Tackling Obesity Through Bariatric Surgery: Long-Term Outcomes and Complication Rates
Main Article Content
Abstract
Background: The prevalence of obesity and its associated health risks have led to a growing interest in bariatric surgery as a treatment option. Sleeve gastroplasty, a common bariatric procedure, has shown promise in addressing obesity-related issues. However, comprehensive studies evaluating its long-term effectiveness and safety are needed to understand its full impact on patient health, including both physical and mental aspects.
Objective: This study aimed to compare the safety and effectiveness of sleeve gastroplasties by assessing patients who underwent the surgery (Patient Group, PG) against those who did not (Control Group, CG). The primary focus was on the resolution of obesity comorbidities, overall surgical morbidity, severe surgical complications, mental health outcomes, and total weight loss percentage (TWL%) over two years.
Methods: The study involved 136 participants, evenly divided between the PG and CG. Propensity Score Matching (PSM) was utilized to ensure balanced comparisons. Key measures included TWL%, resolution of obesity comorbidities, severe surgical complications, total surgical morbidity, and mental health adverse events. Statistical analyses were conducted to identify significant differences between the groups at the two-year follow-up.
Results: After one year, the PG exhibited a TWL% of 32.7%, whereas the CG showed 36.6%, a statistically significant difference (p = 0.002). Surgical morbidity was notably higher in the PG (28%) compared to the CG (17%), with a significant difference (p = 0.01). Severe surgical complications were similar between groups (4% in PG vs. 3% in CG, p = 0.44). Mental health adverse events were more prevalent in the PG. Both groups had comparable remission rates of obesity-related comorbidities at the one-year mark.
Conclusion: The study demonstrated that sleeve gastroplasties result in effective weight reduction, as evidenced by the TWL% differences. However, the higher incidence of surgical morbidity and mental health issues in the PG underscores the need for comprehensive care, addressing both the physical and psychological aspects of bariatric surgery. Future research should focus on identifying factors influencing these outcomes to optimize the benefits of sleeve gastroplasties, considering individual patient profiles.
Article Details
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Minhas AM, Gupta K, Jain V, Kakar TS, Merchant AT, Shapiro MD, et al. Trends in cardiovascular mortality in the United States from 1968 to 2019: analysis of the CDC WONDER database. Eur J Prev Cardiol. 2023 Aug 24;zwad278.
Courcoulas AP, Daigle CR, Arterburn DE. Long term outcomes of metabolic/bariatric surgery in adults. BMJ. 2023 Dec 18;383.
Williamson K, Blane DN, Lean ME. Challenges in obtaining accurate anthropometric measures for adults with severe obesity: A community-based study. Scand J Public Health. 2023 Aug;51(6):935-43.
American Society for Metabolic and Bariatric Surgery. Estimate of Bariatric Surgery Numbers, 2011-2020. 2022.
El Ansari W, El-Ansari K, Lock M. Mind the Overlap! Meta-Analyses That Synthesize the Findings of Primary Studies Based on Large Data Registries: the Case of Metabolic and Bariatric Surgery. Obes Surg. 2023 Oct 5;1-3.
Simonson DC, Vernon A, Foster K, Halperin F, Patti ME, Goldfine AB. Adjustable gastric band surgery or medical management in patients with type 2 diabetes and obesity: three-year results of a randomized trial. Surg Obes Relat Dis. 2019 Dec 1;15(12):2052-9.
Kirwan JP, Courcoulas AP, Cummings DE, Goldfine AB, Kashyap SR, Simonson DC, et al. Diabetes remission in the alliance of randomized trials of medicine versus metabolic surgery in type 2 diabetes (ARMMS-T2D). Diabetes Care. 2022 Jul 7;45(7):1574-83.
Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med. 2017 Feb 16;376(7):641-51.
Ikramuddin S, Korner J, Lee WJ, Thomas AJ, Connett JE, Bantle JP, et al. Lifestyle intervention and medical management with vs without Roux-en-Y gastric bypass and control of hemoglobin A1c, LDL cholesterol, and systolic blood pressure at 5 years in the diabetes surgery study. Jama. 2018 Jan 16;319(3):266-78.
Courcoulas AP, Gallagher JW, Neiberg RH, Eagleton EB, DeLany JP, Lang W, et al. Bariatric surgery vs lifestyle intervention for diabetes treatment: 5-year outcomes from a randomized trial. J Clin Endocrinol Metab. 2020 Mar;105(3):866-76.
Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Capristo E, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2021 Jan 23;397(10271):293-304.
Pouwels S, Omar I, Aggarwal S, Aminian A, Angrisani L, Balibrea JM, et al. The first modified Delphi consensus statement for resuming bariatric and metabolic surgery in the COVID-19 times. Obes Surg. 2021 Jan;31:451-6.
Aminian A, Al-Kurd A, Wilson R, Bena J, Fayazzadeh H, Singh T, et al. Association of bariatric surgery with major adverse liver and cardiovascular outcomes in patients with biopsy-proven nonalcoholic steatohepatitis. Jama. 2021 Nov 23;326(20):2031-42.
Verrastro O, Panunzi S, Castagneto-Gissey L, De Gaetano A, Lembo E, Capristo E, et al. Bariatric–metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomised trial. Lancet. 2023 May 27;401(10390):1786-97.
Albaugh VL, Kindel TL, Nissen SE, Aminian A. Cardiovascular risk reduction following metabolic and bariatric surgery. Surg Clin. 2021 Apr 1;101(2):269-94.
O'Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013 Jan;257(1):87-94. doi: 10.1097/SLA.0b013e31827b6c02. PMID: 23235396.
Golzarand M, Toolabi K, Farid R. The bariatric surgery and weight losing: a meta-analysis in the long- and very long-term effects of laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass, and laparoscopic sleeve gastrectomy on weight loss in adults. Surg Endosc. 2017 Nov;31(11):4331-4345. doi: 10.1007/s00464-017-5505-1. Epub 2017 Apr 4. PMID: 28378086.
Abu-Gazala S, Keidar A. Conversion of failed gastric banding into four different bariatric procedures. Surg Obes Relat Dis. 2012 Jul-Aug;8(4):400-7. doi: 10.1016/j.soard.2011.06.009. Epub 2011 Jun 30. PMID: 21937286.
Chansaenroj P, Aung L, Lee WJ, Chen SC, Chen JC, Ser KH. Revision procedures after failed adjustable gastric banding: comparison of efficacy and safety. Obes Surg. 2017 Nov;27(11):2861-2867. doi: 10.1007/s11695-017-2716-4. PMID: 28569358.
Gulinac M, et al. Long-term effectiveness, outcomes, and complications of bariatric surgery. World J Clin Cases. 2023 Jul 6;11(19):4504-4512. doi: 10.12998/wjcc.v11.i19.4504. PMID: 37469732.