Salvatore Giordano1, Mikael Victorzon. 1. Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland, salvatore.giordano@gmail.com.
Abstract
BACKGROUND: The impact of preoperative weight loss on outcomes following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a controversial issue. We evaluated our outcomes of LRYGB in patients who lost different amount of weight prior to surgery. METHODS: Patients who underwent primary LRYGB were divided in three groups on the basis of preoperative weight loss percentage. Group A comprised 166 patients, who lost <5% of their weight preoperatively; group B comprised 239 patients who lost >5 to 10% and group C included 143 patients who lost >10%. Intra- and postoperative complications at 30 days, hospital stay, and outcomes were evaluated. RESULTS: Significant difference was found in operative (mean ± SD) time [104.43 ± 36.40 min in group A, 80.08 ± 23.07 min in group B, and 76.99 ± 23.23 min in group C; p < 0.001 in group A versus group B or group C; p = 0.210 in group B versus group C]. Difference in hospital stay was significant (3.33 ± 3.22 days in group A, 2.10 ± 2.77 in group B, and 1.87 ± 1.44 in group C; p < 0.001 in group A versus groups B or C). Overall postoperative morbidity rate was 33.13% in group A, 19.25% in group B, and 11.89% in group C, with significant difference in group A versus groups B or C (p = 0.002 and p < 0.001). Mean excess weight loss was significantly higher (72.7%) in group C versus group A (63.1%) (p = 0.015) at 12 months. CONCLUSIONS: Weight loss >5% prior to LRYGB may reduce morbidity, and preoperative weight loss >10% may improve weight loss outcomes at 1-year follow-up.
BACKGROUND: The impact of preoperative weight loss on outcomes following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a controversial issue. We evaluated our outcomes of LRYGB in patients who lost different amount of weight prior to surgery. METHODS:Patients who underwent primary LRYGB were divided in three groups on the basis of preoperative weight loss percentage. Group A comprised 166 patients, who lost <5% of their weight preoperatively; group B comprised 239 patients who lost >5 to 10% and group C included 143 patients who lost >10%. Intra- and postoperative complications at 30 days, hospital stay, and outcomes were evaluated. RESULTS: Significant difference was found in operative (mean ± SD) time [104.43 ± 36.40 min in group A, 80.08 ± 23.07 min in group B, and 76.99 ± 23.23 min in group C; p < 0.001 in group A versus group B or group C; p = 0.210 in group B versus group C]. Difference in hospital stay was significant (3.33 ± 3.22 days in group A, 2.10 ± 2.77 in group B, and 1.87 ± 1.44 in group C; p < 0.001 in group A versus groups B or C). Overall postoperative morbidity rate was 33.13% in group A, 19.25% in group B, and 11.89% in group C, with significant difference in group A versus groups B or C (p = 0.002 and p < 0.001). Mean excess weight loss was significantly higher (72.7%) in group C versus group A (63.1%) (p = 0.015) at 12 months. CONCLUSIONS:Weight loss >5% prior to LRYGB may reduce morbidity, and preoperative weight loss >10% may improve weight loss outcomes at 1-year follow-up.
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