Long-term weight loss outcomes after banded Roux-en-Y gastric bypass: a prospective 10-year follow-up study

Magro, Daniéla Oliveira; Ueno, Mirian; Coelho-Neto, João de Souza; Callejas-Neto, Francisco; Pareja, José Carlos; Cazzo, Everton

doi:10.1016/j.soard.2018.03.023

Cited by 37 publications

(13 citation statements)

References 26 publications

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“…Although not performed during the study period, closure of mesenterial defects is routine practice at our institution. Our 9.7% rate of cholecystectomy is lower than what is reported by others, which could be related to our recommended use of prophylactic ursodeoxycholic acid [6,12].…”

Section: Discussioncontrasting

confidence: 69%

“…Short-term and medium-term outcomes are well documented and include health benefits such as significant weight loss, improvement in obesity-related comorbidities and improved quality of life (QoL) [ 1 – 5 ]. A limited number of studies reports on outcomes 10 years and beyond after RYGB [ 6 – 18 ]. Available studies indicate sustained weight loss and high remission rates of diabetes, hypertension, and dyslipidemia after RYGB.…”

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confidence: 99%

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Health benefits and risks during 10 years after Roux-en-Y gastric bypass

et al. 2020

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Background Long-term evaluations 10 years after Roux-en-Y gastric bypass (RYGB) are limited. We report the development in weight and cardiovascular risk factors during 10 years after laparoscopic RYGB, with evaluation of gastrointestinal symptoms and quality of life (QoL) at 10-year follow-up. Methods We performed a prospective longitudinal cohort study. Patients operated with laparoscopic RYGB from May 2004 to November 2006 were invited to 10-year follow-up consultations. Gastrointestinal Symptom Rating Scale (GSRS) questionnaire and two QoL questionnaires were used for analyses of gastrointestinal symptoms and QoL. Results A total of 203 patients were operated; nine (4.4%) died during follow-up. Of 194 eligible patients, 124 (63.9%) attended 10-year follow-up consultations. Percent excess weight loss (%EWL) and percent total weight loss (%TWL) at 10 years were 53.0% and 24.1%, respectively. %EWL > 50% was seen in 53.2%. Significant weight regain (≥15%) from 2 to 10 years was seen in 63.3%. Remission rates of type 2 diabetes, dyslipidemia, and hypertension were 56.8%, 46.0%, and 41.4%, respectively. Abdominal operations beyond 30 days after RYGB were reported in 33.9%. Internal hernia and ileus (13.7%) and gallstone-related disease (9.7%) were the most common causes. Vitamin D deficiency (<50nmol/L) was seen in 33.3%. At 10 years, bothersome abdominal pain and indigestion symptoms (GSRS scores ≥3) were reported in 42.9% and 54.0%, respectively, and were associated with low QoL. Conclusion We observed significant weight loss and remission of comorbidities 10 years after RYGB. Significant weight regain occurred in a substantial subset of patients. Gastrointestinal symptoms were common and negatively impacted QoL. Keywords Long-term outcomes • Gastric bypass • Weight loss • Cardiovascular risk factors • Gastrointestinal symptoms Roux-en-Y gastric bypass (RYGB) surgery is commonly applied for the treatment of morbid obesity. Short-term and medium-term outcomes are well documented and include health benefits such as significant weight loss, improvement in obesity-related comorbidities and improved quality of life (QoL) [1-5]. A limited number of studies reports on outcomes 10 years and beyond after RYGB [6-18]. Available studies indicate sustained weight loss and high remission rates of diabetes, hypertension, and dyslipidemia after RYGB. The follow-up rates, however, are often low. Long-term evaluations on gastrointestinal symptoms after RYGB are limited. We have previously observed high rates of such symptoms 2 and 5 years after RYGB [19, 20]. Long-term evaluations and knowledge of such symptoms may improve the quality of health care for these patients. Pending results from national and multinational databases will enlighten long-term outcomes after bariatric surgery. However, prospective cohort studies may supplement larger register-based studies, with in-depth individual evaluations. A single-center cohort study aiming to report weight development and remission of metabolic comorbidities, gastrointestinal symptom...

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Section: Discussioncontrasting

confidence: 69%

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confidence: 99%

Health benefits and risks during 10 years after Roux-en-Y gastric bypass

et al. 2020

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“…There is no consensus regarding the influence of the use of a silicone ring or not on weight loss outcomes. A prospective 10-year study by Magro et al reported a %EWL of 79.7% and a %BMIL of 30.8% among individuals with morbid obesity following banded RYGB (18) . Heneghan et al have reported a better weight loss after banding RYGB, especially among individuals with super obesity, and also a low band-related morbidity (8) .…”

Section: Discussionmentioning

confidence: 99%

Early Weight Loss Outcomes and Glucose Metabolism Parameters After Banded Versus Non-Banded One Anastomosis Gastric Bypass: A Prospective Randomized Trial

Cazzo

Valerini

Chaim

et al. 2019

Arq. Gastroenterol.

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BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.

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“…BGBP is as effective as BPD-DS for weight loss and maintenance [104]. Weight loss peaks around 18-24 months after the procedure with maintenance of 70.0-80.0% EWL reported at 4-12 years of follow-up [97,104,105] and significant TBWL of 32.5% [106]. There is slightly better resolution of T2DM and hypertension with BGBP associated with its higher long-term weight loss and maintenance [105].…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 94%

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Bhandari

Fobi

Buchwald³

2019

OBES SURG

109

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Background Standardization of the key measurements of a procedure's finished anatomic configuration strengthens surgical practice, research, and patient outcomes. A consensus meeting was organized to define standard versions of 25 bariatric metabolic procedures. Methods A panel of experts in bariatric metabolic surgery from multiple continents was invited to present technique descriptions and outcomes for 4 classic, or conventional, and 21 variant and emerging procedures. Expert panel and audience discussion was followed by electronic voting on proposed standard dimensions and volumes for each procedure's key anatomic alterations. Consensus was defined as ≥ 70% agreement. Results The Bariatric Metabolic Surgery Standardization World Consensus Meeting (BMSS-WOCOM) was convened March 22-24, 2018, in New Delhi, India. Discussion confirmed heterogeneity in procedure measurements in the literature. A set of anatomic measurements to serve as the standard version of each procedure was proposed. After two voting rounds, 22/25 (88.0%) configurations posed for consideration as procedure standards achieved voting consensus by the expert panel, 1 did not attain consensus, and 2 were not voted on. All configurations were voted on by ≥ 50% of 50 expert panelists. The Consensus Statement was developed from scientific evidence collated from presenters' slides and a separate literature review, meeting video, and transcripts. Review and input was provided by consensus panel members. Conclusions Standard versions of the finished anatomic configurations of 22 surgical procedures were established by expert consensus. The BMSS process was undertaken as a first step in developing evidence-based standard bariatric metabolic surgical procedures with the aim of improving consistency in surgery, data collection, comparison of procedures, and outcome reporting.

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Long-term weight loss outcomes after banded Roux-en-Y gastric bypass: a prospective 10-year follow-up study

Cited by 37 publications

References 26 publications

Health benefits and risks during 10 years after Roux-en-Y gastric bypass

Health benefits and risks during 10 years after Roux-en-Y gastric bypass

Early Weight Loss Outcomes and Glucose Metabolism Parameters After Banded Versus Non-Banded One Anastomosis Gastric Bypass: A Prospective Randomized Trial

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

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