Bařinka ³; M. Čierny ⁴; M. Fried ⁵; A. Gryga ⁶; P. Holéczy ⁷; M. Hrubý K. ⁸; Malčánková ⁹; D. Michalský ¹⁰; V. Procházka ¹¹; I. Satinský ¹²; I. Šimonik ¹³; M. Vraný ¹⁴; P. Zonča ¹⁵
Authors‘ workplace: primář: MUDr. B. Firla ; Chirurgická klinika 2. LF Univerzity Karlovy a ÚVN, Praha přednosta: prof. MUDr. M. Ryska, CSc ¹; FZaSP v Trnave dekan: Prof. MUDr. J. Slaný, CSc. ²; Chirurgické oddělení Nemocnice Vlašské Meziříčí primář: MUDr. A. Beránek ³; Chirurgické oddělení Nemocnice Břeclav primář: MUDr. M. Kříž ⁴; OB Klinika, Praha přednosta: prof. MUDr. M. Fried, CSc. ⁵; Chirurgické oddělení Nemocnice Prostějov primář: MUDr. A. Gryga, CSc. ⁶; Chirurgické oddělení Vítkovická nemocnice primář: MUDr. M. Mazur, PhD, MBA ⁷; Chirurgické oddělení Panochova nemocnice, Turnov primář: MUDr. J. Hain ⁸; CPLO Iscare, Praha primář: MUDr. P. Beňo, CSc. ⁹; 1. Chirurgická klinika 1. LF Univerzity Karlovy a VFN, Praha přednosta: prof. MUDr. Z. Krška, DrSc. ¹⁰; Chirurgická klinika LF Masarykovy univerzity FN Brno Bohunice přednosta: prof. MUDr. Z. Kala, CSc. ¹¹; Chirurgické oddělení Nemocnice s pol. Havířov ¹²; Nemocnice Sv. Zdislavy, Mostiště primář: MUDr. J. Tvarůžek ¹³; Chirurgické oddělení Nemocnice Jablonec n. N. primář: MUDr. M. Vraný ¹⁴; Chirurgická klinika FN Ostrava přednosta: doc. MUDr. P. Zonča, PhD. ¹⁵
Published in: Rozhl. Chir., 2016, roč. 95, č. 12, s. 425-431.
Category: Review

Overview

Introduction:
Sleeve gastrectomy (SG) as a single bariatric/metabolic procedure has been performed since 2003 in the world, and since 2006 in the Czech Republic. We report 10 years’ experience with SG in the Czech Republic from 2006 to 2015.

Method:
Prospectively collected data from 14 surgical departments was evaluated retrospectively using descriptive statistics for every year from 2006 to 2015 and subsequently evaluated and compared for the entire period. The number of the patients, mean age, mean weight and BMI at the time of surgery, the number of patients with T2DM after SG, mean follow-up, mean %BMIL (% Body Mass Index Loss), distance of the starting point of the resection line from the pylorus, the size of the calibration bougie, the rate of complications, and the number and type of conversion procedures were evaluated.

Results:
4134 sleeve gastrectomies were done in the Czech Republic from 2006 to 2015 with the mean follow-up of 32.9 months (range 21−45 months) from the procedure. The mean weight at the time of surgery fluctuated between 114.2 kg and 128.9 kg; mean BMI fluctuated between 42.3 and 46.7. Mean %BMIL was 63.2% for the entire evaluated period. The distance of the starting point of the resection line from the pylorus changed from the mean 6.1 cm (range 6−7 cm) to mean 4.2 cm (range 3−6 cm) and the size of the calibration bougie changed from the mean 39.2 F (range 36−42 F) to mean 37.1 F (range 35−42 F). As regards early postoperative complications, bleeding from the resection line occurred in 1.4% and a leak from the staple line occurred in 1.1%. The gastroesophageal reflux disease and hiatal hernia occurred in 17.3% as the most frequent late complications. Conversion to another bariatric procedure was approached in 3.8% in the event of an unsatisfactory effect of the SG.

Conclusion:
Bariatric or metabolic surgery, respectively, is a safe and effective surgical method for the treatment of severe obesity and T2DM in morbidly obese patients. Currently, SG is the most widely used bariatric/metabolic procedure in the Czech Republic as well as in most other countries and the long-time results are similar in comparison with other authors.

Key words:
bariatric surgery – sleeve gastrectomy – resection line – complications

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Article was published in

Perspectives in Surgery

2016 Issue 12