Five-year Outcomes of Sleeve Gastrectomy: A Prospective Multicenter study

2021 ◽  
pp. 000313482199198
Author(s):  
Imad El Moussaoui ◽  
Etienne Van Vyve ◽  
Hubert Johanet ◽  
André Dabrowski ◽  
Arnaud Piquard ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Body Mass ◽  
Excess Weight Loss ◽  
Prospective Multicenter Study ◽  
Weight Loss Failure ◽  
Obstructive Sleep ◽  
The Mean ◽  
Predictors Of Weight Loss

Background Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in the world. Our purpose was to evaluate the percentage of excess weight loss (%EWL), resolution of obesity-related comorbidities after SG, and identify predictive factors of weight loss failure. Methods A prospective cohort study of adults who underwent SG during 2014 in 7 Belgian-French centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically. Results Overall, 529 patients underwent SG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m2, respectively. Body mass index significantly decreased to 32.2 kg/m2 at 5 years ( P < .001). The mean %EWL was 63.6% at 5 years. A significant reduction in dyslipidemia (28.0%-18.2%), obstructive sleep apnea (OSAS) (34.6%-25.1%), and arterial hypertension (HTN) (30.4%-21.5%) was observed after 5 years, but not for diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age >50 years old, BMI >50 kg/m2, and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure. Conclusions Five years after SG, weight loss was satisfactory; the reduction of comorbidities was significant for dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age >50 years old, BMI >50 kg/m2, and previous LAGB were independent predictors of weight loss failure.

scholarly journals Outcomes of Weight Loss, Diabetes, Hypertension and Obstructive Sleep Apnoea after Bariatric Surgery in Patients with Super Morbid Obesity

2020 ◽  
pp. 1-4
Author(s):  
Abdulmenem Abualsel ◽  
Abdulmenem Abualsel ◽  
Ashish Mhatre ◽  
Nalin Mathur ◽  
Susan Dovey
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Super Morbid Obesity ◽  
Obstructive Sleep

Introduction: There is currently a high prevalence of obesity in the Arabian Gulf yet relatively little research on bariatric surgery. In this study we investigate the efficacy of bariatric surgery in patients with super morbid obesity, defined as a Body Mass Index (BMI) of ≥ 50 kg/m2 . Methods: All records of bariatric surgery at a single centre were examined. Outcomes measured include Body Mass Index (BMI), percentage Excess Weight Loss (%EWL), Obstructive Sleep Apnoea (OSA), Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM). Statistical relationships between %EWL against age, type of surgery and gender were analysed. Results: 144 patients were found to meet the inclusion criteria. Mean pre-operative BMI was 56.9 ± 6.1 kg/m2 . 90 (62.5%) patients underwent sleeve gastrectomy, 24 (16.7%) had one anastomosis gastric bypass, 16 (11.1%) had biliopancreatic diversion (Scopinaro’s procedure), and 14 (9.7%) had sleeve gastrectomy with transit loop bipartition. 12 months post-operatively, mean BMI was 37.7 ± 7.5 kg/m2 , with a mean %EWL of 62.9% ± 17.9%. There was 100% OSA resolution, 95.3% HTN resolution, and 79.4% T2DM resolution. %EWL was found to decrease slightly with increased age, however no difference in %EWL was found between types of surgery or genders. Conclusion: Bariatric surgery is effective and may be justified in patients with super morbid obesity, including the elderly population. However, there is a great need for larger, longitudinal studies. This would be made possible by hospitals employing more regular and systematic reporting of data, and encouragement of patients to follow up.

scholarly journals Decision Regret after Laparoscopic Sleeve Gastrectomy—5 Years’ Perspective

2021 ◽  
Author(s):  
Katarzyna Bartosiak ◽  
Michał R. Janik ◽  
Piotr Kowalewski ◽  
Maciej Walędziak ◽  
Andrzej Kwiatkowski
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Negative Correlation ◽  
Telephone Survey ◽  
Significant Negative Correlation ◽  
Decision Regret ◽  
The Mean

Abstract Introduction Patient's satisfaction after weight loss surgery is in the research spotlight. However, there are still no quantitative data regarding whether patients regret their decision to undergo laparoscopic sleeve gastrectomy (SG). Objectives The present study aimed to evaluate whether patients regret their decision to undergo SG 5 years after surgery. The secondary objective was to identify whether weight loss and a higher quality of life (QoL) score correlate with the regret expressed by patients. Setting Military Hospital, Poland Methods A telephone survey was carried out among patients 5 years after surgery. Patient satisfaction regarding their decision to undergo SG was assessed using the Decision Regret Scale. QoL scores were determined using the 36-Item Short Form Survey (SF-36). Results One hundred and four patients who answered a full telephone survey were enrolled in the study. Change in body mass index (ΔBMI) was 12.31±6.2, excess body mass index loss (%EBMIL) was 55.45%±25.52%, and percent total weight loss (%TWL) was 25.20%±11.7%. At the 5-year postoperative telephone survey, the mean general health score was 50.96±14.0 and the mean regret score was 32.33±13.24 (range, 25–85). A statistically significant negative correlation was observed between %EBMIL and regret score (r=−0.435; p<0.001). There was a significant negative association between regret score and energy/fatigue QoL (r=−0.205; p=0.040). Only eight patients (7.69%) scored >50 on the Decision Regret Scale, which was considered to represent overall regret for their decision. Conclusion Our study suggests that, in general, patients did not regret their decision to undergo SG. Key Points The majority of patients did not regret their decision to undergo SG. There was a statistically significant negative correlation between weight loss and patients’ feelings of regret. Energy/fatigue QoL was the strongest correlate of whether patients regretted their decision to undergo SG. Graphical Abstract

Psychosoziale Charakterisierung und Integrative Versorgung arbeitsloser Jugendlicher mit extremer Adipositas – ein Modellprojekt

2019 ◽  
Vol 69 (12) ◽  
pp. 490-498 ◽  
Author(s):  
Yvonne Mühlig ◽  
Miriam Remy ◽  
Rolf Holle ◽  
André Scherag ◽  
Martin Wabitsch ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Body Mass ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Soziale Benachteiligung ◽  
Berufliche Entwicklung

Zusammenfassung Einleitung Soziale Benachteiligung stellt eine Behandlungsbarriere für Jugendliche mit (extremer) Adipositas dar. Mit der Implementierung einer Spezialambulanz in Kooperation mit fünf Job-Centern sollte geprüft werden, ob arbeitslose Jugendliche mit Adipositas Interesse an einer Behandlung ihrer Adipositas haben und welche Teilnahmeraten sie in einem mehrstufigen Behandlungsprogramm aufweisen. Material und Methoden Jugendliche (15,0–24,9 Jahre) mit einem Body-Mass-Index (BMI) ≥30 kg/m2 erhielten das Angebot zur Beratung bzgl. Behandlungsmöglichkeiten der Adipositas im Job-Center. Interessierte Jugendliche wurden nach einer psychologischen Diagnostik in ein multimodales Behandlungsprogramm (6 Sitzungen) aufgenommen. Bei Interesse und bewiesener Adhärenz (Teilnahme an ≥5 Sitzungen) folgte ein Informationskurs (4 Sitzungen) und eine Indikationsprüfung für eine adipositaschirurgische Maßnahme. Ergebnisse Von 2012–2017 wurden 83 Jugendliche (im Mittel 21,1 Jahre, BMI 48,1 kg/m2, BMI 35,0–39,9 kg/m2: N=7, ≥ 40 kg/m2: N=71) eingeschlossen. 34 bewiesen ihre Adhärenz (≥5/6 Sitzungen in der multimodalen Adipositasintervention), 20 interessierten sich für einen adipositaschirurgischen Eingriff. Bisher wurden 11 Jugendliche operiert mit einer mittleren BMI-Reduktion von 14,3 kg/m2 3–36 Monate nach der Operation („Excess Weight Loss“ 27,3%) im Vergleich zu 3,8 kg/m2 6–48 Monate nach Behandlungsbeginn bei den nicht-operierten Jugendlichen. 13 Teilnehmer wurden auf dem ersten Arbeitsmarkt integriert. Diskussion Einige arbeitslose Jugendliche nahmen das Behandlungsangebot gut an und zeigten eine positive gesundheitliche und berufliche Entwicklung im Verlauf ihrer Teilnahme. Schlussfolgerung Die Implementierung einer Spezialambulanz für arbeitslose Jugendliche mit Adipositas in deutschen Job-Centern erweist sich als eine erfolgreiche Strategie, um diese oft unbehandelte Hochrisikogruppe zu charakterisieren und den individuellen Behandlungsbedarf zu ermitteln. Dieser Befund muss an einer größeren Stichprobe im Langzeitverlauf bestätigt werden.

scholarly journals Changes in Body Mass Index and Physical Activity Predict Changes in Vitality During a Weight Loss Trial in Breast Cancer Survivors

2018 ◽  
Vol 52 (12) ◽  
pp. 999-1009 ◽  
Author(s):  
Kelly M Kenzik ◽  
Wendy Demark-Wahnefried ◽  
Patricia A Ganz ◽  
Graham Colditz ◽  
Cheryl L Rock ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Body Mass Index ◽  
Weight Loss ◽  
Cancer Survivors ◽  
Body Mass ◽  
Structural Equation ◽  
Breast Cancer Survivors ◽  
Structural Equation Models ◽  
The Mean

AbstractBackgroundBreast cancer survivors rank fatigue (e.g., decreased vitality) as their number one concern affecting quality of life. Excess adiposity is associated with decreased vitality in breast cancer survivors, yet weight loss intervention trials report inconsistent effects on this parameter.MethodsThis is a secondary analysis of the Exercise and Nutrition to Enhance Recovery and Good Health for You trial, in which 692 overweight or obese breast cancer survivors ≤5 years from diagnosis, initiated weight loss interventions, and completed assessments semi-annually for 2 years. Assessments included the Godin Leisure-Time Exercise Questionnaire and the SF-36 MOS vitality subscale as an inverse measure of fatigue. Multilevel structural equation models estimated the direct effects of physical activity on vitality and indirect effects through body mass index (BMI) changes.ResultsWithin-person findings show that at assessments with greater physical activity, BMI was significantly lower (B = −0.07, p &lt; 0.001) and vitality was higher (B = 0.22, p &lt; 0.001). However, there was no direct relationship between lower BMI and higher vitality (B = −0.11, p = 0.262) after controlling for the relationship of physical activity with BMI and physical activity with vitality. The between-person indirect effect of physical activity change through BMI change to vitality was significant (B = 0.03, p &lt; 0.001). Participants whose physical activity was above the mean (B = 0.37, p &lt; 0.001) and whose BMI was below the mean (B = −1.05, p &lt; 0.001) were more likely to report greater vitality.ConclusionImprovements in vitality are primarily associated with increases in physical activity rather than BMI changes in this trial. Vitality was lower among survivors with higher BMI, although within-individual changes in BMI had no effect on vitality. Physical activity and weight loss share mechanistic links to vitality with physical activity potentially increasing (e.g., in an additive or synergistic manner) the effect of BMI reduction on vitality.

scholarly journals The Early Results of the Laparoscopic Mini-Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mohsen Mahmoudieh ◽  
Behrouz Keleidari ◽  
Naser Afshin ◽  
Masoud Sayadi Shahraki ◽  
Shahab Shahabi Shahmiri ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Vitamin B12 ◽  
Body Mass ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
One Anastomosis Gastric Bypass ◽  
Mini Gastric Bypass

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods. 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients’ BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results. Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007). Six-month follow-up showed statistically significant reduction in total cholesterol, total triglyceride, Fe, and vitamin B12 among patients with higher BMI level (P value <0.05). Conclusion. Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.

Laparoscopic Sleeve Gastrectomy: Outcomes at a Military Training Center

2010 ◽  
Vol 76 (8) ◽  
pp. 835-840
Author(s):  
Robert D. Rice ◽  
Todd E. Simon ◽  
Jason M. Seery ◽  
James D. Frizzi ◽  
Farah A. Husain ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Military Training ◽  
Excess Weight ◽  
Bariatric Procedure ◽  
Outcome Analysis ◽  
Long Term Outcome ◽  
The Mean

Laparoscopic sleeve gastrectomy (LSG) has gained support as a single-staged and stand-alone bariatric procedure. Reports of excess weight loss of 35 to 83 per cent, reduction in comorbidities, and decreased operative morbidity have garnered support for LSG. This study represents an initial outcome analysis of LSG performed solely at a military treatment center. This study is a retrospective analysis of all patients receiving LSG at Dwight D. Eisenhower Army Medical Center from September 2007 to December 2009. The patients were planned for a stand-alone procedure. One hundred and fifteen patients received LSG over this time period with a mean body mass index of 45.5 ± 6.2 (range 35.1-58.3). The average age was 47.4 ± 12.5 years. Diabetes mellitus was seen in 47 per cent and 68 per cent of patients had hypertension. The mean and median length of operation was 124 ± 48 and 115.5 minutes. The mean percentage of excess weight loss was 16.6 ± 6.40 per cent at 1 month, 31.5 ± 7.6 per cent at 3 months, 41.2 ± 13.9 per cent at 6 months, and 53.7 ± 12.5 per cent at 1 year from surgery. One or more of patient's preoperative diabetic or hypertensive medications were improved postoperatively in 18.7 per cent and 16.3 per cent, respectively. Incidence of major complications occurred in 4.35 per cent of patients in this study to include four leaks (3.4%), one death (0.87%), and 10 readmissions. Midterm analysis of outcomes related to LSG as a single-stage bariatric procedure is promising as long-term outcome data is collected; the efficacy of this procedure as a sole bariatric procedure will continue to be borne out.

scholarly journals Collar Size as Predictor of Obstructive Sleep Apnea

2008 ◽  
Vol 23 (2) ◽  
pp. 14-16
Author(s):  
Lyra V. Veloro ◽  
Michael Alexius A. Sarte ◽  
Samantha S. Castañeda
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Neck Circumference ◽  
Normal Group ◽  
Physical Measurements ◽  
Obstructive Sleep ◽  
Male Patients ◽  
The Mean

Objective: This study focuses on evaluating the relationship between physical findings, particularly collar size and Body Mass Index (BMI), and polysomnographic parameters in male patients seen at a Sleep Disorders Laboratory, suspected to have Obstructive Sleep Apnea (OSA).    Methods: Design: Cross-sectional study Setting: Academic tertiary private hospital Participants:  Charts of 149 adult male patients referred for polysomnography between July 1, 2005 and June 30, 2006 were reviewed.  Height, weight, and external neck circumference measurements were obtained.  The data from polysomnography results were noted and correlated with the physical measurements.    Results: The mean collar size for the OSA group was 42.03 cm with a mean BMI of 29.14 while the mean collar size for the normal group was 39.05 cm with a mean BMI of 25.36.  A significant difference was noted in both the collar size and body mass index (BMI) between the OSA group and the normal group (p<0.005).  Results showed a significant correlation between collar size and BMI.  Collar size and BMI measurements were also correlated with increasing severity of sleep apnea in the OSA group.  The ³40 cm collar size among male adults with symptoms of OSA was 80% sensitive and 67% specific with a positive predictive value of 94% in predicting true OSA.   Conclusion: This study suggests that the external neck circumference and the degree of obesity determined through BMI measurement may be important predictors of sleep apnea in adult Filipino males suspected to have OSA.  Given the high probability of having true OSA in symptomatic male adults with a collar size ³ 40 cm, outright definitive management may be opted for in these patients, while those with a collar size < 40 cm may need to undergo further confirmatory tests.     Keywords: obstructive sleep apnea, external neck circumference, collar size, body mass index, polysomnography, obesity  

scholarly journals Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Seda Beyhan Sagmen ◽  
Sevda Cömert
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Severe Disease ◽  
Upper Airway ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Abstract Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compared to the non-positional patients (43.32 ± 2.54) (p < 0.001). Sleep values were compared based on the presence of positional sleep apnea. In the positional patients, sleep duration, sleep efficiency (percentage), duration of stage N3, minimum, and mean saturation values were found to be higher compared to the non-positional patients, while nightlong apnea hypopnea index, apnea index, percentage of sleep time with oxygen saturation below 90%, oxygen desaturation index, mean heart rate, and periodic limb movement index values were found to be lower (p < 0.05). The rate of severe sleep apnea (7.95%) in the positional patients was lower than the non-positional patients (53.65%) (p < 0.001). Conclusion In the light of these data, positional OSA is a very important condition presented in 31.43% of OSA patients and it was determined that these patients were younger, had less body mass index, and shorter neck circumference. The rate of severe disease was found to be lower in positional OSA patients

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