Initial experience in laparoscopic sleeve gastrectomy for Japanese morbid obesity

Introduction: We evaluated the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in Japanese patients with morbid obesity. Materials and Methods: Between June 2006 and March 2009, seven morbidly obese Japanese patients (four women, three men; mean age 36 +/- 12 years; mean body mass index (BMI) 51 +/- 3 kg/m(2)) underwent LSG at our institute. The inclusion criteria were morbid obesity (BMI435 kg/m(2)), the presence of obesity-related disorders, and failure to lose weight while using other medical therapies for at least 6 months. The criteria also included contraindications for laparoscopic adjustable gastric banding or super-obesity (BMI450 kg/m(2)). LSG was carried out using endoscopic linear staplers from the greater curvature of the antrum 6-7cm proximal to the pyloric ring to the angle of His alongside a 32-Fr endoscope or a 45-Fr overtube of the endoscope. Results: In all of the patients, LSG was successfully performed without open conversion. There were no serious postoperative complications and there was no mortality. The mean weight loss and percent excess weight loss after LSG were 33 +/- 8 kg and 47 +/- 16% at 6 months, and then 44 +/- 16 kg and 63 +/- 30% at 12 months. Due to the weight loss, the resolution and improvement rates of comorbidities in the five patients followed up for 43 months were 100% and 100% in type 2 diabetes, 67% and 100% in hypertension, 60% and 100% in dyslipidemia, and 100% and 100% in metabolic syndrome. Discussion: Although further long-term studies are necessary with regard to weight maintenance, LSG is a feasible and safe treatment for Japanese patients with morbid obesity.