Abstract
Introduction: Body Mass Index (BMI) is an independent predictor of overall mortality and risk of vascular disease. In the U.S., obesity (BMI 440) rates are 32.6% among males and 36.2% among females. Bariatric surgery is associated with weight loss and the reduction of certain medical comorbidities in obese adult patients However, there is limited literature regarding male sex as a predictor of periand post-operative outcomes in super-super obese patients who underwent bariatric surgery. The aim of this study was to examine whether male sex predicts pre-surgical comorbidities, perioperative outcomes and % excess weight loss in super-super obese patients who underwent bariatric surgery. Material and Methods: This study was a nonrandomized, controlled, retrospective review of 750 patients who underwent sleeve gastrectomy (SG) or Roux-en-Y Gastric Bypass (RYGB) surgery at the University of Illinois Hospital and Health Sciences System from January 2008 to June 2014. From this group, 89 SSO patients were selected for inclusion in this study. Patients were divided into two groups (male/female) based on sex. Patient demographics, pre-surgical comorbidities, perioperative outcomes, post-operative complications (leak and conversions to open surgery), operating time, length of hospitalization, and percent excess weight loss (% EWL) at 6, 12 and 24 months were examined. Results: Out of 89 super-super obese patients, 19.1% (n1⁄417) patients were male and 81.9% (n1⁄462) were female. In males, 52.9% (n1⁄49) were African-American, 41.2% (n1⁄47) were Caucasian, and 5.8% (n1⁄41) were Hispanic (po.05). All male patients underwent SG. There were no significant sex differences in presurgical comorbidities, length of hospitalization, or post-operative complications (1 vs. 0) between males and females, respectively. Perioperative parameters showed operative time was longer in males versus females (po.05). Percent excess weight loss at 6 months was 24.2% vs. 32.7%, (n.s.), 34.3% vs. 47.9% at 12 months (po.05) and 35.3% vs. 52.7% at 24 months (n.s.) followup for males and females respectively. Conclusions: Male sex predicted longer operative time and lower % excess weight loss at 6 months. A larger sample size with longer follow up is warranted in order to further understand reasons for the sex differences in these variables in order to improve weight loss outcomes in both males and females.
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