Effects of Perioperative Cannabis Use on Bariatric Surgical Outcomes: a Systematic Review
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ORIGINAL CONTRIBUTIONS
Effects of Perioperative Cannabis Use on Bariatric Surgical Outcomes: a Systematic Review Flora Jung 1 & Yung Lee 2,3 & Saba Manzoor 4 & Dennis Hong 3,5 & Aristithes G. Doumouras 3,5 Received: 20 June 2020 / Revised: 31 August 2020 / Accepted: 4 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose While cannabis is the most commonly used non-prescription drug in the USA and has established effects on weight, its implication for bariatric surgery has not been formally evaluated. We aimed to review the current literature on perioperative cannabis use in patients undergoing bariatric surgery. Materials and Methods Our systematic search of MEDLINE and Embase until March 2020 returned 169 citations. Screening and abstraction of results were performed in duplicate, and qualitative synthesis of the data was performed. Primary outcomes were cannabis use characteristics, weight loss outcomes, and 30-day postoperative morbidity. Study quality was assessed through the MINORS risk-of-bias tool. Results Six observational studies with a total of 1167 patients (78.6% female, median follow-up 12 months [3–38.4 months]) were included. A total of 9.9% of patients (n = 116/1167) used cannabis in the perioperative period. Compared with non-users, 1year weight loss was significantly higher in a study evaluating 8 preoperative cannabis users (n = 8/239, p = 0.002); however, there were no differences in single-study data on 90-day total weight loss (n = 434, p = 0.89) nor 2-year excess BMI loss (n = 146, p = 0.631). There was no difference in 30-day minor (RR 0.91, 95%CI 0.49–1.71, p = 0.77) or major morbidity (RR 0.75, 95%CI 0.31–1.79; p = 0.50). Conclusion There are only uncontrolled studies to date on cannabis use in bariatric surgery. While these have reported conflicting effects on weight loss and no effect on morbidity to date, validation in randomized trials is required to facilitate evidence-based recommendations. Keywords Obesity . Bariatric surgery . Metabolic surgery . Cannabis . Marijuana
Introduction The international prevalence of obesity has nearly doubled in 30 years and becomes a widespread priority for global health
[1, 2]. Bariatric surgery is the most effective and enduring treatment for severe obesity and has been performed at increasing frequencies in the high-income world [3–9]. However, the overall uptake of this treatment remains as low
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04962-x) contains supplementary material, which is available to authorized users. * Aristithes G. Doumouras [email protected] Flora Jung [email protected] Yung Lee [email protected]
2
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
3
Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
5
Centre for Minimal
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