Is Laparoscopic Roux-en-Y Gastric Bypass Still the Gold Standard Procedure for Indians? Mid- to Long-Term Outcomes from
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Is Laparoscopic Roux-en-Y Gastric Bypass Still the Gold Standard Procedure for Indians? Mid- to Long-Term Outcomes from a Tertiary Care Center Shivanshu Misra 1 & B. Deepa Nandhini 1 & S. Christinajoice 1 & S. Saravana Kumar 1 & S. Prabhakaran 1 & C. Palanivelu 1 & P. Praveen Raj 1 Received: 24 April 2020 / Revised: 4 July 2020 / Accepted: 8 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Laparoscopic Roux-en-Y gastric bypass (RYGB) is the oldest and most widely performed bariatric surgery worldwide. There is, however, a scarcity of mid- to long-term data of RYGB, especially from the Indian subcontinent. Materials and Methods The study was a single-center, retrospective analysis from patients who underwent RYGB between January 2009 and November 2014 from a tertiary care center in India. Percent of total weight loss (%TWL) was taken as the primary outcome of the study. Secondary outcomes included type 2 diabetes mellitus (T2DM) remission, comorbidity resolution, revisional surgeries, and complications related to RYGB at 1 year, at 3 years, and during the long term, following surgery. Postoperative visits took place at 1 and 3 years, while the long-term outcome was at median 8.3 years (range 5.4–11.2 years), with a follow-up of 92.4% (488/528), 80.5% (424/527) and 69.5% (363/522), respectively. Results Out of 528 patients studied, 56% were females. The mean body mass index (BMI) was 40.6 ± 6.9 kg/m2. The %TWL in the long-term follow-up was 21.8 ± 11.3%. T2DM remission rates at 1 year, at 3 years, and during the long term were 84.5%, 70.0%, and 60.0%, respectively. Preoperative HBA1c (p = 0.002) and insulin usage (p = 0.016) had a significant predictive effect on T2DM remission. Gastroesophageal reflux disease (GERD) improved significantly (p < 0.001). Early (< 30 days) and late (> 30 days) complications were observed in 2.3% and 4.3% of the patients, respectively. Conclusion Weight loss during mid to long-term follow-up was maintained in the majority of the patients after RYGB. However, a small proportion had significant weight regain in the long term. T2DM, GERD, and other comorbidities were well improved after RYGB. Keywords Laparoscopic Roux-en-Y gastric bypass . RYGB . Long term . Weight loss . Type 2 diabetes mellitus . Comorbidity resolution . Revisions . Complications . Predictors of success
* P. Praveen Raj [email protected]
S. Saravana Kumar [email protected]
Shivanshu Misra [email protected]
S. Prabhakaran [email protected]
B. Deepa Nandhini [email protected]
C. Palanivelu [email protected]
S. Christinajoice [email protected]
1
Department of Bariatric and Metabolic Surgery, GEM Hospital & Research Center, Coimbatore, Tamil Nadu 641045, India
OBES SURG
Introduction Roux-en-Y gastric bypass (RYGB) is widely considered as the gold standard and a reference procedure in metabolic surgery. The surgery has well-sustained results of weight loss, diabetes control, and other comorbidity res
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