1
|
Madani S, Shahsavan M, Pazouki A, Setarehdan SA, Yarigholi F, Eghbali F, Shahmiri SS, Kermansaravi M. Five-Year BAROS Score Outcomes for Roux-en-Y Gastric Bypass, One Anastomosis Gastric Bypass, and Sleeve Gastrectomy: a Comparative Study. Obes Surg 2024; 34:487-493. [PMID: 38147191 DOI: 10.1007/s11695-023-07015-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Metabolic and bariatric surgery (MBS) has been shown to enhance the quality of life (QoL) in individuals with obesity. The Bariatric Analysis and Reporting Outcome System (BAROS) is a highly reliable scoring system utilized to assess weight loss, obesity-associated medical conditions, and QoL following MBS. This study aimed to assess the efficacy of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB) in improving health outcomes for individuals with severe obesity, employing the BAROS questionnaire. METHODS A retrospective study was conducted, enrolling 299 patients with a body mass index (BMI) of 40 or higher who had undergone primary MBS (RYGB, OAGB, or SG) and had a 5-year follow-up. Patients were evaluated using the BAROS scoring system, which included measures of % excess weight loss (%EWL), improvement and remission of obesity-related medical problems, and postoperative short-term and long-term complications. RESULTS The mean age and pre-op BMI of the patients was 39.4 ± 9.4 years and 44.6± 6.5 kg/m2, respectively. The total BAROS score was significantly higher in patients who underwent OAGB compared to those who underwent RYGB and SG (P, 0.02). However, no significant differences were observed in other aspects of the BAROS score, such as QoL. CONCLUSION This study demonstrated that all three common metabolic and bariatric surgical procedures (SG, RYGB, and OAGB) significantly improved the QoL after surgery. Furthermore, patients who underwent OAGB had a significantly higher total BAROS score at the 5-year follow-up compared to those who underwent RYGB and SG.
Collapse
Affiliation(s)
- Saeed Madani
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Surgery, Qom University of Medical Sciences, Qom, Iran
| | - Masoumeh Shahsavan
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Abdolreza Pazouki
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran
| | - Seyed Amin Setarehdan
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Yarigholi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Foolad Eghbali
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran
| | - Shahab Shahabi Shahmiri
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran
| | - Mohammad Kermansaravi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran.
| |
Collapse
|
2
|
Möller F, Hedberg J, Skogar M, Sundbom M. Long-term Follow-up 15 Years After Duodenal Switch or Gastric Bypass for Super Obesity: a Randomized Controlled Trial. Obes Surg 2023; 33:2981-2990. [PMID: 37584851 PMCID: PMC10514119 DOI: 10.1007/s11695-023-06767-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/16/2023] [Accepted: 07/25/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND In super obesity, Roux-en-Y gastric bypass (RYGB) may be insufficient why some surgeons advocate biliopancreatic diversion with duodenal switch (BPD/DS), a more malabsorptive procedure. There is a paucity of evidence regarding results beyond 10 years, especially after BPD/DS. The aim of this randomized controlled trial was to compare the long-term outcome of BPD/DS, and RYGB in patients with super obesity, i.e., body mass index (BMI) > 50 kg/m2. METHODS This is a 13- to 17-year follow-up study of a single-center, single-blinded randomized trial in which 47 patients (BMI > 48 and eligible for bariatric surgery) were randomized 1:1 to BPD/DS and RYGB (25 men, 24 BPD/DS, 39.1 ± 9.9 years, BMI 54.5 ± 6.1 kg/m2). The primary outcome was weight loss. The study was financed by Swedish governmental funding of clinical research (ALF). TRIAL REGISTRATION NUMBER ISRCTN10940791. RESULTS Thirty-four (18 BPD/DS) of the living 42 patients (81.0%) participated. BPD/DS resulted in higher BMI loss (20.4 ± 7.9 vs. 12.4 ± 8.6, p = .008) and higher percent of total body weight loss (37.5% ± 12.2 vs. 22.8% ± 14.8, p = .004). BPD/DS was associated with lower fasting glucose, glycated hemoglobin (HbA1c), and low-density lipoprotein (LDL) as well as lower hemoglobin. Adverse events were more common after BPD/DS (2.7 vs. 0.9 per patient, p = .004). The global assessment tool BAROS (Bariatric Analysis and Reporting Outcome System) demonstrated superior scores for BPD/DS (p = .047). CONCLUSION When compared to RYGB, BPD/DS results in superior weight loss and metabolic control as well as superior BAROS score, however, at the cost of more adverse events.
Collapse
Affiliation(s)
- Filip Möller
- Department of Surgical Sciences, Uppsala University, Entrance 70, 751 85, Uppsala, Sweden.
| | - Jakob Hedberg
- Department of Surgical Sciences, Uppsala University, Entrance 70, 751 85, Uppsala, Sweden
| | - Martin Skogar
- Department of Surgical Sciences, Uppsala University, Entrance 70, 751 85, Uppsala, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Entrance 70, 751 85, Uppsala, Sweden
| |
Collapse
|
3
|
Alqahtani AR, Alqahtani O, Amro N, Al Qahtani A, Elahmedi M, Abdurabu H, Boutros A, Abdo N, Ebishi A, Awil A, Aldarwish A. Long-term outcomes of laparoscopic sleeve gastrectomy in those with class I obesity: safety, efficacy, and quality of life. Surg Obes Relat Dis 2023; 19:1135-1141. [PMID: 37076319 DOI: 10.1016/j.soard.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/19/2023] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Class I obesity carries significant morbidity and mortality risk similar to higher grades of obesity, and persons with class I obesity have a high risk of progression to class II and III obesity. While bariatric surgery has made strides in safety and efficacy, it remains inaccessible for persons with class I obesity (body mass index [BMI] of 30-35 kg/m2). OBJECTIVES To assess safety, weight loss durability, co-morbidity resolution, and quality of life after laparoscopic sleeve gastrectomy (LSG) in persons with class I obesity. SETTING Multidisciplinary medical center that specializes in obesity management. METHODS A longitudinal prospective single-surgeon registry was queried for data pertaining to persons with class I obesity who underwent primary LSG. Primary endpoint was weight loss. Secondary endpoints included change in obesity-related co-morbidities, adverse events, and post hoc analysis of symptoms of gastroesophageal reflux disease (GERD) and Bariatric Analysis and Reporting Outcome System results. Follow-up was divided into short- (1-3 yr), intermediate- (4-7 yr), and long-term (8-12 yr). We evaluated percent excess weight loss (%EWL) using linear mixed models adjusting for age, sex, years since operation, and baseline BMI. Least-squares means estimates and 95% confidence intervals (CI) were generated. RESULTS Of 13,863 bariatric procedures, a total of 1851 patients were included. Mean baseline BMI, age, and male:female ratio were 32.6 ± 2.1 kg/m2, 33.7 ± 9.2 years, and 1:5, respectively. Adjusted mean %EWL (95% CI) at short-, intermediate-, and long-term follow-up were 111% (95% CI, 91%-131%), 110% (95% CI, 89%-131%), and 141% (95% CI, 57%-225%), respectively. Of 195 patients with type 2 diabetes, 59% experienced complete remission, and of 168 patients with hypertension, 43% experienced complete remission. Being on oral antidiabetes medication was a significant predictor of sustained remission compared with being on insulin or combination therapy (P < .001). Sixty-nine patients had symptoms of GERD before surgery, which improved in 55 (79.7%). Thirty-three patients developed de novo symptoms of GERD. The average Bariatric Analysis and Reporting Outcome System score was 4.5 ± 1.7, with 83% of participants rating their quality of life after surgery as good, very good, or excellent. CONCLUSION Those with class I obesity who undergo LSG experience normalization of weight, sustained remission of co-morbidity, and good quality of life without significant risk of morbidity or mortality.
Collapse
Affiliation(s)
| | - Omar Alqahtani
- Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nizar Amro
- New You Medical Center, Riyadh, Saudi Arabia
| | - Awadh Al Qahtani
- Department of Surgery, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Nael Abdo
- New You Medical Center, Riyadh, Saudi Arabia
| | | | - Amal Awil
- New You Medical Center, Riyadh, Saudi Arabia
| | | |
Collapse
|
4
|
Kayali M, Arslan H, Yilmaz E, Eti S, Özdenkaya Y, Omer A. WEIGHT LOSS AND BEYOND, ASSESSMENT OF QUALITY OF LIFE AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY USING BAROS IN PATIENTS WITH OBESITY IN TURKEY. Acta Endocrinol (Buchar) 2023; 19:326-332. [PMID: 38356975 PMCID: PMC10863971 DOI: 10.4183/aeb.2023.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Context Sleeve gastrectomy is an effective method for management of obesity. The Bariatric Analysis and Reporting Outcome System (BAROS) is a comprehensive and standard system for the assessment of outcomes of weight loss surgery. It is consisted of weight loss, changes in obesity-related comorbidities and quality of life measurements. We investigated results of the sleeve gastrectomy based on the BAROS. Material and Methods Outcomes of laparoscopic sleeve gastrectomy surgery was studied in 45 patients with obesity (11 male, 34 female), after 45 months in Turkey. Results Total weight loss was 26.4±0.1% of body weight at 45 months. Weight regain was seen in 97.8% of the patients with an average 14.5 kg and 13.7% body mass index points. The surgery caused 76% decrease in incidence of obstructive sleep apnea, 73% decrease in type 2 diabetes, 63% decrease in hyperlipidemia and 62% decrease in hypertension. Significant improvement is observed in all quality-of-life parameters. The final score of the BAROS was 4.23±1.02. Conclusion Based on BAROS, sleeve gastrectomy provides significant improvements in weight loss, incidence of medical comorbidities and quality of life after surgery. Future studies should address prevention of weight regain after the surgery.
Collapse
Affiliation(s)
- M.S. Kayali
- Department of Gynecology and Obstetrics, School of Medicine, Istanbul, Turkey
| | - H.K. Arslan
- International School of Medicine, Istanbul, Turkey
| | - E. Yilmaz
- Institute of Health Sciences, Istanbul, Turkey
| | - S. Eti
- Department of General Surgery, School of Medicine, Istanbul, Turkey
| | | | - A. Omer
- Department of Endocrinology, Diabetes and Metabolism, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
5
|
Sierżantowicz R, Ładny JR, Lewko J. Quality of Life after Bariatric Surgery-A Systematic Review. Int J Environ Res Public Health 2022; 19:ijerph19159078. [PMID: 35897447 PMCID: PMC9330722 DOI: 10.3390/ijerph19159078] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 12/10/2022]
Abstract
Background: Most studies analyzing the health-related quality of life (HRQOL) after bariatric treatment ceased at five years post-surgery or even earlier, and it is unclear whether the HRQOL benefit persists for a longer time. This paper reviews sparse evidence regarding HRQOL in patients who underwent bariatric surgery at least nine years prior. Materials and Methods: A of PubMed, Scopus and Google Scholar between 2007–2021 was carried out for the studies investigating HRQOL as an outcome measure in patients after bariatric surgery of any type and having at least a 9-year follow-up. Inconsistent reporting of weight loss or postgraduate study results unrelated to QoL were not included in the study. The study used the PICO procedure. Results: The review of 18 identified publications demonstrated that bariatric treatment seems to provide a persistent benefit in terms of HRQOL, especially its physical component score. Due to psychological predispositions, some patients appear to be less likely to benefit from bariatric treatment, whether in terms of HRQOL or bodyweight reduction. Inconsistent and imprecise studies may limit the evidence included in a review. Conclusions: The early identification of such patients and providing them with holistic care, including psychological intervention, would likely further improve the outcomes of bariatric treatment.
Collapse
Affiliation(s)
- Regina Sierżantowicz
- Department of Surgical Nursing, Medical University of Bialystok, 15-274 Bialystok, Poland
- Correspondence:
| | - Jerzy Robert Ładny
- Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Jolanta Lewko
- Department of Primary Health Care, Medical University of Bialystok, 15-054 Bialystok, Poland;
| |
Collapse
|
6
|
Junquera Bañares S, Ramírez Real L, Camuñas Segovia J, Martín García-Almenta M, Llanos Egüez K, Álvarez Hernández J. Evaluation of quality of life, weight loss and evolution of comorbidities at 6 years after bariatric surgery. ENDOCRINOL DIAB NUTR 2021; 68:501-508. [PMID: 34863415 DOI: 10.1016/j.endien.2021.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Morbid obesity is a disease with multiple comorbidities and considerably limits the quality of life and life expectancy. Bariatric surgery is an effective therapeutic alternative in these patients; it acts on the decrease and / or absorption of nutrients, achieving a significant weight loss which is maintained over time. The objective of the study is to determine the long-term results, in terms of efficacy, regarding weight loss, the resolution of comorbidities and improvement in the quality of life of our patients. MATERIAL AND METHODS This was a retrospective study that comprised all patients consecutively undergoing laparoscopic bariatric surgery at our center over a 10 year period. In all patients, the anthropometric and clinical data were collected prior to surgery and in subsequent protocolized visits after surgery. At the end of the follow-up, a BAROS questionnaire was used that recorded weight loss, the resolution of comorbidities, complications and the quality of life test completed by the patients. RESULTS 353 patients (303 GBPRY and 50 GV), 105 men and 248 women, with a mean age of 42.14 ± 10.16 years, BMI 48.63 kg / m2 and 68.5% had some comorbidity. The mean follow-up was 5.7 ± 2.6 years for 96.7% of the total number operated on. At the end of the follow-up the %EWL was 59.00 ± 19.50, %EBMIL 68.15 ± 22.94, the final BMI 32.65 ± 5.98 and 31.3% of the patients had %EWL ≤ 50. The resolution of comorbidities was as follows: 48.7% hypertension, 70.3% Type 2 Diabetes, 82.6% DLP and 71.6% SAHS. The result of the quality of life test was 1.51 ± 0.93, with 67.2% of patients reporting good or very good quality, with the highest score being for self-esteem, followed by physical condition, work and social activity, and the lowest being for sexual quality of life in that only 40.3% reported an improvement. The BAROS score was 4.35 ± 2.06 with 84.7% of the patients in the good to excellent range, while 91.2% of all patients would undergo surgery again. CONCLUSIONS Bariatric surgery is an effective technique for reducing weight, resolving comorbidities and improving the quality of life of patients with morbid obesity, mainly in its physical aspect. In our series, the percentage of follow-up and average time was within the range of established quality standards.
Collapse
Affiliation(s)
- Sonia Junquera Bañares
- Servicio de Endocrinología y Nutrición, Hospital Central de la Cruz Roja, Madrid, Spain.
| | - Luis Ramírez Real
- Servicio de Endocrinología y Nutrición, Hospital Central de la Cruz Roja, Madrid, Spain
| | - Juan Camuñas Segovia
- Servicio Cirugía General y Aparato Digestivo, Hospital Central de la Cruz Roja, Madrid, Spain
| | | | - Katiuska Llanos Egüez
- Servicio Cirugía General y Aparato Digestivo, Hospital Central de la Cruz Roja, Madrid, Spain
| | - Julia Álvarez Hernández
- Servicio de Endocrinología y Nutrición, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| |
Collapse
|
7
|
Abstract
BACKGROUND AND AIMS: Laparoscopic sleeve gastrectomy (SG) has massively increased in numbers over the last decade and is the most frequently performed bariatric procedure worldwide today. The aim of this review is to evaluate SG in terms of weight loss and resolution of comorbidities, based on data gained from the latest long-term studies available. MATERIAL AND METHODS: This review includes the results of any long-term studies on SG available at this point as well as a selection of short- and mid-term studies. RESULTS: There are only a handful of studies on sleeve gastrectomy with long-term follow-up available at this point. Conversion rates in these long-term studies amount to up to one-third of their cohorts; however, excess weight loss in patients maintaining their sleeve is over 50%. Results on the resolution of comorbidities vary among the studies available today. SUMMARY: Sleeve gastrectomy is a valid bariatric method but one has to be aware of its limitations.
Collapse
Affiliation(s)
- D M Felsenreich
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - F B Langer
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - G Prager
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
8
|
Skogar ML, Sundbom M. Duodenal Switch Is Superior to Gastric Bypass in Patients with Super Obesity when Evaluated with the Bariatric Analysis and Reporting Outcome System ( BAROS). Obes Surg 2017; 27:2308-16. [PMID: 28439748 DOI: 10.1007/s11695-017-2680-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background It is not clear which bariatric procedure that gives the best outcome for patients with super obesity (body mass index [BMI] > 50 kg/m2). This study aims to compare outcomes in patients with super obesity after Roux-en-Y gastric bypass (RYGB) and duodenal switch (BPD/DS) using the Bariatric Analysis and Reporting Outcome System (BAROS) and a local questionnaire for gastrointestinal symptoms. Methods A retrospective mail survey including 211 patients, 98 RYGB and 113 BPD/DS, with a mean follow-up time of 4 years for both groups. Gender distribution, age, and comorbidities were similar. Weight loss, changes in comorbidities, quality of life (QoL), and adverse events were registered, as well as gastrointestinal symptoms. Results Preoperative BMI was higher in the BPD/DS group (56 ± 6.7 vs. 52 ± 4.0 kg/m2, p < 0.01); despite this, the postoperative BMI was lower (31 ± 5.5 vs. 36 ± 7.1 kg/m2, p < 0.01). The effect on diabetes was superior after BPD/DS; otherwise, both groups had a similar reduction in comorbidities. There was no difference in QoL. Adverse events were less common after RYGB (14 vs. 27%). Overall, the BPD/DS group had a superior BAROS score (4.7 ± 2.0 vs. 4.0 ± 2.1, p < 0.05). Dumping was more common after RYGB (p < 0.01), while reflux, diarrhea, fecal incontinence, and problems with malodorous flatus were more common after BPD/DS (all p < 0.05). Frequency of nausea/vomiting and abdominal pain were similar. Conclusion Patients with super obesity have a better weight reduction and metabolic control with BPD/DS, at the cost of higher incidence of adverse events, compared to patients operated with RYGB.
Collapse
|
9
|
Bergeat D, Lechaux D, Ghaina A, Thibault R, Bouygues V. Postoperative Outcomes of Laparoscopic Bariatric Surgery in Older Obese Patients: a Matched Case-Control Study. Obes Surg 2017; 27:1414-1422. [PMID: 28035521 DOI: 10.1007/s11695-016-2517-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Laparoscopic bariatric surgery (LBS) in older obese patients remains debated regarding postoperative outcomes. OBJECTIVES The aim of this case-control study is to evaluate global results of LBS in patients ≥60 years (yr) with a matched case control study. METHODS All patients ≥60 years who benefited from LBS in our center between January 2009 and January 2014 were included in this retrospective study. They were matched (1:2) to patients <40 and 40-59 years on BMI, surgical procedure and year, and history of previous LBS. Postoperative complications in the first 90 days following LBS, micronutrient and mineral deficiencies, and Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed. RESULTS Fifty-five patients ≥60 year (40 sleeve gastrectomy, 14 one anastomosis gastric bypass, 1 gastric bypass revision) were matched to patients <40 year and patients 40-59 year (n = 55 each). Patients ≥60 year presented more obesity-related comorbidities at baseline. Except for bleeding complications (P = 0.01), no difference in major complication rate was observed (P = 0.43). At 24 months, %EWL was lower in older patients compared to others (76.3, 82.2 and 89.7, respectively, P = 0.009). Iron and vitamin B12 deficiencies were less prevalent in patients ≥60 year After a mean follow-up of 27 months, BAROS score (filled in by 82% of patients) was lower in patients ≥60 years (P = 0.01). CONCLUSION Despite less weight loss, postoperative complications rate, and lower BAROS results, LBS keeps an acceptable benefit-risk balance in selected older patients and should not be rejected on the sole argument of age. Additional studies are needed to assess the long-term benefits of LBS in older patients.
Collapse
Affiliation(s)
- Damien Bergeat
- Service de Chirurgie Hépatobiliaire et Digestive, Hôpital Pontchaillou, Rennes, France.
- Université de Rennes 1, Rennes, France.
- UMR NuMeCan (Nutrition, Métabolismes, Cancer), INRA, ALICE, St Gilles, France.
| | - David Lechaux
- Service de Chirurgie Digestive, Hôpital Yves-le-Foll, Saint Brieuc, France
| | - Adil Ghaina
- Service de Chirurgie Digestive, Hôpital Yves-le-Foll, Saint Brieuc, France
| | - Ronan Thibault
- Université de Rennes 1, Rennes, France
- UMR NuMeCan (Nutrition, Métabolismes, Cancer), INRA, ALICE, St Gilles, France
- Unité de Nutrition, Service d'Endocrinologie-Diabétologie-Nutrition, INSERM U991, CHU Rennes, Université Rennes 1, F-35000, Rennes, France
| | - Vianney Bouygues
- Service de Chirurgie Digestive, Hôpital Yves-le-Foll, Saint Brieuc, France
| |
Collapse
|
10
|
Lewis M, Netz U, Mizrahi S, Avinoah E, Gal D, Perry ZH. Do Male Patients Benefit from Laparoscopic Adjustable Gastric Banding More than Female Patients? A Retrospective Cohort Study. Obes Surg 2017; 28:760-766. [PMID: 28861730 DOI: 10.1007/s11695-017-2916-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Clinical trials in the field of bariatrics, and specifically laparoscopic adjustable gastric banding (LAGB), have frequently been gender imbalanced, with males representing only 20% of examinees. Long-term gender-oriented results, and specifically quality of life (QOL) parameters, have not been addressed sufficiently. The aim of our study was to examine the long-term gender association with outcome of LAGB including the impact on QOL. METHODS A retrospective cohort study of patients who underwent LAGB between 2006 and 2014 by a single surgeon was conducted. Data were collected from the hospital registry and a telephone interview that included a standardized questionnaire. Outcomes including BMI reduction, evolution of comorbidities, complications, reoperations, and QOL were compared according to the Bariatric Analysis and Reporting Outcome System (BAROS). RESULTS Included were 114 males and 127 females, with a mean age of 38.2 years at surgery, and an average post-surgery follow-up of 6.5 years. Similar BMI reduction (p = 0.68) and perioperative complication rates (p = 0.99) were observed. Males had a greater improvement in comorbidities (p < 0.001), less band slippage (p = 0.006), underwent fewer reoperations (p = 0.02), and reported higher QOL scores (p = 0.02) than females. The total BAROS score was significantly higher for males than females (p < 0.001). CONCLUSIONS LAGB surgery results in better outcomes for male than female patients as measured by the BAROS, despite a similar BMI reduction. Gender-specific outcomes should be taken into consideration in optimizing patient selection and preoperative patient counseling.
Collapse
Affiliation(s)
- Maor Lewis
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Uri Netz
- Department of Surgery A, Soroka University Medical Center, PO Box 151, 64101, Beer-Sheva, Israel.
| | - Solly Mizrahi
- Department of Surgery A, Soroka University Medical Center, PO Box 151, 64101, Beer-Sheva, Israel
| | - Eliezer Avinoah
- Department of Surgery A, Soroka University Medical Center, PO Box 151, 64101, Beer-Sheva, Israel
| | - Doron Gal
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Zvi H Perry
- Department of Surgery A, Soroka University Medical Center, PO Box 151, 64101, Beer-Sheva, Israel
| |
Collapse
|
11
|
Felsenreich DM, Langer FB, Kefurt R, Panhofer P, Schermann M, Beckerhinn P, Sperker C, Prager G. Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 2016; 12:1655-62. [PMID: 27317599 DOI: 10.1016/j.soard.2016.02.021] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/17/2016] [Accepted: 02/21/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND With promising short-term results, laparoscopic sleeve gastrectomy (SG) has become the second most frequently performed bariatric procedure worldwide. Aside from a growing number of reports covering up to 10 years of follow-up, only limited data have been published so far on long-term results. OBJECTIVES The aim of the study was to present a 10-year follow-up for SG. SETTING University hospital setting, Austria. METHODS We present the first complete 10-year follow-up of 53 consecutive patients who underwent SG before 2006. In this multicenter study, weight loss success, weight regain, and revisional surgery were analyzed beside Bariatric Analysis and Reporting Outcome System (BAROS) scores. RESULTS A mean maximum percent excess weight loss of 71±25% (percent total weight loss: 28±15%) was reached at a median of 12 (range 12-120) months after SG. At 10 years, a mean percent excess weight loss of 53±25% was achieved by 32 patients, corresponding to a percent total weight loss of 26.3±13.4%. Nineteen of the 53 patients (36%) were converted to Roux-en-Y gastric bypass (n = 18) or duodenal switch (n = 1) due to significant weight regain (n = 11), reflux (n = 6), or acute revision (n = 2) at a median of 36 months. Two patients died at 3 and 101 months postoperatively, unrelated to SG. A total of 31 patients (59%) suffered from weight regain of 10 kg or more, among them 24 patients (45%) with 15 kg or more, 16 patients (30%) with 20 kg or more, and 7 patients (13%) with 25 kg or more weight regain from nadir. Mean BAROS score was 2.4±2.2 at 10 years follow-up, classifying SG as "fairly efficient." CONCLUSION Within a long-term follow-up of 10 years or more after SG, a high incidence of both significant weight regain and intractable reflux was observed, leading to conversion, most commonly to Roux-en-Y gastric bypass.
Collapse
|
12
|
Lee YJ, Song HJ, Heo Y, Oh SH, Kwon JW, Moon KH, Park JM, Lee SK. Validation of the Korean version Moorehead-Ardelt quality of life questionnaire II. Ann Surg Treat Res 2014; 87:265-72. [PMID: 25368853 PMCID: PMC4217256 DOI: 10.4174/astr.2014.87.5.265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/27/2014] [Accepted: 04/28/2014] [Indexed: 11/30/2022] Open
Abstract
Purpose To investigate the weight loss effects with higher sensitivity, disease specific quality of life (QoL) instruments were important. The Moorehead-Ardelt quality of life questionnaire II (MA-II) is widely used, because it was simple and validated the several languages. The aims of present study was performed the translation of MA-II Korean version and the validation compared with EuroQol-5 dimension (EQ-5D), obesity-related problems scale (OP-scale), and impact of weight quality of life-lite (IWQoL-Lite). Methods The study design was a multicenter, cross-sectional survey and this study was included the postoperative patients. The validation procedure is translation-back translation procedure, pilot study, and field study. The instruments of measuring QoL included the MA-II, EQ-5D, OP-scale, and IWQoL-lite. The reliability was checked through internal consistency using Cronbach alpha coefficients. The construct validity was assessed the Spearman rank correlation between 6 domains of MA-II and EQ-5D, OP-scale, and 5 domains of IWQoL-Lite. Results The Cronbach alpha of MA-II was 0.763, so the internal consistency was confirmed. The total score of MA-II was significantly correlated with all other instruments; EQ-5D, OP-scale, and IWQoL-Lite. IWQoL-lite (ρ = 0.623, P < 0.001) was showed the strongest correlation compared with MA-II, followed by OP-scale (ρ = 0.588, P < 0.001) and EQ-5D (ρ = 0.378, P < 0.01). Conclusion The Korean version MA-II was valid instrument of measuring the obesity-specific QoL. Through the present study, the MA-II was confirmed to have good reliability and validity and it was also answered simple for investigating. Thus, MA-II could be estimated sensitive and exact QoL in obesity patients.
Collapse
Affiliation(s)
- Yeon Ji Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hyun Jin Song
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea. ; School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Yoonseok Heo
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea. ; Department of Surgery, Inha University School of Medicine, Incheon, Korea
| | - Sung-Hee Oh
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Jin Won Kwon
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea. ; College of Pharmacy, Kyungpook National University, Daegu, Korea
| | - Kon-Hak Moon
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Joong-Min Park
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sang Kuon Lee
- Department of Surgery, The Catholic University of Korea School of Medicine, Seoul, Korea
| |
Collapse
|