Metabolic effects and outcomes of sleeve gastrectomy and gastric bypass: a cohort study
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and Other Interventional Techniques
Metabolic effects and outcomes of sleeve gastrectomy and gastric bypass: a cohort study B. Calvo1 · J. A. Gracia1 · M. A. Bielsa1 · M. Martínez1 Received: 27 June 2019 / Accepted: 24 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The outcomes of bariatric surgery should not be evaluated only for weight loss purposes but from a wider point of view that is closer to the reality of morbidly obese patients. The study of the influence of bariatric surgery over obesityrelated diseases in bariatric patients is worthwhile. Methods We present a cohort study of 329 patients who underwent either laparoscopic sleeve gastrectomy (LSG: 165 patients) or laparoscopic gastric bypass (LRYGBP: 164). We analyzed complication rate, comorbidities and weight loss evolution. Results Both groups were comparable in demographic characteristics at baseline. Significant statistical differences were found in length of hospital stay and operative time (both were lower in the LSG group). Bleeding and wound infection were higher in the LRYGBP group, as it happened with intestinal occlusion as a late complication (p 30 days after surgery). Type 2 diabetes remission was defined as normal values of fasting glycemia and glycated hemoglobin with no hypoglycemic treatment. We defined arterial hypertension remission as normal blood pressure without medication. Dyslipidemia remission was defined as normal plasma lipid values without medication. Laboratory assessment included blood count, fasting glucose, HbA1C, serum folate, serum iron, B12 vitamin, D vitamin, proteins and parathyroid hormone. The International Diabetes Federation (IDF) definition of metabolic syndrome (MeTS) [12] was used for this study: Central obesity (defined as waist circumference ≥ 94 cm for Europid men and ≥ 80 cm for Europid women, with
Surgical Endoscopy
ethnicity-specific values for other groups) AND any two of the following factors:
Table 1 Preoperative obesity-related morbidity
– Raised triglycerides, > 150 mg/dL (1.7 mmol/L), or specific treatment for this lipid abnormality. – Reduced HDL cholesterol, 85 mm Hg, or treatment of previously diagnosed hypertension. – Raised fasting plasma glucose (FPG), > 100 mg/dL (5.6 mmol/L), or previously diagnosed type 2 diabetes. If FPG > 5.6 mmol/L or 100 mg/dL, oral glucose tolerance test is strongly recommended but it is not necessary to define presence of the syndrome.
Hypertension T2D OSA Hyperlipidemia Cardiovascular disease Musculoskeletal disease GERD Deep vein thrombosis Cholelithiasis
If body mass index (BMI) is > 30 kg/m2, central obesity can be assumed, and waist circumference does not need to be measured. Data are expressed as the mean ± standard deviation and median with interquartile range for quantitative variables. Nominal variables are expressed using numbers with the corresponding percentages in parentheses, unless indicated otherwise. p 0.05). Preoperative obesity-related morbidity was similar in both groups as n
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