Abstract
BackgroundSome bariatric practices, mainly those conducted under public-funded services, have adopted achieving a target preoperative weight loss (PrWL) before offering surgery. There are varied opinions on the correlation between preoperative and postoperative weight loss (PoWL) for the different surgical options. This study investigated the impact of target PrWL on PoWL for patients who underwent laparoscopic sleeve gastrectomy (LSG).Materials and methodsA longitudinal retrospective cohort study was carried out on patients who had documented preoperative weight before LSG (n=155) from the authors’ institution between February 2008 to October 2017. Patients were grouped into two cohorts based on meeting the 5% target PrWL or not. The endpoint included percent postoperative weight loss (% PoWL) at one year and two to three years.ResultsA total of 155 individuals were identified and analysed. Of these patients, 78.7% of them (n=122) achieved the 5% target PrWL (target group) while 21.3% (n= 33) did not (non-target group). At one year, there was no statistical significant difference in the mean % PoWL between the non-target and target groups (22.3 ± 8.1% versus 19.4 ± 11.8% p value= 0.08). A similar observation was made at two-three years, where the mean % PoWL in the non-target group was 14.7 ± 10.7% versus 16.3 ± 14.4% in the target group (p value= 0.07). Our further analysis highlighted a statistically significant weak inversely proportional correlation between % PrWL and % PoWL at one year and two to three years.ConclusionMeeting target PrWL does not significantly impact on PoWL after LSG. Therefore, it should not serve as exclusion criteria for eligible patients who are in need of surgery.
Highlights
The stark epidemic proportion of obesity is a reality in today’s world [1]
The most significant rise was that of laparoscopic sleeve gastrectomy (LSG) from 0 to 37% of the world total from 2003 to 2013 [6]
We identified all patients who underwent any bariatric operation (n=339) from February 2008 to October 2017
Summary
The stark epidemic proportion of obesity is a reality in today’s world [1]. The World Health Organization (WHO) in 2014 revealed estimates that show a staggering 39% of adults to be overweight and 13% obese [2]. Obesity is associated with comorbidities such as metabolic disease (such as type 2 diabetes), cardiovascular and joint disease, certain types of cancer, reduction in self-reported quality of life, and increased mortality in the long run [3] It poses a huge health burden on the individual and has a large societal strain in terms of costs associated with human resources, administration, and long-term patient management [4]. Surgical intervention has been shown to result in greater improvement in terms of weight loss and obesityassociated comorbidities when compared with non-surgical interventions, regardless of the procedure [5] This epidemic proportion of obesity has witnessed an attendant increase in laparoscopic bariatric surgery worldwide with estimates of about 468,609 procedures performed as of 2013. This study investigated the impact of target PrWL on PoWL for patients who underwent laparoscopic sleeve gastrectomy (LSG)
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