Sleeve Gastrectomy In Iraq Is A Great Challenge

Introduction: Laparoscopic Sleeve gastrectomy (LSG) is the most common restrictive procedure performed worldwide for treatment of morbid obesity.Objectives: To assess the safety, effectiveness and complications of LSG performed for Iraqi patients and the challenge of performing LSG in military conflict regions.Methods: Prospective clinical case series study conducted in Al-Jumhoori Teaching Hospital and involved 70 patients (57 females and 13 males); their age (19-59 average 37 years) underwent LSG(6 open,64 laparoscopically with one conversion); 51 patients finish 1 year follow up and only 7 cases performed after the conflict.Results: The initial body weight 70-195(122Kg); BMI 31.8-65.9 (50.16Kg/m(2)); two patients with diabetes mellitus and BMI less than 35Kg/m(2) involved.The average weight loss assessed and found to be (13.85, 32.8, 40.8 and 48.3 Kg) in 1st, 3rd, 6th and 12th month interval; The BMI reduced from 50.16 to 35.43 and 29.52 at 6th and 12th months.We recorded 1 mortality after 10 days (massive pulmonary embolism), 1 case converted to open and minigastric bypass due to narrowing of the sleeve part.The associated comorbidities improved after weight loss, and the quality of life improved in 88% of patients depending on bariatric analysis and reporting outcome systems (BAROS).Conclusion: Sleeve gastrectomy is relatively safe and effective procedure to decrease weight for morbid obesity and it improves the quality of life, but all bariatric procedures needs good health resources and settled countries which were not present in Iraq for the time being.