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Nasta AM, Goel R, Goel M, Malek A. Undiagnosed Hyperglycemia Is a Potential Long-term Risk in Metabolic Surgery Patients: 7 Years Follow-up Study. Obes Surg 2021; 31:4251-4256. [PMID: 34273069 DOI: 10.1007/s11695-021-05570-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Diabetes is considered to be a surgically correctable illness. As glycemic control begins soon after surgery, the cessation of anti-diabetic medications is early. Patients believe that their diabetes has been "cured" and the need for blood sugar monitoring is forgotten, leading to undiagnosed hyperglycemia and risk of diabetes-related complications. AIMS To study the effect of bariatric surgery on long-term glycemic control and identify the patients with undiagnosed hyperglycemia. METHODS All patients with type 2 diabetes who underwent bariatric surgery at our center from January 2012 to December 2013 were included in the study. For each patient, demographic, preoperative, and postoperative data were retrospectively reviewed. RESULTS Out of the total 119 patients with diabetes, 91 patients underwent sleeve gastrectomy and 28 underwent Roux-en-Y gastric bypass. Diabetes status at 7 years of follow-up was possible in 53 (44.5%) patients: 44 (48.4%) in SG and 9 (32.2%) in RYGB groups. Overall, complete remission at 7 years was seen in 17 (32.1%) patients and partial remission in 12 (22.6%) patients. Amongst non-remitters (n = 24, 45.3%), 7 (13.2%) patients were on medications with good glycemic control (A1C < 6.5) while 8 (15.1%) patients had poor control (A1C > 6.5) despite ongoing medications. Additionally, 9 (17%) patients had poor glycemic control (A1C > 6.5) and were not receiving any anti-diabetic medications. Patients in whom follow-up A1C was unavailable and their diabetes status remain unknown were 66 (55.5%) at 7 years. CONCLUSION Our study clearly demonstrates high risk of undiagnosed hyperglycemia. Regular long-term follow-up in diabetic patients is even more desirable than amongst patients undergoing bariatric surgery for weight loss alone. Graphical abstract.
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Affiliation(s)
- Amrit Manik Nasta
- Bariatric Surgery, Wockhardt Hospitals, Mumbai Central, Mumbai, India.
| | - Ramen Goel
- Bariatric and Metabolic Surgery, Wockhardt Hospitals, Mumbai, India
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The First Sri Lankan Experience on Laparoscopic Bariatric Surgery. Obes Surg 2021; 31:5057-5058. [PMID: 34184184 DOI: 10.1007/s11695-021-05540-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
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Shetty A, Nasta A, Gupte A, Goel R. The role of upper gastrointestinal endoscopy in bariatric procedure selection: A case series and literature review. J Minim Access Surg 2021; 17:81-84. [PMID: 33353892 PMCID: PMC7945648 DOI: 10.4103/jmas.jmas_139_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Bariatric surgery leads to a significant improvement in obesity and associated comorbidities. Safe surgical outcomes are especially desirable in bariatric, as most patients perceive it as an aesthetic surgery, while an intestinal/gastric surgery may be associated with morbidity. A detailed pre-operative evaluation is required to avoid surgical surprises and post-operative complications. Besides other routine investigations, pre-surgery upper gastrointestinal (GI) endoscopy has always been a topic of debate. Some surgeons perform it routinely before the surgery, whereas others perform it selectively. It is mostly accepted that pre-operative diagnosis of gastro-oesophageal reflux disease could change the plan of surgery in favour of Roux-en-Y gastric bypass although similar consensus does not exist in favour of Sleeve gastrectomy if a gastric/duodenal pathology is detected pre-operatively in a planned roux-en-y gastric bypass patient. Aim: Through this case series, we want to highlight the role of routine pre-operative upper GI endoscopy in selecting the bariatric surgery. Cases: We present four cases, from amongst many others, where endoscopy changed the course of bariatric surgery. Conclusion: Upper GI endoscopy should be performed before bariatric surgery, even in asymptomatic patients, to avoid post-operative surprise/complication.
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Affiliation(s)
- Aashik Shetty
- Centre for Metabolic Surgery, Wockhardt Hospital, Mumbai, Maharashtra, India
| | - Amrit Nasta
- Centre for Metabolic Surgery, Wockhardt Hospital, Mumbai, Maharashtra, India
| | - Amit Gupte
- Department of Gastroenterology, Wockhardt Hospital, Mumbai, Maharashtra, India
| | - Ramen Goel
- Centre for Metabolic Surgery, Wockhardt Hospital, Mumbai, Maharashtra, India
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Goel R, Nasta AM, Goel M, Prasad A, Jammu G, Fobi M, Ismail M, Raj P, Palaniappan R, Aggarwal S, Bindal V, Katakwar A, Vennapusa A, Bhasker AG, Peters A, Goel D, Bedi D, Palep J, Kona L, Mehrotra M, Baijal M, Bhandari M, Dukkipati N, Wadhawan R, Baig S, Pattanshetti S, Ugale S. Complications after bariatric surgery: A multicentric study of 11,568 patients from Indian bariatric surgery outcomes reporting group. J Minim Access Surg 2021; 17:213-220. [PMID: 32964881 PMCID: PMC8083745 DOI: 10.4103/jmas.jmas_12_20] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Complications after bariatric surgery are not uncommon occurrences that influence the choice of operations both by patients and by surgeons. Complications may be classified as intra-operative, early (<30 days post-operatively) or late (beyond 30 days). The prevalence of complications is influenced by the sample size, surgeon's experience and length and percentage of follow-up. There are no multicentric reports of post-bariatric complications from India. Objectives To examine the various complications after different bariatric operations that currently performed in India. Materials and Methods A scientific committee designed a questionnaire to examine the post-bariatric surgery complications during a fixed time period in India. Data requested included demographic data, co-morbidities, type of procedure, complications, investigations and management of complications. This questionnaire was sent to all centres where bariatric surgery is performed in India. Data collected were reviewed, were analysed and are presented. Results Twenty-four centres responded with a report on 11,568 bariatric procedures. These included 4776 (41.3%) sleeve gastrectomy (SG), 3187 (27.5%) one anastomosis gastric bypass (OAGB), 2993 (25.9%) Roux-en-Y gastric bypass (RYGB) and 612 (5.3%) other procedures. Total reported complications were 363 (3.13%). Post-operative bleeding (0.75%) and nutritional deficiency (0.75%) were the two most common complications. Leaks (P = 0.009) and gastro-oesophageal reflux disease (P = 0.019) were significantly higher in SG, marginal ulcers in OAGB (P = 0.000), intestinal obstruction in RYGB (P = 0.001) and nutritional complications in other procedures (P = 0.000). Overall, the percentage of complications was higher in 'other' procedures (6.05%, P = 0.000). There were 18 (0.16%) reported mortalities. Conclusions The post-bariatric composite complication rate from the 24 participating centres in this study from India is at par with the published data. Aggressive post-bariatric follow-up is required to improve nutritional outcomes.
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Affiliation(s)
- Ramen Goel
- Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Amrit Manik Nasta
- Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Madhu Goel
- Centre For Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Arun Prasad
- Department of Surgery, Manipal Hospital, New Delhi, India
| | - Gurvinder Jammu
- Director and Chief Surgeon, Bariatric Surgery, Jammu Hospital, Jalandhar, Punjab, India
| | - Mathias Fobi
- Director of Clinical Affairs and Research, Mohak Bariatrics and Robotics; Clinical Professor of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
| | - Mohamed Ismail
- Bariatric Surgeon, Moulana Hospital, Perintalmanna; Bariatric Surgeon, RIMS Hospital, Kottayam, Kerala, India
| | - Praveen Raj
- Bariatric Surgeon, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India
| | - Raj Palaniappan
- Lead Consultant, Bariatric, Metabolic and Robotic Surgery, Institute of Bariatrics, Apollo Hospitals, Chennai, Tamil Nadu, India
| | | | - Vivek Bindal
- Vice-Chairman, Institute of Minimal Access, Metabolic and Bariatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Abhishek Katakwar
- Associate Director, Laparoscopic/Robotic Bariatric and Metabolic Surgery, AIG Hospitals, Hyderabad, Telangana, India
| | - Amar Vennapusa
- Chief Consultant Metabolic and Bariatric Surgeon, Dr. Amar Bariatric and Metabolic Center, Hyderabad, Telangana, India
| | - Aparna Govil Bhasker
- Bariatric and Laparoscopic GI Surgeon, Gleneagles Global Hospital, Parel, Mumbai; Bariatric and Laparoscopic GI Surgeon, Apollo Hospital, Navi Mumbai, Maharashtra, India
| | - Atul Peters
- HOD and Senior Consultant, Apollo Institute of Bariatric and Metabolic Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - Deep Goel
- Department of Surgical Gastroenterology, Bariatric and Metabolic Surgery, BLK Super Specialty Hospital, New Delhi, India
| | | | - Jaydeep Palep
- Department of Bariatric and Minimal Access Surgery, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India
| | - Lakshmi Kona
- Senior Consultant, Gleneagles Global Hospital, Hyderabad, Telangana, India
| | - Magan Mehrotra
- Director, Bariatric Surgery, Apex Hospital, Moradabad, Uttar Pradesh, India
| | - Manish Baijal
- Director, Institute of Minimal Access, Metabolic and Bariatric Surgery, Max Hospital, New Delhi, India
| | - Mohit Bhandari
- Director of Clinical Affairs and Research, Mohak Bariatrics and Robotics; Clinical Professor of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
| | | | - Randeep Wadhawan
- Department of Minimal Access, Bariatric and Gastrointestinal Surgery, Fortis Hospital, New Delhi, India
| | - Sarfaraz Baig
- Department of Minimal Access Surgery, Belle Vue Clinic, Kolkata, West Bengal, India
| | | | - Surendra Ugale
- Director, Bariatric and Metabolic Surgery, Kirloskar and Virinchi Hospitals, Hyderabad, Telangana, India
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Hasan NA, Freije A, Abualsel A, Al-Saati H, Perna S. Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain. Sultan Qaboos Univ Med J 2020; 20:e344-e351. [PMID: 33110651 PMCID: PMC7574803 DOI: 10.18295/squmj.2020.20.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/05/2019] [Accepted: 03/12/2020] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aimed to investigate the effect of bariatric surgery on degree of weight loss, as well as the prevalence of nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations in a cohort of patients from Bahrain. Methods This retrospective cohort study took place between March and September 2018 at two hospitals in Bahrain. All adult patients who had undergone bariatric surgery between 2012–2017 were included. Sociodemographic and clinical information was collected from the patients’ medical records and during phone interviews. Results A total of 341 patients participated in the study. The mean age was 39.82 ± 9.95 years and 67.7% were female. There was a significant relationship between postoperative body mass index and both the type of surgery and time since surgery (P = 0.025 and 0.008, respectively). While type of surgery had no significant effect on percent of excess weight loss (EWL) or percent of total weight loss (TWL), time since surgery significantly affected both of these weight loss measures (P = 0.006 and 0.001, respectively). Biochemical tests revealed haemoglobin, mean corpuscular volume, 25-hydroxy vitamin D, ferritin and iron deficiencies. Commonly reported complications included hair loss (59.5%), flatulence/abdominal pain (39.3%), dry skin (34.3%) and gastroesophageal reflux disease (33.1%). The level of adherence to dietary and lifestyle recommendations was high to moderate. Conclusion Bariatric surgery was effective in accelerating EWL and TWL; however, it also resulted in complications such as nutritional deficiencies and gastrointestinal side-effects.
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Affiliation(s)
- Nawal A Hasan
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
| | - Afnan Freije
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
| | | | - Hani Al-Saati
- Department of Surgery, Salmania Medical Complex, Manama, Bahrain
| | - Simone Perna
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
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Gupta M, Aggarwal S, Bhambri A, Singla V, Chaudhary R. Impact of bariatric surgery on type 2 diabetes in morbidly obese patients and its correlation with pre-operative prediction scores. J Minim Access Surg 2020; 17:462-469. [PMID: 32964893 PMCID: PMC8486063 DOI: 10.4103/jmas.jmas_19_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Bariatric surgery, besides causing significant weight reduction, leads to improvement in type 2 diabetes mellitus (T2DM). However, there is a scarcity of data on the prediction of diabetes resolution in non-Western population. Objective To evaluate the impact of bariatric surgery on T2DM and to assess the accuracy of pre-operative scoring systems in predicting remission. Study Setting A tertiary care academic centre, India. Methodology We used a retrospective cohort of all diabetic patients (n = 244) who underwent bariatric surgery at our centre in the past 10 years. The cohort was followed up for diabetes remission, and pre-operative scoring systems were analysed against the observed results. Results Of 244 patients, we were able to contact 156 patients. The median period of follow-up was 38 months. The mean body mass index (BMI) of the study group decreased from 45.4 to 33.4 kg/m2 (%excess BMI loss = 61.2%). The number of patients dependent on oral anti-diabetic pharmacotherapy and on insulin decreased from 133 (85.3%) to 40 (25.6%) and from 31 (19.9%) to 7 (4.5%), respectively. Remission was analysed for 96 patients, who submitted complete biochemical investigations. The median follow-up period for this sub-cohort was 36 months. 38 (39.6%) patients were in complete remission, 15 (15.6%) patients in partial remission and 34 (38.5%) patients showed an improved glycaemic control. The three pre-operative scores, Advanced-DiaRem, DiaRem and ABCD, showed predictive accuracies of 81.1%, 75.6% and 77.8%, respectively. Conclusions Besides leading to excess BMI loss of 61.2%, bariatric surgery also resulted in diabetes remission in 55.2% of the patients. Amongst various pre-operative scores, Advanced-DiaRem has the highest predictive accuracy for T2DM remission.
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Affiliation(s)
- Mehul Gupta
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Aggarwal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Bhambri
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Vitish Singla
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Chaudhary
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
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Bhatia IN, Nasta AM, Goel MR, Goel RG. Prevalent bariatric dietary practices: Is India on the same page? J Minim Access Surg 2020; 16:381-385. [PMID: 31997784 PMCID: PMC7597891 DOI: 10.4103/jmas.jmas_205_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: In the past decade, there has been an increase in the number and types of bariatric procedures in India. It is, thus, important to monitor prevalent bariatric practices. Aim: To identify prevalent pre- and post-operative dietary practices by bariatric professionals across India. Materials and Methods: Data regarding various pre- and post-surgery dietary practices were collected using an Internet-based survey. Thirty-three bariatric professionals including dietitians (n = 25) and surgeons (n = 8) across the country participated in the survey. The data were analysed, and prevalent dietary practices were identified. Results: Five (20%) dietitians were not involved in the pre-surgery consultation. Nineteen (70%) professionals put all patients on a low-calorie pre-surgery diet regardless of their body mass index, with a preference (n = 21; 77.7%) for liquid diet. Twenty-three (70%) professionals put patients on post-surgery liquid diet for 1–2 weeks. Thereafter, 28 (84.8%) professionals recommended soft diet for 2–4 weeks. Twenty-seven (81%) professionals used protein shakes (as opposed to dietary sources) as their primary source of protein for the first 3 months post-surgery. Fourteen (36%) professionals stopped protein shake supplements within 6 months post-surgery. Ten (30%) professionals reported whey protein aversions in >25% of the patients. Twenty-three (71%) professionals advocated a meal with <30% of carbohydrates for up to 1 year. Twenty-eight (84%) professionals used portion control method for meals. Conclusion: Our study reflects that prevalent dietary practices among Indian bariatricians are in line with national and international guidelines.
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Affiliation(s)
- Ishitaa N Bhatia
- Department of Bariatric and Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Amrit M Nasta
- Department of Bariatric and Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Madhu R Goel
- Department of Bariatric and Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
| | - Ramen G Goel
- Department of Bariatric and Metabolic Surgery, Wockhardt Hospitals, Mumbai, Maharashtra, India
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Nasta AM, Vyas S, Goel M, Goel R. Is sleeve gastrectomy overcriticized? A single-center Indian experience with 5-year follow-up results. Surg Obes Relat Dis 2019; 15:1883-1887. [PMID: 31564636 DOI: 10.1016/j.soard.2019.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/05/2019] [Accepted: 08/21/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bariatric surgery has seen a sharp rise in numbers worldwide in the last decade. Being a popular procedure, sleeve gastrectomy (SG) has been widely studied over the years for its efficacy, potential for weight regain, metabolic impact, and de novo gastroesophageal reflux disease (GERD). OBJECTIVES To evaluate clinical outcomes of laparoscopic SG after 5 years of follow-up in terms of weight loss, co-morbidity resolution, and GERD. SETTING The study was performed in a center of excellence in bariatric surgery in India. METHODS All patients who underwent laparoscopic SG from January 2012 to April 2013 were included in the study. Their demographic, preoperative, and postoperative data were prospectively maintained in Microsoft Excel and analyzed statistically. RESULTS Two hundred eighteen patients underwent SG in 2012-2013. Patients had a preoperative body mass index of 45.8 ± 9.5 kg/m2 (mean ± standard deviation) and excess weight of 54.1 ± 25.6 kg. Percent excess weight loss was 87.6% ± 28.9% at 1 year, 77.2% ± 29.3% at 3 years, and 69.1% ± 27.8% at 5 years. Percent total weight loss at 1 year was 35.5% ± 7.6%, 31.4% ± 9.1% at 3 years, and 29.2% ± 9.8% at 5 years. At 5 years, 11 of 25 (44%) showed complete diabetic remission and 5 of 25 (20%) showed partial remission. De novo GERD was seen in 24 of 153 (15.7%) patients. CONCLUSION Our study reflects good outcomes after SG in terms of weight loss and diabetes resolution at 5-year follow-up, though GERD remains a matter of concern.
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Affiliation(s)
| | | | - Madhu Goel
- Wockhardt Hospitals, Mumbai Central, Mumbai, India
| | - Ramen Goel
- Wockhardt Hospitals, Mumbai Central, Mumbai, India
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Vilallonga R, Curbelo Y, Sanchez-Cordero S, Roriz-Silva R, Bademci R, Torres AJ. Laparoscopic Conversion from Single Anastomosis Duodeno-Jejunal Bypass with Sleeve Gastrectomy (SADJ-S) to Roux-en-Y Gastric Bypass (GBP): Improving Unsatisfactory Outcomes. Obes Surg 2019; 30:365-368. [PMID: 31183786 DOI: 10.1007/s11695-019-03994-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) can be considered as either a primary procedure or second stage procedure. Malnutrition is rare but could lead to a reversal of the SADI-S. The aim of this manuscript is to present the management and technique of weight regain after proximalization of a SADI-S by converting it to a gastric bypass.
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Affiliation(s)
- Ramon Vilallonga
- Quirobes, Integral Obesity Care, Centro Médico Teknon, C. Marquesa de Vilallonga, 12, 08017, Barcelona, Spain. .,Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Center of Excellence for the EAC-BC, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Yuhamy Curbelo
- General Surgery Department, Hospital Universitari de Vic (Consorci Hospitalari de Vic), Vic, Spain
| | | | - Renato Roriz-Silva
- Department of Medicine, Federal University of Rondônia-Unir, Porto Velho, Brazil.,Division of General Surgery, Hospital de Base of Porto Velho-Brazil, Porto Velho, Brazil
| | - Refik Bademci
- Camlica Hospital, Istanbul Medipol University, 34767, Istambul, Turkey
| | - Antonio José Torres
- Chief General Surgery Department, Hospital Clínico San Carlos, Universidad Autónoma de Madrid, Madrid, Spain
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Goel R, Goel M, Nasta AM, Vyas S, Dharia S, Hamrapurkar S. Portion Control Eating-a Determinant of Bariatric Outcomes. Obes Surg 2018; 28:3738-3743. [PMID: 30074144 DOI: 10.1007/s11695-018-3436-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Bariatric surgery leads to significant weight loss but the results vary. Application of dietary principles like portion-controlled eating leads to greater weight loss and fewer complications. AIMS To evaluate the improvement in weight loss outcomes by incorporating portion-controlled eating behavior in postbariatric patients. METHODS All patients who underwent bariatric surgery from January 2012 to December 2013 were included in the study. Portion-controlled eating behavior was incorporated in the post-bariatric nutritional protocol. Their demographic, preoperative, and postoperative data were prospectively maintained on Microsoft Office Excel and analyzed statistically. RESULTS Three hundred and seventy-two (89.6%) underwent laparoscopic sleeve gastrectomy (LSG), while 43 (10.4%) underwent laparoscopic Roux-en-Y gastric bypass (RYGB). In the LSG group, lowest (nadir) BMI was 28.99 ± 5.6 kg/m2 and % Excess weight loss (EWL) was 87.3 ± 27.2%, achieved between 1 and 2 years. In the RYGB group, lowest (nadir) BMI was 27.5 ± 12.09 kg/m and % EWL was 94.32 ± 33.12%. Surgical failure (less than 50% EWL) were 10 (3.27%) in the LSG group and 1 (3%) in the RYGB group. There were no leaks reported in our study. CONCLUSION Our study highlights the importance of postoperative nutritional interventions like portion-controlled eating for successful bariatric outcome.
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Affiliation(s)
- Ramen Goel
- Wockhardt Hospitals, Mumbai Central, Mumbai, India
| | - Madhu Goel
- Wockhardt Hospitals, Mumbai Central, Mumbai, India
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