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Impact of Functional Laparoscopic Gastric Bypass with Fundectomy and Gastric Remnant Exploration (LRYGBfse) on Patients’ Quality of Life: Trajectory and 5-Year Follow-up Result

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Abstract

Purpose

Morbid obesity is associated with reduced patients’ perception quality of life (QoL). The health benefit of Laparoscopic Roux-en-Y gastric bypass (LRYGB) is well established with long-term weight control and QoL improvement. The laparoscopic functional gastric bypass with fundectomy and gastric remnant exploration (LRYGBfse) has been described with promising results in terms of weight loss and comorbid resolution. The purpose of this study was to investigate its contribution on patients’ QoL at 5-year follow-up.

Material and Methods

Multicenter prospective study (2009–2018). QoL was assessed at baseline and annually with the Gastrointestinal Quality of Life Index (GIQLI), Moorehead-Ardelt Quality of Life Questionnaire II (M-A-QoLQII), and Short-Form 36 (SF-36).

Results

Overall, 752 patients underwent the LRYGBfse. Three-hundred forty-four patients completed the 5-year follow-up. Median postoperative %TBWL at 1, 2, 3, and 5 years were 33.6, 33.9, 33.7, and 31.4%, respectively. Median GIQLI total score before and at 1, 2, 3, and 5 years after LRYGBfse was 82.6, 96.1, 113.1, 112.5, and 108.4. Median M-A-QoLQII total score before and at 1, 2, 3, and 5 years after surgery was 0.6, 1.6, 2.1, 2.0, and 1.6. Compared with baseline, the 5-year follow-up improvement was statistically significant for the GIQLI and M-A-QoLQII (p < 0.001). Similarly, all eight SF-36 items and both the Physical and Mental component scores were significantly improved (p < 0.001).

Conclusions

The functional LRYGBfse seems associated with a long-standing weight loss and QoL improvement. This seems driven by better gastrointestinal symptoms and physical and social functions combined with improved emotional aspects.

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Authors and Affiliations

  1. Department of General Surgery, Fondazione Salus Clinica Di Lorenzo, Via Vittorio Veneto 37, Avezzano, AQ, Italy

    Giovanni Lesti & Francesco Lesti

  2. Department of Biomedical Science for Health, Division of General Surgery, Istitituto Clinico Sant’Ambrogio, University of Milan, Milan, Italy

    Davide Bona, Andrea Sozzi, Gianluca Bonitta & Alberto Aiolfi

  3. Department of General and Emergency Surgery, Ospedale Fatebenefratelli Sacra Famiglia, University of Milan, Milan, Italy

    Marco Antonio Zappa

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Contributions

AA, FL, and MAZ did the literature search. AA, DB, and GL formed the study design. Data collection done by AA, FL, AS, GB, GL, and MAZ. AA, GB, GL, and DB analysed the data. AA, GL, DB, and MAZ interpreted the data. AA wrote the manuscript. AA, GL, DB, and MAZ critically reviewed the manuscript

Corresponding author

Correspondence to Alberto Aiolfi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lesti, G., Bona, D., Sozzi, A. et al. Impact of Functional Laparoscopic Gastric Bypass with Fundectomy and Gastric Remnant Exploration (LRYGBfse) on Patients’ Quality of Life: Trajectory and 5-Year Follow-up Result. OBES SURG 30, 3046–3053 (2020). https://doi.org/10.1007/s11695-020-04650-w

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