Lidia Castagneto Gissey1, James R Casella Mariolo1, Alfredo Genco1, Alfonso Troisi2, Nicola Basso1, Giovanni Casella3. 1. Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. 2. Department of Systems Medicine Clinical Psychiatry Unit, University of Rome Tor Vergata, Rome, Italy. 3. Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: giovanni.casella@uniroma1.it.
Abstract
BACKGROUND: Sleeve gastrectomy (SG) has grown into the most popular bariatric operation. Nevertheless, a scarcity of long-term outcomes are available. OBJECTIVES: This study aims at evaluating the long-term percent weight loss (%WL), excess weight loss (%EWL), weight regain (WR), and co-morbidity resolution rates in a single-center cohort undergoing SG as a primary procedure, with a minimum 10-year follow-up. SETTING: University hospital, Italy. METHODS: One hundred eighty-two morbidly obese patients with body mass index (BMI) 46.6 ± 7.3 kg/m2 underwent SG. Obesity-related co-morbidities (type 2 diabetes, hypertension, sleep apnea, gastroesophageal reflux disease) were investigated. Predictors of dichotomous dependent-variable diabetes remission were computed using a binomial logistic regression. RESULTS: Patient retention rate was 77%. Mean %WL was 30.9, %EWL was 52.5%, and WR (≥25% maximum WL) occurred in 10.4%. Baseline BMI significantly (P = .001) and linearly predicted %EWL (10 yr %EWL = 18.951 + initial BMI × .74); the super-obese subgroup generated substantially greater WL compared with those with BMI <50 kg/m2 (%EWL 48.0 ± 18.5 versus 61.5 ± 23.2; P < .001). Type 2 diabetes remission occurred in 64.7%; 42.9% patients developed de novo gastroesophageal reflux disease symptoms postoperatively (P < .0001). CONCLUSIONS: SG generates sustained WL and co-morbidity resolution up to 10 years postoperatively. Although a notable portion of patients experience WR, mean %WL persists to exceed 30%, translating in adequate WL also in the long term. Additionally, WR does not seem to impact negatively on co-morbidity resolution. SG represents a safe and effective bariatric operation, which easily grants the possibility to proceed to revisional bariatric surgery in patients with WR or failure to WL.
BACKGROUND: Sleeve gastrectomy (SG) has grown into the most popular bariatric operation. Nevertheless, a scarcity of long-term outcomes are available. OBJECTIVES: This study aims at evaluating the long-term percent weight loss (%WL), excess weight loss (%EWL), weight regain (WR), and co-morbidity resolution rates in a single-center cohort undergoing SG as a primary procedure, with a minimum 10-year follow-up. SETTING: University hospital, Italy. METHODS: One hundred eighty-two morbidly obesepatients with body mass index (BMI) 46.6 ± 7.3 kg/m2 underwent SG. Obesity-related co-morbidities (type 2 diabetes, hypertension, sleep apnea, gastroesophageal reflux disease) were investigated. Predictors of dichotomous dependent-variable diabetes remission were computed using a binomial logistic regression. RESULTS:Patient retention rate was 77%. Mean %WL was 30.9, %EWL was 52.5%, and WR (≥25% maximum WL) occurred in 10.4%. Baseline BMI significantly (P = .001) and linearly predicted %EWL (10 yr %EWL = 18.951 + initial BMI × .74); the super-obese subgroup generated substantially greater WL compared with those with BMI <50 kg/m2 (%EWL 48.0 ± 18.5 versus 61.5 ± 23.2; P < .001). Type 2 diabetes remission occurred in 64.7%; 42.9% patients developed de novo gastroesophageal reflux disease symptoms postoperatively (P < .0001). CONCLUSIONS: SG generates sustained WL and co-morbidity resolution up to 10 years postoperatively. Although a notable portion of patients experience WR, mean %WL persists to exceed 30%, translating in adequate WL also in the long term. Additionally, WR does not seem to impact negatively on co-morbidity resolution. SG represents a safe and effective bariatric operation, which easily grants the possibility to proceed to revisional bariatric surgery in patients with WR or failure to WL.
Authors: Mauro Lombardo; Arianna Franchi; Roberto Biolcati Rinaldi; Gianluca Rizzo; Monica D'Adamo; Valeria Guglielmi; Alfonso Bellia; Elvira Padua; Massimiliano Caprio; Paolo Sbraccia Journal: Int J Environ Res Public Health Date: 2021-04-25 Impact factor: 3.390
Authors: James Casella-Mariolo; Lidia Castagneto-Gissey; Giulia Angelini; Andrea Zoli; Pierluigi Marini; Stefan R Bornstein; Dimitri J Pournaras; Francesco Rubino; Carel W le Roux; Geltrude Mingrone; Giovanni Casella Journal: EBioMedicine Date: 2019-08-07 Impact factor: 8.143