A127 - Impact of Metabolic Surgery for Patients With Bmi Less Than 35 Kg/M2 on Health-Related and Eating Quality of Life

Abstract

fall into this low BMI category. Methods: Data were retrieved from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) dataset (2005-2013). Inclusion criteria included: adult patients aged Z18 years, BMI Z25 but o35 kg/m, who were being treated with medications for T2D and underwent elective primary bariatric surgical procedures including Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), sleeve gastrectomy (SG), and duodenal switch (DS). Data of the subgroup of patients with BMI 25-30 were detailed separately, as there is a paucity of such data in the literature. Postoperative composite adverse outcome was defined as presence of any of 16 major adverse events. Results: The mean BMI of the 1,003 patients who met the inclusion criteria was 33.5 1.6 kg/m. Fortysix patients had a BMIo30 kg/m. Forty percent were taking insulin and 60% were on oral hypoglycemic medications. The most prevalent baseline comorbidities were hypertension (77.6%) and cardiac diseases (9.1%). Surgical procedures included RYGB (57.2%), AGB (22.6%), SG (18.8%), and DS (1.3%). The mean operative time and length of hospital stay were 110.3 51.6 min and 2.0 1.7 days, respectively. Incidence of all individual complications was r 0.5% in this cohort except postoperative bleeding, which was 1.6%. Thirty-day postoperative mortality and composite adverse event rates were 0.2% and 4.2%, respectively. Reoperation within 30 days after the primary procedure was necessary in 1.6% of patients (Table 1). Conclusion: A 2-hour surgical procedure requiring a two day hospital stay that is associated with modest early morbidity (4%) and low mortality (0.2%) can lead to remission of a chronic, progressive and disabling disease. Based on these findings, bariatric surgery can be considered a relatively safe option for managing T2D in patients with mild obesity. Further large clinical studies on long-term safety and efficacy outcomes of bariatric surgery in patients with T2D and low BMI are warranted.