A retrospective audit of weight loss in bariatric surgery patients

Abstract

Background: Bariatric surgery results in significant weight loss and a reduction in co-morbidities in morbidly obese patients (Colquitt et al., 2009). The number of patients undergoing bariatric surgery nationally has increased significantly since 2002 (Ells et al., 2007). The aim of this audit was to evaluate an emerging bariatric service by comparing the weight loss achieved by local bariatric patients with published literature. Methods: Case notes of 28 patients who underwent bariatric surgery in a University Hospital Trust were reviewed. Patients had undergone either Laparoscopic adjustable gastric banding (LAGB) (n = 7) or a laparoscopic Roux en Y gastric bypass (LRYGB) (n = 21). The initial weight (kg) on admission for surgery, and weight loss (kg) of patients at 6 months (n = 28) and at 1 year (n = 24) post-surgery were recorded. The mean weight loss and total percentage weight loss at 6 months and 1 year post-surgery were calculated and analysis of variance used to compare the groups at 6 and 12 months. Results: Patients undergoing LTYGB lost significantly more weight at 6 (P < 0.005) and 12 months P < (0.005) than the LAGB. The differential between the two groups increased over the next 6 months as shown in Table 1. Discussion: This audit showed a trend towards higher weight loss in patients who underwent LRYGB versus LAGB; a trend that has also been reported by larger published studies (Maggard et al., 2005; Strostrom et al., 2004). Maximum weight loss post-bariatric surgery occurs at 1–2 years (Colquitt et al., 2009; Strostrom et al., 2004). Because this was an audit of an emerging bariatric service, weight loss data at 1 year post-surgery were available for only 24 patients. The average weight loss and percentage weight loss of patients post-LRYGB was higher than the weight loss of 37 kg reported in a meta-analysis of controlled studies on weight loss in bariatric surgery (Maggard et al., 2005). However, in this audit of patients post-LAGB, the average total and percentage weight loss and average percentage weight loss was below the 24.2 kg reported by Maggard et al. (2005) and 21% by Strostrom et al. (2004). Before changes are made to clinical practice, this audit should be repeated to reflect increasing patient numbers over time. Future audits could address further outcome measures to facilitate a wider evaluation of the bariatric service. Conclusions: In this audit, weight loss post-LRYGB is greater, and weight loss post-LAGB is less than published data. Larger numbers are required before altering clinical practice.