Postoperative Outcomes, Weight Loss Predictors, and Late Gastrointestinal Symptoms Following Laparoscopic Sleeve Gastrectomy

Goldenshluger, Michael; Goldenshluger, Ariela; Keinan‐Boker, Lital; Cohen, Matan J.; Ben-Porat, Tair; Gerasi, Heba; Amun, M.; Abu-Gazala, Mahmud; Khalaileh, Abed; Mintz, Yoav; Elazary, Ram

doi:10.1007/s11605-017-3585-9

Cited by 25 publications

(15 citation statements)

References 28 publications

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“…It is therefore not known if the increased satiety was perceived as discomfort, equivalent to what has been reported in patients with IBS [ 15 ]. In line with previous studies [ 8 , 10 , 11 , 16 , 19 , 20 ], food intolerance was a common complication after the surgery. The finding of a correlation between increased satiety and reduced food tolerance in the present study implies that the increased satiety was in part an unfavorable outcome.…”

Section: Discussionsupporting

confidence: 86%

Changes in gastrointestinal symptoms and food tolerance 6 months following weight loss surgery: associations with dietary changes, weight loss and the surgical procedure

Kvehaugen

Farup

2018

BMC Obes

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BackgroundGastrointestinal (GI) co-morbidity is common in obese patients, but the effect of weight loss surgery on GI symptoms is incompletely elucidated. The aims of the present study were to explore changes in GI symptoms and food tolerance following weight loss surgery and to study whether such changes were associated with dietary modifications and/or the type of surgical procedure [Roux-en-Y Gastric Bypass (RYGB) versus Vertical Sleeve Gastrectomy (VSG)].MethodsParticipants: Patients with morbid obesity scheduled for weight loss surgery.The patients filled in paper-based questionnaires addressing diet, GI symptoms (bloating, pain, satiety, constipation and diarrhea) and food tolerance/quality of alimentation (satisfaction about current food intake, tolerance to specific foods and frequency of vomiting/regurgitation/reflux) 6 months prior to and 6 months after the surgery. Patients with pre-existing major GI co-morbidity or previous major GI surgery were excluded.ResultsFifty-four patients (RYGB/VSG: 43/11) were included. Constipation and satiety increased and food tolerance decreased significantly after the surgery (all p-values < 0.05). The increase in satiety was significantly more notable after VSG than after RYGB (p < 0.05).The increase in satiety also correlated with an overall reduction in food tolerance (rho: -0.488, p < 0.01). Divergent changes were seen in the frequency of vomiting/regurgitation/reflux, with a decline after RYGB (p = 0.01) and an increase after VSG (p = 0.06). Intakes of energy, macronutrients, fiber and fluid decreased significantly after the surgery (all p-values < 0.05), but did not correlate with the changes in constipation, satiety or food tolerance (all p-values > 0.05). Pre-operatively, total energy intake correlated with bloating and abdominal pain (rho = 0.343 and 0.310 respectively, p < 0.05 for both), but these correlations did not persist 6 months after the surgery (rho = 0.065 and 0.054 respectively, p > 0.05 for both).ConclusionA high caloric intake may explain some of the GI symptoms experienced by non-operated obese patients. The worsening or new-onset of symptoms post-surgery is likely due to anatomical or physiological alterations following surgery. The increase in satiety and the decrease in food tolerance are likely explained by the restrictive nature of the surgeries, as satiety increased more after VSG than after RYGB and correlated with an overall reduction in food tolerance.

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Section: Discussionsupporting

confidence: 86%

Changes in gastrointestinal symptoms and food tolerance 6 months following weight loss surgery: associations with dietary changes, weight loss and the surgical procedure

Kvehaugen

Farup

2018

BMC Obes

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“…It did not report on the way physical activity was identified or measured. Increased physical activity levels were reported to be associated with higher postoperative weight loss 10 . The measure of association was not reported.…”

Section: Resultsmentioning

confidence: 98%

“…As such, increasing emphasis is now being placed on identifying modifiable preoperative predictors 9 . A subset of these are behavioural factors such as preoperative weight loss, eating behaviours, physical activity, tobacco use and substance abuse 8,10‐13 . Findings in this area could subsequently be used to formulate interventions similar to prehabilitation programmes used in multiple other disciplines of surgery 14 …”

Section: Introductionmentioning

confidence: 99%

Weight loss in adults following bariatric surgery, a systematic review of preoperative behavioural predictors

et al. 2020

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Summary Bariatric surgery is effective in treating obesity in many cases, yet as many as 50% of patients may not achieve the desired weight reduction. Preoperative modifiable behavioural factors could help patient selection and intervention design to improve outcomes. Medline, EMBASE, Cochrane Library and PsychINFO were searched to identify studies published between 1 January 2008 and 14 February 2019 reporting on preoperative modifiable behavioural factors associated with postoperative weight loss, with minimum 2 years follow‐up. A total of 6888 articles were screened, 34 met the inclusion criteria. Maladaptive eating behaviours (MEB), preoperative weight loss (PWL), and tobacco use were reported 21, 18, and 3 times respectively. Physical activity and substance abuse were each reported once. Most articles on PWL (72.2%) and MEB (52.4%) reported no association. Positive associations were reported in 22.2% and 14.3% of articles for PWL and MEB respectively. Negative associations were reported in 5.6% and 33.3% of articles for PWL and MEB, respectively. Marked heterogeneity in outcome reporting hindered quantitative synthesis. The current paucity of evidence amenable to synthesis leads to ongoing uncertainty regarding the size and direction of association between PWL and MEB with outcomes following bariatric surgery. Long‐term studies with common reporting of outcomes are needed.

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“…Albanopoulos 27 informó la reducción del reflujo gastroesofágico en el 9,2%, pero en el 11,4% de los casos, nuevos casos de ERGE aparecieron a los 36 meses. Goldenshluger 28 informó recientemente una remisión del 60,7% para el reflujo gastroesofágico. Angrisani 29 asocia la remisión de los síntomas de ERGE con el % de pérdida de peso después de 5 años de seguimiento.…”

Section: Síntomasunclassified

“…En la actualidad, a los 5-9 años de seguimiento, el esófago de Barrett aumenta a 4,8%. Muchos autores de los ya antes citados han señalado lo mismo [12][13][14][15][16][17][20][21][22][23][24][25][26][27][28] . De acuerdo con estas experiencias, hemos observado esofagitis endoscópica muy severa (Grado C) después de la GVT (Tabla 3).…”

Section: Esofagitis Posoperatoria Esófago De Barrett Y Hernia Hiatalunclassified

Consecuencias clínicas posgastrectomía vertical tubular: enfermedad por reflujo gastroesofágico

Braghetto

2018

Rev Chil Cir

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Clinical consequences post tubular vertical gastrectomy: gastroesophageal reflux disease Several publications report an increase in the rate of gastroesophageal reflux disease (GERD) after surgery, although there is still no consensus on this. The aim of this article is to show our own experience and literature regarding the clinical aspects of GERD disease after tubular vertical gastrectomy. From the analysis of our results and data from the literature, studies evaluating the prevalence of postoperative gastro-oesophageal reflux disease show that GVT can cause symptoms of de novo GERD or worsening of pre-existing GERD.

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Postoperative Outcomes, Weight Loss Predictors, and Late Gastrointestinal Symptoms Following Laparoscopic Sleeve Gastrectomy

Abstract: Our study shows LSG as a potential tool in achieving almost 75% of EWL% with significant remission of co-morbidities, along with various late gastrointestinal symptoms.

Cited by 25 publications

References 28 publications

Changes in gastrointestinal symptoms and food tolerance 6 months following weight loss surgery: associations with dietary changes, weight loss and the surgical procedure

Changes in gastrointestinal symptoms and food tolerance 6 months following weight loss surgery: associations with dietary changes, weight loss and the surgical procedure

Weight loss in adults following bariatric surgery, a systematic review of preoperative behavioural predictors

Consecuencias clínicas posgastrectomía vertical tubular: enfermedad por reflujo gastroesofágico

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