Laparoscopic sleeve gastrectomy: a study of efficiency in treatment of metabolic syndrome components, comorbidities and influence on certain biochemical markers

Paweł A Wojciak; Patrycja Pawłuszewicz; Inna Diemieszczyk; Ewa Komorowska-Wojtunik; Mikołaj Czerniawski; Adam Krętowski; Agnieszka Błachnio-Zabielska; Jacek Dadan; Jerzy R Ładny; Hady Razak Hady

doi:10.5114/wiitm.2019.84718

Laparoscopic sleeve gastrectomy: a study of efficiency in treatment of metabolic syndrome components, comorbidities and influence on certain biochemical markers

Wideochir Inne Tech Maloinwazyjne. 2020 Mar;15(1):136-147. doi: 10.5114/wiitm.2019.84718. Epub 2019 Apr 25.

Affiliations

¹ First Department of General and Endocrine Surgery, University Clinical Hospital of Bialystok, Bialystok, Poland.
² Intensive Care Unit, Ministry of the Interior Hospital of Bialystok, Bialystok, Poland.
³ Department of Endocrinology, Diabetology and Internal Diseases, University Clinical Hospital of Bialystok, Bialystok, Poland.
⁴ Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Bialystok, Poland.

Abstract

Introduction: The worldwide outbreak of morbid obesity forced contemporary medicine to adopt a multidisciplinary approach, which led to the description of metabolic syndrome (MS): a disease with self-aggravating components and one of the most important causes of morbidity and mortality. The need for therapeutic methods provoked development of metabolic surgery, which nowadays give possibilities for safe and effective treatment of all MS aspects simultaneously and improves many obesity-related comorbidities.

Aim: To assess the laparoscopic sleeve gastrectomy (LSG) procedure's efficiency in resolving MS components, treating comorbidities and to analyze the influence on certain biochemical markers in 1-year follow-up.

Material and methods: The retrospective cohort study of 211 patients after an LSG operation relied on statistical analysis of clinical data collected prospectively in follow-up visits. All applicable guidelines and bioethical recommendations were respected in this study.

Results: Assessment of bariatric efficiency proved the LSG operation to be effective in inducing significant weight loss and treating obesity. Analysis on the influence on MS components, such as non-insulin dependent diabetes (NIDDM), arterial hypertension (AH) and dyslipidemia, showed substantial improvement in all observed cases of these diseases. In the present study, follow-up also proved a partial remission inducing effect of this bariatric operation in many comorbidities, especially in chronic obstructive pulmonary disease, obstructive sleep apnea, peptic ulcer disease and depression. A desirable reduction in creatinine, C-reactive protein, uric acid, alanine aminotransferase, asparagine aminotransferase, γ-glutamyltransferase serum levels has also been observed during the follow-up.

Conclusions: The LSG is an effective method of treatment in all areas of metabolic syndrome, provides a significant positive clinical outcome in obesity-related comorbidities and induces desirable changes in inflammatory, kidney and liver related biomarkers.

Keywords: bariatric surgery; laparoscopic sleeve gastrectomy; metabolic syndrome; morbid obesity; obesity.