Impact of Functional Laparoscopic Gastric Bypass with Fundectomy and Gastric Remnant Exploration (LRYGBfse) on Patients' Quality of Life: Trajectory and 5-Year Follow-up Result.

Abstract

Morbid obesity is associated with reduced patients' perception quality of life (QoL). The health benefit of Laparoscopic Roux-en-Y gastric bypass (LRYGB) is well established with long-term weight control and QoL improvement. The laparoscopic functional gastric bypass with fundectomy and gastric remnant exploration (LRYGBfse) has been described with promising results in terms of weight loss and comorbid resolution. The purpose of this study was to investigate its contribution on patients' QoL at 5-year follow-up. Multicenter prospective study (2009-2018). QoL was assessed at baseline and annually with the Gastrointestinal Quality of Life Index (GIQLI), Moorehead-Ardelt Quality of Life Questionnaire II (M-A-QoLQII), and Short-Form 36 (SF-36). Overall, 752 patients underwent the LRYGBfse. Three-hundred forty-four patients completed the 5-year follow-up. Median postoperative %TBWL at 1, 2, 3, and 5years were 33.6, 33.9, 33.7, and 31.4%, respectively. Median GIQLI total score before and at 1, 2, 3, and 5years after LRYGBfse was 82.6, 96.1, 113.1, 112.5, and 108.4. Median M-A-QoLQII total score before and at 1, 2, 3, and 5years after surgery was 0.6, 1.6, 2.1, 2.0, and 1.6. Compared with baseline, the 5-year follow-up improvement was statistically significant for the GIQLI and M-A-QoLQII (p < 0.001). Similarly, all eight SF-36 items and both the Physical and Mental component scores were significantly improved (p < 0.001). The functional LRYGBfse seems associated with a long-standing weight loss and QoL improvement. This seems driven by better gastrointestinal symptoms and physical and social functions combined with improved emotional aspects.