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Effect of Laparoscopic Sleeve Gastrectomy on Clinical Hypothyroidism in Morbidly Obese Patients

Ahmed Elnabil, Ossama Ashraf Ahmed and Bassem Murad Mostafa

Background: Laparoscopic sleeve gastrectomy (LSG) has an increase in popularity as a definitive bariatric operation. The purpose of this study was to evaluate excess weight loss (EWL) and the change in thyroxin (T4) requirement in morbidly obese patients with clinical hypothyroidism after LSG.

Methods: Between June 2012 and June 2015, 33 morbidly obese patients candidate for laparoscopic sleeve gastrectomy were enrolled in a prospective comparative study at Ain Shams University Hospitals, Egypt, and Muhayl National Hospital, Saudi Arabia. The patients were assigned to either Group A (13 patients) with clinical hypothyroidism on thyroxin treatment or Group B (20 patients) with euthyroid as control group. We compared postoperative EWL between two groups and preoperative and postoperative thyroxin requirements in Group A at one-year follow up.

Results: There was no significant difference in excess weight loss at 3,6 and 12 months after surgery between two groups, the dose of L-thyroxin was highly significantly decreased from 130.76 ± 49.11(mcg/d) to 69.23 ± 67.81(mcg/d) in 10/13 patients (77%), with complete resolution in 5/13(38.5%), and 5 patients (38.5%) had 40% median reduction of their thyroxin requirements range (16.5%-62.5%), while 3/13 patients (23%) continued on the same preoperative thyroxin dose. The mean change and percentage change in T4 requirement for all of Group A were 61.53 ± 48.53 mcg (range: 0-150 mcg) and 54.34 ± 42.12% (range: 0-100%), respectively.

Conclusion: .Improvement of clinical hypothyroidism after laparoscopic sleeve gastrectomy was evidenced by a reduction in T4 requirement with comparable weight loss to euthyroid patients at short-term follow up.