Tomasz Stefura1, Jakub Droś1, Artur Kacprzyk1, Mateusz Wierdak2,3, Monika Proczko-Stepaniak4, Michał Szymański4, Magdalena Pisarska2,3, Piotr Małczak2,3, Mateusz Rubinkiewicz2, Michał Wysocki2,3, Anna Rzepa2, Michał Pędziwiatr2,3, Andrzej Budzyński2,3, Piotr Major5,6. 1. Students' Scientific Group at 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland. 2. 2nd Department of General Surgery, Jagiellonian University Medical College, ul. Kopernika 21, 30-501, Krakow, Poland. 3. Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland. 4. Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland. 5. 2nd Department of General Surgery, Jagiellonian University Medical College, ul. Kopernika 21, 30-501, Krakow, Poland. piotr.major@uj.edu.pl. 6. Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland. piotr.major@uj.edu.pl.
Abstract
INTRODUCTION: The enhanced recovery after surgery (ERAS) protocol, which emphasizes preoperative interventions, is safely implemented in patients undergoing bariatric surgery. Patients are additionally encouraged to achieve weight loss preoperatively. We aimed to identify factors contributing to preoperative weight loss and assess their influence on outcomes of bariatric surgery among patients under the ERAS protocol. MATERIALS AND METHODS: We reviewed a prospectively created database in two bariatric centers with 909 bariatric patients treated in accordance with ERAS principles. The database included demographic characteristics, factors related to the surgery or perioperative period, and short-term outcomes. Our endpoints included analyses of (1) factors potentially contributing to preoperative weight loss and (2) the influence of preoperative weight loss on short-term outcomes of bariatric treatment. RESULTS: Diabetes mellitus (p = 0.007), obstructive sleep apnea (p < 0.001), and previous surgery (p = 0.012) were identified as predictors of preoperative weight loss. Steatohepatitis (p < 0.001) and respiratory disorder (p = 0.004) decreased the chance of achieving satisfactory preoperative body mass reduction. Except for operative time, early outcomes of bariatric surgery were not influenced by preoperative weight loss. Patients who achieved preoperative weight loss were less likely to be lost to follow-up (p = 0.023). Postoperative weight loss was better in patients who could lose ≥ 5% total weight preoperatively (p = 0.009). CONCLUSION: Unsatisfactory preoperative weight loss among patients treated under ERAS principles is not associated with increased risk of complications. Satisfactory preoperative weight loss predicts superior postoperative weight loss and follow-up participation.
INTRODUCTION: The enhanced recovery after surgery (ERAS) protocol, which emphasizes preoperative interventions, is safely implemented in patients undergoing bariatric surgery. Patients are additionally encouraged to achieve weight loss preoperatively. We aimed to identify factors contributing to preoperative weight loss and assess their influence on outcomes of bariatric surgery among patients under the ERAS protocol. MATERIALS AND METHODS: We reviewed a prospectively created database in two bariatric centers with 909 bariatric patients treated in accordance with ERAS principles. The database included demographic characteristics, factors related to the surgery or perioperative period, and short-term outcomes. Our endpoints included analyses of (1) factors potentially contributing to preoperative weight loss and (2) the influence of preoperative weight loss on short-term outcomes of bariatric treatment. RESULTS: Diabetes mellitus (p = 0.007), obstructive sleep apnea (p < 0.001), and previous surgery (p = 0.012) were identified as predictors of preoperative weight loss. Steatohepatitis (p < 0.001) and respiratory disorder (p = 0.004) decreased the chance of achieving satisfactory preoperative body mass reduction. Except for operative time, early outcomes of bariatric surgery were not influenced by preoperative weight loss. Patients who achieved preoperative weight loss were less likely to be lost to follow-up (p = 0.023). Postoperative weight loss was better in patients who could lose ≥ 5% total weight preoperatively (p = 0.009). CONCLUSION: Unsatisfactory preoperative weight loss among patients treated under ERAS principles is not associated with increased risk of complications. Satisfactory preoperative weight loss predicts superior postoperative weight loss and follow-up participation.
Authors: Michał Pędziwiatr; Mikhail Kisialeuski; Mateusz Wierdak; Maciej Stanek; Michał Natkaniec; Maciej Matłok; Piotr Major; Piotr Małczak; Andrzej Budzyński Journal: Int J Surg Date: 2015-07-29 Impact factor: 6.071
Authors: Piotr Major; Michał Wysocki; Michał Pędziwiatr; Magdalena Pisarska; Jadwiga Dworak; Piotr Małczak; Andrzej Budzyński Journal: Int J Surg Date: 2016-12-10 Impact factor: 6.071
Authors: Piotr Małczak; Magdalena Pisarska; Major Piotr; Michał Wysocki; Andrzej Budzyński; Michał Pędziwiatr Journal: Obes Surg Date: 2017-01 Impact factor: 4.129
Authors: Piotr Major; Tomasz Stefura; Piotr Małczak; Michał Wysocki; Jan Witowski; Jan Kulawik; Mateusz Wierdak; Magdalena Pisarska; Michał Pędziwiatr; Andrzej Budzyński Journal: Obes Surg Date: 2018-04 Impact factor: 4.129
Authors: Piotr Małczak; Michał Wysocki; Hanna Twardowska; Alicja Dudek; Justyna Tabiś; Piotr Major; Magdalena Pisarska; Michał Pędziwiatr Journal: Obes Surg Date: 2020-04 Impact factor: 4.129
Authors: Erik Stenberg; Luiz Fernando Dos Reis Falcão; Mary O'Kane; Ronald Liem; Dimitri J Pournaras; Paulina Salminen; Richard D Urman; Anupama Wadhwa; Ulf O Gustafsson; Anders Thorell Journal: World J Surg Date: 2022-01-04 Impact factor: 3.352