Efficacy of whole-body cryotherapy in complex medical rehabilitation of patients after laparoscopic bariatric gastric bypass for the treatment of morbid obesity

Abstract

The steady growth in the number of obese patients consequently leads to an increase in bariatric surgeries, while the issues of rehabilitation of these patients remain not fully resolved. Aim of the research: to evaluate the effectiveness of using the whole-body cryotherapy (WBC) in complex medical rehabilitation of patients after laparoscopic gastric bypass in the treatment of obesity. Materials and methods. An interventional, single-center, prospective, controlled, single-blinded, experimental, randomized study. The study included 2 stages. Stage 1: 40 patients underwent laparoscopic mini-gastric bypass with band-separated gastric pouch. Stage 2: the patients were divided into 2 groups: with the use of WBC as part of complex medical rehabilitation (Group A, n = 20) and without additional physiotherapy methods (Group B, n = 20). The course of WBC was 15 sessions of 1–3 minutes. The CryoSpace 2K device consists of a cryochamber (temperature –110 °С) and a pre-chamber (–60 °С). The procedures were carried out every other day; the exposure duration increased in parallel with the growth of cryoresistance. The patients were followed up for a total of 2 years. Results. Surgical results: the average duration of surgery was 85 ± 26 minutes; the length of stay in the hospital was 3.7 ± 1.5 days. One complication was registered. Initially, the patients in groups A and B did not differ in terms of sex, age, anthropometric data, and comorbidities composition. After 2 years of follow-up, BMI was significantly lower in group A with the use of WBC compared with group B (26.7 vs 29.4 kg/m2). The percentage of total weight loss, percentage of BMI loss and percentage of excess weight loss were significantly higher in group A. Conclusion. Taking into account the ongoing rehabilitation measures, the group with the use of WBC showed significantly better indicators for achieving ideal body weight and losing excess weight, which is an argument for recommending the use of this type of physiotherapy in the rehabilitation complex after bariatric procedures.