Laila Sheikh1, Lyn A Pearless2, Michael Wc Booth3,2. 1. Department of Surgery North Shore Hospital, 124 Shakespeare Road, Takapuna, Auckland, New Zealand. lailasheikh@gmail.com. 2. Waitemata Specialist Centre, 13-15 Shea terrace, Takapuna, Auckland, New Zealand. 3. Department of Surgery North Shore Hospital, 124 Shakespeare Road, Takapuna, Auckland, New Zealand.
Abstract
BACKGROUND: Bariatric surgery is well established as an effective method for treating obesity and its related comorbidities. The laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to a Roux-en-Y gastric bypass (RYGBP). The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports long-term results from a cohort of patients undergoing a SR-MGBP in a single centre. METHODS: Long-term outcomes (up to 11 years) in a cohort of 156 patients undergoing surgery between August 2005 and January 2008 were analysed. A combination of follow-up questionnaires and electronic hospital records were used to assess weight loss, comorbidity resolution and complications. RESULTS: A total of 156 patients (mean body mass index 46 kg/m2) underwent surgery. Ninety-two patients responded to the follow-up questionnaires. Computer-based hospital information was available on a total of 139 patients. Mean percent excess weight loss (%EWL) at 11 years was 84.3%. Comorbidity resolution, determined by medication use, showed a reduction in diabetes (21.8% to 7.1%), hypertension (37.2% to 21.4%) and hypercholesterolaemia (40.4% to 13.4%). Five of 139 patients (3.6%) had SR problems needing removal. Two other patients had the SR changed to a bigger size and a further two had endoscopic removal of the SR for erosion. Of the 139 patients, 9.4% required conversion to a Roux-en-Y gastric bypass (RYGBP). The number of patients on anti-reflux medications increased from 5.1% to 44.6% at 11 years. There were two deaths unrelated to surgery. CONCLUSIONS: SR-MGBP appears to be a safe and effective operation for the morbidly obese. It is durable, with good weight loss at up to 11 years post-surgery. The SR can easily be removed or exchanged for another size and is reasonable to consider when performing a MGBP. Concerns about bile reflux appear to be well founded, and some patients who are poorly controlled medically will require revision.
BACKGROUND: Bariatric surgery is well established as an effective method for treating obesity and its related comorbidities. The laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to a Roux-en-Y gastric bypass (RYGBP). The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports long-term results from a cohort of patients undergoing a SR-MGBP in a single centre. METHODS: Long-term outcomes (up to 11 years) in a cohort of 156 patients undergoing surgery between August 2005 and January 2008 were analysed. A combination of follow-up questionnaires and electronic hospital records were used to assess weight loss, comorbidity resolution and complications. RESULTS: A total of 156 patients (mean body mass index 46 kg/m2) underwent surgery. Ninety-two patients responded to the follow-up questionnaires. Computer-based hospital information was available on a total of 139 patients. Mean percent excess weight loss (%EWL) at 11 years was 84.3%. Comorbidity resolution, determined by medication use, showed a reduction in diabetes (21.8% to 7.1%), hypertension (37.2% to 21.4%) and hypercholesterolaemia (40.4% to 13.4%). Five of 139 patients (3.6%) had SR problems needing removal. Two other patients had the SR changed to a bigger size and a further two had endoscopic removal of the SR for erosion. Of the 139 patients, 9.4% required conversion to a Roux-en-Y gastric bypass (RYGBP). The number of patients on anti-reflux medications increased from 5.1% to 44.6% at 11 years. There were two deaths unrelated to surgery. CONCLUSIONS:SR-MGBP appears to be a safe and effective operation for the morbidly obese. It is durable, with good weight loss at up to 11 years post-surgery. The SR can easily be removed or exchanged for another size and is reasonable to consider when performing a MGBP. Concerns about bile reflux appear to be well founded, and some patients who are poorly controlled medically will require revision.
Authors: Ashraf Haddad; Ahmad Bashir; Mathias Fobi; Kelvin Higa; Miguel F Herrera; Antonio J Torres; Jacques Himpens; Scott Shikora; Almino Cardoso Ramos; Lilian Kow; Abdelrahman Ali Nimeri Journal: Obes Surg Date: 2021-01-31 Impact factor: 4.129
Authors: Karl A Miller; Marcus Radauer; J N Buchwald; T W McGlennon; Elisabeth Ardelt-Gattinger Journal: Obes Surg Date: 2020-07-21 Impact factor: 4.129
Authors: Paul E O'Brien; Annemarie Hindle; Leah Brennan; Stewart Skinner; Paul Burton; Andrew Smith; Gary Crosthwaite; Wendy Brown Journal: Obes Surg Date: 2019-01 Impact factor: 4.129