Silvia Palmisano1, Marta Silvestri2, Michela Giuricin3, Edoardo Baldini4, Simone Albertario5, Patrizio Capelli6, Bernardo Marzano7, Giovanni Fanti8, Aron Zompicchiatti9, Paolo Millo10, Massimiliano Fabozzi11, Riccardo Brachet Contul12, Riccardo Brachet Contul12, Elisa Ponte13, Rosaldo Allieta14, Nicolò de Manzini15. 1. Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. spalmisano@units.it. 2. Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. silvestri_marta@libero.it. 3. Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. michelagiuricin@libero.it. 4. Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy. e.baldini@ausl.pc.it. 5. Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy. s.albertario@ausl.pc.it. 6. Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy. p.capelli@ausl.pc.it. 7. Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy. bernardo.marzano@gmail.com. 8. Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy. giovanni.fantipn@gmail.com. 9. Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy. aronillo@yahoo.it. 10. Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. pmillo@ausl.vda.it. 11. Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. mfabozzi@ausl.vda.it. 12. Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. rbrachetcontul@ausl.vda.it. 13. Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. eponte@ausl.vda.it. 14. Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. rallieta@ausl.vda.it. 15. Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. demanzini@units.it.
Abstract
BACKGROUND: Gastric bypass (GBP) is one of the most effective surgical procedures to treat morbid obesity and the related comorbidities. This study aimed at identifying preoperative predictors of successful weight loss and type 2 diabetes mellitus (T2DM) remission 1 year after GBP. METHODS: Prospective longitudinal study of 771 patients who underwent GBP was performed at four Italian centres between November 2011 and May 2013 with 1-year follow-up. Preoperative anthropometric, metabolic and social parameters, the surgical technique and the previous failed bariatric procedures were analyzed. Weight, the body mass index (BMI), the percentage of excess weight lost (% EWL), the percentage of excess BMI lost (% BMIL) and glycated haemoglobin (HbA1c) were recorded at follow-up. RESULTS: Univariate and multivariate analysis showed that BMI <50 kg/m(2) (p = 0.006) and dyslipidaemia (p = 0.05) were predictive factors of successful weight loss. Multivariate analysis of surgical technique showed significant weight loss in patients with a small gastric pouch (p < 0.001); the lengths of alimentary and biliary loops showed no statistical significance. All diabetic patients had a significant reduction of HbA1c (p < 0.001) after surgery. BMI ≥ 50 kg/m(2) (p = 0.02) and low level of preoperative HbA1c (p < 0.01) were independent risk factors of T2DM remission after surgery. CONCLUSIONS: This study provides a useful tool for making more accurate predictions of best results in terms of weight loss and metabolic improvement.
BACKGROUND: Gastric bypass (GBP) is one of the most effective surgical procedures to treat morbid obesity and the related comorbidities. This study aimed at identifying preoperative predictors of successful weight loss and type 2 diabetes mellitus (T2DM) remission 1 year after GBP. METHODS: Prospective longitudinal study of 771 patients who underwent GBP was performed at four Italian centres between November 2011 and May 2013 with 1-year follow-up. Preoperative anthropometric, metabolic and social parameters, the surgical technique and the previous failed bariatric procedures were analyzed. Weight, the body mass index (BMI), the percentage of excess weight lost (% EWL), the percentage of excess BMI lost (% BMIL) and glycated haemoglobin (HbA1c) were recorded at follow-up. RESULTS: Univariate and multivariate analysis showed that BMI <50 kg/m(2) (p = 0.006) and dyslipidaemia (p = 0.05) were predictive factors of successful weight loss. Multivariate analysis of surgical technique showed significant weight loss in patients with a small gastric pouch (p < 0.001); the lengths of alimentary and biliary loops showed no statistical significance. All diabeticpatients had a significant reduction of HbA1c (p < 0.001) after surgery. BMI ≥ 50 kg/m(2) (p = 0.02) and low level of preoperative HbA1c (p < 0.01) were independent risk factors of T2DM remission after surgery. CONCLUSIONS: This study provides a useful tool for making more accurate predictions of best results in terms of weight loss and metabolic improvement.
Authors: Austin Cottam; Daniel Cottam; Walter Medlin; Christina Richards; Samuel Cottam; Hinali Zaveri; Amit Surve Journal: Surg Endosc Date: 2015-12-22 Impact factor: 4.584
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Authors: Austin Cottam; Daniel Cottam; Dana Portenier; Hinali Zaveri; Amit Surve; Samuel Cottam; Legrand Belnap; Walter Medlin; Christina Richards Journal: Obes Surg Date: 2017-02 Impact factor: 4.129
Authors: Georgi Vassilev; Till Hasenberg; Johannes Krammer; Peter Kienle; Ulrich Ronellenfitsch; Mirko Otto Journal: Obes Surg Date: 2017-03 Impact factor: 4.129