Pre-specified Weight Loss Before Bariatric Surgery and Postoperative Outcomes

Chinaka, Ugochukwu; Fultang, Joshua; Ali, Abdulmajid; Rankin, Jean; Bakhshi, Andisheh

doi:10.7759/cureus.12406

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Consistent with previous publications in the literature, the respondents' opinion of the benefits of preoperative weight loss on outcomes was inconsistent. There is not enough high quality evidence showing benefits of preoperative weight loss [25]. Further validation may need to be carried out.…”

Section: Discussionmentioning

confidence: 99%

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

et al. 2022

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Background Bariatric surgery in patients with BMI over 50 kg/m2 is a challenging task. The aim of this study was to address main issues regarding perioperative management of these patients by using a worldwide survey. Methods An online 48-item questionnaire-based survey on perioperative management of patients with a BMI superior to 50 kg/m2 was ideated by 15 bariatric surgeons from 9 different countries. The questionnaire was emailed to all members of the International Federation of Surgery for Obesity (IFSO). Responses were collected and analyzed by the authors. Results 789 bariatric surgeons from 73 countries participated in the survey. Most surgeons (89.9%) believed that metabolic/bariatric surgery (MBS) on patients with BMI over 50 kg/m2 should only be performed by expert bariatric surgeons. Half of the participants (55.3%) believed that weight loss must be encouraged before surgery and 42.6% of surgeons recommended an excess weight loss of at least 10%. However, only 3.6% of surgeons recommended the insertion of an Intragastric Balloon as bridge therapy before surgery. Sleeve Gastrectomy (SG) was considered the best choice for patients younger than 18 or older than 65 years old. SG and One Anastomosis Gastric Bypass were the most common procedures for individuals between 18 and 65 years. Half of the surgeons believed that a 2-stage approach should be offered to patients with BMI > 50 kg/m2, with SG being the first step. Postoperative thromboprophylaxis was recommended for 2 and 4 weeks by 37.8% and 37.7% of participants, respectively. Conclusion This survey demonstrated worldwide variations in bariatric surgery practice regarding patients with a BMI superior to 50 kg/m2. Careful analysis of these results is useful for identifying several areas for future research and consensus building.

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Section: Discussionmentioning

confidence: 99%

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

et al. 2022

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“…Many bariatric surgery services withhold surgery to patients who do not meet a target weight loss, 15 , 16 despite the lack of scientific evidence to justify such practice. 17 The dominant weight-centric paradigm in healthcare services may have unintentional negative consequences, including stigmatisation, and therefore there are calls to move away from a weight-centric to health-focused approach to patient care. 13 …”

Section: Introductionmentioning

confidence: 99%

“Is it time to throw out the weighing scales?” Implicit weight bias among healthcare professionals working in bariatric surgery services and their attitude towards non-weight focused approaches

et al. 2023

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“…A parameter that has not been examined yet in the context of gastric wall thickness is preoperative weight loss (PWL). Currently, available data concerning the beneficial effects of preoperative weight loss on the outcomes of bariatric surgery are inconclusive [8][9][10][11]. Nevertheless, we encourage patients to lose their body weight up to 5-10% of the initial body weight before the surgery due to the subjectively greater simplicity of carrying out the surgery.…”

Section: Introductionmentioning

confidence: 99%

Influence of preoperative weight loss on gastric wall thickness—analysis of laparoscopic sleeve gastrectomy histological material

Barski¹,

Binda²,

Jaworski³

et al. 2022

Langenbecks Arch Surg

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Purpose The variables possibly enabling the prediction of gastric wall thickness during laparoscopic sleeve gastrectomy remain undetermined. The aim of the study was to identify preoperative factors affecting gastric wall thickness in patients undergoing laparoscopic sleeve gastrectomy. Methods The measurements of the double-wall thickness of gastric specimen excised during sleeve gastrectomy were taken at three locations after 15 s of compression with an applied pressure of 8 g/mm2. Statistical calculations were used to determine the influence of preoperative weight loss and other perioperative parameters on gastric wall thickness. Results The study involved one hundred patients (78 female; 22 male). The thickest tissue was observed at the antrum with the mean value 2.55 mm (range 1.77–4.0 mm), followed by the midbody, mean 2.13 mm (range 1.34–3.20 mm), and the fundus, mean 1.69 mm (range 0.99–2.69 mm). Positive relationships were found between gastric wall thickness and both preoperative weight loss and age in all three measured locations; p < 0.05. In a linear regression model, age and preoperative weight loss were found to be statistically significant and positive predictors of higher gastric wall thickness only at the antrum. Male patients were observed to have thicker gastric wall at all three locations as compared to female patients. Conclusion Preoperative weight loss should be considered an important factor influencing gastric wall thickness. Age and gender can also be helpful in predicting the varying tissue thickness. Anatomical region is a key factor determining thickness of the stomach walls.

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Pre-specified Weight Loss Before Bariatric Surgery and Postoperative Outcomes

Cited by 4 publications

References 23 publications

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

The first survey addressing patients with BMI over 50: a survey of 789 bariatric surgeons

“Is it time to throw out the weighing scales?” Implicit weight bias among healthcare professionals working in bariatric surgery services and their attitude towards non-weight focused approaches

Influence of preoperative weight loss on gastric wall thickness—analysis of laparoscopic sleeve gastrectomy histological material

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