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Padova University Hospital Bariatric Unit

Padova University Hospital Bariatric Unit. SLEEVE OR PLICATION?. Mirto Foletto, M.D. LAPAROSCOPIC GASTRIC PLICATION. OUR DATA Foletto. 2011 Jan- 2012 Sep 50 pts ( 43 F, 7 M) Mean BMI 40.9 ( 33.59-58.03 ) Kg/m 2 Mean age 36 ( 16-72 ) ys. TECHNICAL DATA

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Padova University Hospital Bariatric Unit

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  1. Padova University Hospital Bariatric Unit SLEEVE OR PLICATION? Mirto Foletto, M.D.

  2. LAPAROSCOPIC GASTRIC PLICATION

  3. OUR DATAFoletto 2011 Jan- 2012 Sep 50pts (43 F, 7M) Mean BMI 40.9 (33.59-58.03)Kg/m2 Mean age 36 (16-72)ys TECHNICAL DATA Mean operative time (including endoscopy): 73.3 (60-110)minutes Intraoperative endoscopy in all patients Single running row (Prolene 2.0): 7 Double row: Interrupted (Vicryl 2.0) + Running (Prolene 2.0) : 43 No conversion required Concurrent operations: 1Colecistectomy Mean hospital stay: 3.8days

  4. LAPAROSCOPIC SLEEVE GASTRECTOMY

  5. 2005 Feb - 2012 Jul 333patients (102 M, 231 F) Mean age 47.13 ± 10.89 ys Mean BMI 47.77 ± 8.81 Kg/m2 Mean weight 131.95 ± 29.06 Kg OUR DATA Foletto

  6. Metabolic comorbidities 45% Failure 15.9% Complications 9.6% Psychological distress 4.8% • BGR cx • Slippage • Erosion • Rupture • Intolerance • n=27 • n=3 • n=1 • n=1 Superobesity 19.5% Super-superobesity 2.7% Klinefelter S. 0.6% Prader Willi S. 0.6% VBG cx Stenosis+Fistula • n=1 LSG RESULTS Foletto INDICATIONS TECHNICAL DATA Mean operative time 88.05 ± 40.55minutes Laparotomy conversion rate 3,3% Mean hospital stay 4.52 ± 2.84days

  7. COMPLICATIONS Nausea in 40%, well tolerated,treated with i.m steroids up to POD3 LGCP OUR DATAFoletto

  8. LATE RE-DO SURGERY Mean time after Plication: 7,57 months OUR DATAFoletto

  9. GASTRIC PROLAPSE

  10. RESIDUAL GASTRIC FUNDUS

  11. OUTCOME OUR DATAFoletto

  12. OUTCOME OUR DATAFoletto

  13. CONCURRENT OPERATIONS AGB removal 12.3% Colecistectomy 4.2% Crura repair 1.8% Incisional hernia repair 0.6% POST LSG SURGERY Reintervention rate 7.8% Mean time postLSG (mos)29.92±14.78 Duodenal Switch 3.3% Re-sleeve 3.3% (with crura repair in 8 pts) Tot Gastrectomy 0.6% LSG RESULTS Foletto COMPLICATIONS • Overall complication rate11.4% • Medical complication rate 2.4% • Hypertension 0.9% • Respiratory 1.5% • Surgical complications 9.3% • Leaks 2.1% • Bleeding 5.1% • Stenosis 1.2% • Spleno-mesentheric thrombosis 0.6% • Perigastric hematoma 0.9% • Perioperative mortality 0% • Deaths (> POD-30 (2 LSG-related) n=5

  14. 68 51.1% 28 21.1% RESULTS Foletto OUTCOME (Reinhold's criteria)

  15. RESULTS Foletto(overall)

  16. LSG I LSG conv LSG I LSG conv Females p=0,00 63.2% 83.3% OR time (min) p=0,000 Weight (Kg) SG p=0,00 Laparotomy p=0,002 BMI(Kg/m2) SGp=0,000 Hospital stay (gg) p=0,000 RESULTS Foletto + VS n = 97 n = 5 n = 231 PATIENTS CHARACTERISTICS TECHNICAL DATA

  17. LSG I LSG conv Overall complications p=0,045 LSG I LSG conv Surgical complications p=0,025 Reintervention rate p=0,000 Perigastric Hematoma p=0,01 Resleeve p=0,06 Leaks p=0,000 RESULTS Foletto + VS n = 97 n = 5 n = 231 COMPLICATIONS SURGERY AFTER LSG

  18. RESULTS Foletto + VS VS n= 97 n=5 n=231 OUTCOME

  19. RESULTS Foletto + VS VS n= 97 n=5 n=231 OUTCOME

  20. Thanks for your attention

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