Abstract
Background: This study aims to evaluate long-term quality of life (QoL) and primary clinical outcomes, 10 years after biliointestinal bypass (BIB) surgery. It was expected that, although BIB might show encouraging primary outcomes, long term QoL could be significantly impaired.Methods: Ninety patients were contacted for a phone interview [age 41.0 ± 10.6 (mean ± SD) years, age-range 31-65 years]. QoL (by SF-36) and the clinical situation (by ad hoc questionnaire) were collected. Data were analyzed with SPSS 22. SF-36 scores were compared with Italian normative data from general and healthy population. We also compared primary clinical outcomes and SF-36 scores between patients who reported high and low levels of satisfaction with BIB.Results: Considering SF-36 results, patients showed significant impairments in QoL compared to general and healthy populations. Sixty-five percent would repeat the BIB. All patients showed at least one chronic adverse event. It occurred a significant decrease in pre-post co-occurrence rates of diabetes (χ2 = 18.41; p < 0.001) and hypertension (χ2 = 50.27; p < 0.001). Large and significant weight loss indexes (i.e., percent excess weight loss (%EWL); body mass index) were observed between pre-post intervention.Conclusion: BIB showed promising primary clinical outcomes (i.e., hypertension, diabetes, and weight loss). However, subjects reported a significant impairment in all SF-36 domains. Ad hoc psychological interventions should be implemented to ameliorate the quality of life of these patients.
Highlights
The obesity epidemic has reached alarming proportions in western countries
This study aims to evaluate the quality of life (QoL) in patients who underwent biliointestinal bypass (BIB) procedure in a 10-year follow-up period
Our follow-up study showed good results considering the traditional outcomes of bariatric surgery, but less clear findings considering QoL and self-reported overall satisfaction
Summary
The obesity epidemic has reached alarming proportions in western countries. In the United States 34% of the population is obese (Flegal et al, 2010) and, in many European countries, including Spain, Italy, and United Kingdom, the prevalence of obesity is up to 20% (Berghöfer et al, 2008). BIB and other bariatric surgery procedures have demonstrated relevant short-term effects considering primary clinical outcomes (i.e., weight loss and improvements of comorbid conditions), it is well-established that after the first year of intervention many patients start to gradually regain weight over several years (Karlsson et al, 2007), as well as it was observed how some psychological factors, such as alexithymia, are implicated in long-term weight regain (e.g., Lai et al, 2016; Paone et al, 2017). In addition to primary outcomes previously mentioned, several bariatric surgery studies considered quality of life (QoL) as a reliable outcome of surgical interventions efficacy (Hell et al, 2000; Nguyen et al, 2001; Nickel et al, 2017), especially considering a long-term follow-up period (Karlsson et al, 2007). This study aims to evaluate long-term quality of life (QoL) and primary clinical outcomes, 10 years after biliointestinal bypass (BIB) surgery. BIB might show encouraging primary outcomes, long term QoL could be significantly impaired
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