Jérémie Thereaux1, Sebastien Czernichow2, Nicola Corigliano1, Christine Poitou3, Jean-Michel Oppert3, Jean-Luc Bouillot4. 1. Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France. 2. Department of Nutrition, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France; Centre for Research in Epidemiology and Population Health (INSERM U1018), Paul Brousse Hospital, Villejuif, France. 3. Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique- Hôpitaux de Paris, Pierre-et-Marie-Curie-Paris 6 University, Human Nutrition Research Center Île-de-France (CRNH IdF), Institute of Cardiometabolic Disease and Nutrition (ICAN), Paris, France. 4. Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France. Electronic address: jl.bouillot@apr.aphp.fr.
Abstract
BACKGROUND: Laparoscopic gastric bypass (LRYGB) is feasible for patients with body mass index (BMI)≥60 kg/m² (super-super-obesity [SSO]) but long-term data are lacking. The objective of this study was to compare the 5-year weight loss and changes in obesity-related co-morbidities after LRYGB for SSO and non-SSO patients. METHODS: From January 2004 to November 2008, 32 SSO and 320 non-SSO patients underwent LRYGB. We matched 30 SSO patients undergoing LRYGB (case group) with 60 non-SSO patients (control group) for age, sex, and presence of type 2 diabetes. RESULTS: Baseline data indicate that case and control groups did not differ for age (42±12.4 versus 41.8±11.5 yr; P=.92) or sex ratio (80% female, P=.99). Preoperative BMI were 64.1±4.1 and 46.3±5.6 kg/m² in SSO and non-SSO groups, respectively (P<.0001). The rates of coexisting conditions in the 2 groups were comparable except for hypertension (76.7% versus 53.3%; P=.03). At 5 years after surgery, the percentage of initial weight loss (%IWL) (27.4±11.8 versus 29.7±9.2; P=.35) for the groups were comparable whereas percentage of excess weight loss (%EWL) (44.9±19.9 versus 66.5±21.2; P<.0001) was higher for non-SSO patients. Rates of remission or improvement of coexisting conditions, including diabetes and hypertension, did not differ significantly different between groups. CONCLUSION: According to %IWL and rate of partial or complete remission of diabetes and hypertension, our study shows similar outcomes for LRYGB in SSO and non-SSO patients 5 years after surgery. The %EWL does not seem to be an adequate indicator for evaluation of LRYGB outcomes in patients with extreme obesity, such as SSO.
BACKGROUND: Laparoscopic gastric bypass (LRYGB) is feasible for patients with body mass index (BMI)≥60 kg/m² (super-super-obesity [SSO]) but long-term data are lacking. The objective of this study was to compare the 5-year weight loss and changes in obesity-related co-morbidities after LRYGB for SSO and non-SSO patients. METHODS: From January 2004 to November 2008, 32 SSO and 320 non-SSO patients underwent LRYGB. We matched 30 SSO patients undergoing LRYGB (case group) with 60 non-SSO patients (control group) for age, sex, and presence of type 2 diabetes. RESULTS: Baseline data indicate that case and control groups did not differ for age (42±12.4 versus 41.8±11.5 yr; P=.92) or sex ratio (80% female, P=.99). Preoperative BMI were 64.1±4.1 and 46.3±5.6 kg/m² in SSO and non-SSO groups, respectively (P<.0001). The rates of coexisting conditions in the 2 groups were comparable except for hypertension (76.7% versus 53.3%; P=.03). At 5 years after surgery, the percentage of initial weight loss (%IWL) (27.4±11.8 versus 29.7±9.2; P=.35) for the groups were comparable whereas percentage of excess weight loss (%EWL) (44.9±19.9 versus 66.5±21.2; P<.0001) was higher for non-SSO patients. Rates of remission or improvement of coexisting conditions, including diabetes and hypertension, did not differ significantly different between groups. CONCLUSION: According to %IWL and rate of partial or complete remission of diabetes and hypertension, our study shows similar outcomes for LRYGB in SSO and non-SSO patients 5 years after surgery. The %EWL does not seem to be an adequate indicator for evaluation of LRYGB outcomes in patients with extreme obesity, such as SSO.
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