Effect of preoperative weight loss in bariatric surgical patients: a systematic review

Cassie, Scott; Menezes, Carlos; Birch, Daniel W.; Shi, Xinzhe; Karmali, Shahzeer

doi:10.1016/j.soard.2011.08.011

Cited by 125 publications

(85 citation statements)

References 31 publications

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“…This review focuses on understanding merits and demerits of each intervention and attempts to examine evidence base in support of each. We did not attempt to carry out a systematic review as several systematic reviews have already examined the evidence base for preoperative weight loss, the most commonly used preoperative intervention [2][3][4]. For other interventions, the body of evidence is so small that it would preclude any meaningful quantitative or qualitative synthesis of data.…”

Section: Methodsmentioning

confidence: 99%

Preoperative Interventions for Patients Being Considered for Bariatric Surgery: Separating the Fact from Fiction

et al. 2015

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Preoperative interventions aimed at patients referred for bariatric surgery continue to divide funders, commissioners, and practitioners alike. A number of preoperative interventions and variables have been used to influence patient selection. Many of these are believed to lead to better postoperative outcomes by helping target a limited resource (bariatric surgery) at those most likely to benefit. Inevitably, this leads to competition amongst patients and some being denied benefits of surgery. There is a risk that these strategies for resource allocation may actually deprive the most vulnerable and those most in need. This review examines evidence and justification behind popular preoperative interventions for patients being considered for bariatric surgery patients in the light of published English language scientific literature.

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Section: Methodsmentioning

confidence: 99%

Preoperative Interventions for Patients Being Considered for Bariatric Surgery: Separating the Fact from Fiction

et al. 2015

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“…In a retrospective analysis of 884 patients, Still et al (24) found that patients who lost >5% EBW preoperatively were more likely to have a shorter LoS compared to those with less pronounced weight loss. In a systematic review, Cassie et al (10) pooled data from five studies with heterogeneous designs and reported, based on their analysis, that the mean LoS after preoperative weight loss was 3.34 days compared to 3.98 days for the non-preoperative weight loss patients (p < 0.05). In these uncontrolled studies, LoS as a parameter obviously suffers from several biases, some of the most important being the time relationship between changes in routines for postoperative hospital stay and preoperative dietary recommendations, increased hospital volume and surgical skills.…”

Section: Losmentioning

confidence: 99%

Weight loss prior to bariatric surgery: An updated review of the literature

2014

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Background and Aims: prior to bariatric surgery, a preoperative weight-reducing regimen is usually adhered to in most centers. the clinical effects of such a regimen are yet to be determined.Material and Methods: We reviewed the current literature by searching in pubMed for publications reporting clinical effects resulting from a preoperative weight loss regimen prior to bariatric surgery published from January 1, 1995 to april 30, 2014.Results: in total, we identified 23 original publications and 2 review articles which met all inclusion criteria. these were included and fully analyzed with regard to effects of preoperative weight loss. in general, for parameters such as operating time and intraoperative complications including blood loss and recovery, inconsistent data were reported. Most studies included low number of patients and with heterogenic designs, and the results could not form the base for recommendations. however, for outcomes such as postoperative complications and weight development over time, data from large-scale studies and randomized controlled trials suggest beneficial effects following adherence to weight loss prior to bariatric surgery.Conclusion: although a large amount of data in the current literature on the effects of weight loss prior to bariatric surgery are inconsistent for many outcome parameters, recently published results regarding effects on postoperative complications and weight development over time strongly suggest that such a regimen should be recommended. Whether a certain degree of weight loss should be mandatory before being accepted for bariatric surgery is, however, still controversial.

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“…Weight loss of 5 % of excess body weight or 10 % of total weight is associated with reduced liver volume and shortened operative time [54][55][56]. Whether preoperative weight loss has an impact on long-term outcomes such as postoperative weight loss and resolution of comorbidities is still unclear [57][58][59][60]. There is a concern that patients who are unable to lose some amount of weight prior to bariatric surgery will be unable to comply with medical advice and the necessary dietary restrictions after surgery.…”

Section: Preoperative Weight Loss and Glycemic Controlmentioning

confidence: 99%