Long-term evaluation of patients with BMI = 50kg/m2 who underwent Bariatric Surgery

Abstract

Purpose: to determine the risks and benefits of bariatric surgery in patients with super obesity (SO) in comparison with obesity grades II and III. Methods: retrospective cohort that included a study group of 178 patients with SO and a control group of 181 patients with BMI 35-49.9Kg/m2. The groups were formed in a 1:1 nearest neighbor matching. The main variables were pre- and postoperative BMI and comorbidities, occurrence of severe postoperative complications, bowel obstruction, marginal ulcer, fistulae and 30-day death, besides the necessity of emergency room (ER) admission and abdominal computed tomography (CT) scans in the postoperative period due to acute abdomen. Results: the study group comprised 74.0% of women while the control group had 56.7%. The mean follow-up time was similar between both groups (5.48 x 6.09 years, p=0.216). There was no statistically significant difference on the prevalence of hypertension and T2D between the groups according to the surgical technique. All deaths occurred in the Study group (BMI = 50kg/m2) who underwent RYGB. There was no difference between the groups regarding the occurrence of severe complications. Data on ER admissions and the need for abdominal CT to investigate postoperative abdominal pain did not show statistically significant difference between the groups. Conclusion: despite the high risk related to bariatric surgery in patients with SO, the benefits related to the remission of comorbidities are significant; although being lower than those found in patients with milder grades of obesity.

A influência da cirurgia bariátrica no controle da síndrome metabólica

“…Diante disso, não restam dúvidas sobre a influência positiva da cirurgia na síndrome metabólica e o eficaz controle das comorbidades associadas a ela. 1,20 No entanto, apesar de todos esses benefícios, é fundamental ressaltar que o procedimento cirúrgico não exclui a necessidade de mudanças no estilo de vida como forma de evitar o reganho de peso e retrocesso do tratamento. O compromisso com hábitos saudáveis, alimentação equilibrada e prática regular de exercícios físicos são essenciais para o sucesso a longo prazo da cirurgia e para manter os resultados obtidos.…”

“…A abordagem multidisciplinar e o acompanhamento contínuo são fundamentais para garantir os benefícios duradouros da cirurgia bariátrica no tratamento da síndrome metabólica. 1,20…”