Predictors of weight loss after laparoscopic gastric plication: a prospective study.

Abstract

Laparoscopic gastric plication (LGP) is a bariatric procedure for the treatment of morbid obesity that has recently increased in popularity. Herein, the predictors of weight loss following LGP are investigated. This prospective study was performed on cases performed by a single surgeon between 2000 and 2011. The association between nine independent variables and ideal weight loss (percentage of excess weight loss [%EWL] ≥80%) at 24 months postoperatively was assessed in 330 patients who underwent LGP. The studied variables were as follows: age at surgery, gender, preoperative body mass index, preoperative comorbidities, marital status (single versus married), employment status (employed versus unemployed), family support in helping the patient to engage in physical activities and continue on a healthy diet (never/a little versus sometimes/a lot), the experience of pain or gastroesophageal reflux during or after eating (yes or no), and participation in support groups following LGP (yes or no). Ideal weight loss (%EWL ≥80%) was achieved in 60 patients, and %EWL <80% (suboptimal weight loss) occurred in 270 patients. Being single, female, and of younger age and participation in group meetings were significantly associated with experiencing ideal weight loss at 24 months, postoperatively. However, no significant difference was observed between the two groups in terms of preoperative body mass index, comorbidities, employment, a relative being a coworker, and the experience of pain or gastroesophageal reflux after eating. This study identified predictor factors positively associated with ideal weight loss. These results would aid surgeons in better patient selection and identification of patients requiring more careful follow-up. In addition, it provides patients with more realistic assessment of potential outcome of the procedure.