Effect of preoperative intragastric balloon treatment on perioperative and postoperative outcomes after laparoscopic sleeve gastrectomy - a retrospective cohort study.

Abstract

Introduction Intragastric balloon (IGB) insertion is used as a bridging therapy in patients with body mass index (BMI) ≥ 50kg/m2. We arranged a retrospective study to evaluate whether pre-operative IGB treatment influences perioperative and postoperative weight loss outcomes after laparoscopic sleeve gastrectomy (SG) particularly on the impact of post-IGB percentage of excessive weight loss (%EWL) on postoperative %EWL.Materials and methods Patients who have undergone IGB placement followed by laparoscopic SG were divided into the following groups considering %EWL after IGB:Group 1 <=10.38%Group 2 >10.38% and <=17.27%Group 3 >17.27% and <=24.86%Group 4 >24.86%1 year after SG data have been collected. The following parameters were compared between groups: operative time, total blood loss, length of stay and weight, BMI, percentage of total weight loss (%TWL), %EWL.Results There were no statistically significant differences between groups in perioperative results. Post-SG %EWL was the highest in intermediate groups: 2 and 3. Post-treatment results were observed: body weight and BMI were the lowest in group 4 and the highest in group 1. Post-treatment %EWL was the highest in group 4, the lowest in group 1 and grow gradually in subsequent groups. Discussion The study confirmed the impact of weight loss on the IGB on postoperative results. The study showed that %EWL after the IGB treatment influences on %EWL after SG and most of all affects definitive %EWL after two-stage treatment and it could be a foreshadowing factor of these outcomes.Importance of research for the development of the field %EWL after the IGB influences the final BMI and final weight, what means that patients with the greatest %EWL after IGB are more likely to have the greatest postoperative weight loss and overall weight loss.