To review metabolic outcomes, rates of de novo GERD, and revisional surgery at 10+ years after LSG, highlighting their clinical significance.
Key Findings:
80% of studies reported a %TWL >20%, with an overall weighted mean TWL of 24.4%. Weighted remission rates for type 2 diabetes and hypertension were 45.6% and 41.4%, respectively. De novo GERD prevalence was 32.3%, with 5 cases of Barrett’s disease reported. 19.2% of patients required revisional surgery, primarily Roux-en-Y gastric bypass, indicating the need for careful patient selection and follow-up.
Interpretation:
LSG shows significant metabolic benefits at 10+ years, but concerns about GERD and revision rates persist, necessitating ongoing monitoring.
Limitations:
Majority of studies were retrospective with varying follow-up durations, and potential biases in study selection may affect outcomes.
Conclusion:
LSG provides substantial long-term weight loss and metabolic improvement, but the risk of GERD and need for revision surgery are notable concerns that warrant attention.
A four-factor staging system stratified response rates from 90.9% to 37.5% in a retrospective cohort study, although the model showed only moderate discrimination (C statistic, 0.68) and requires external validation
