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Predictability of first-year weight loss in laparoscopic sleeve gastrectomy

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Abstract

Background

Bariatric surgery is a significant investment for the patient and weight loss team. In some cases, this includes a requirement for pre-operative weight loss despite the lack of evidence for a correlation with successful outcomes. We sought to determine whether weight loss on a short, immediate pre-operative diet, as well as across the medical weight loss program, would correlate with 1-year outcomes of patients undergoing laparoscopic sleeve gastrectomy (LSG).

Methods

All patients having a LSG between March 2013 and March 2016 were reviewed. Demographics and biometrics [weight, body mass index (BMI)] were collected at initial, day of surgery and follow-up (2 weeks, 6 weeks, 4 months, and 1 year). Pre-operative weight loss was determined both cumulative (initial to day of surgery) and for the pre-operative diet (2 weeks). Weight loss and percent excess weight loss (%EWL) were calculated and correlated at all time points.

Results

A total of 127 patients were reviewed for this study. The mean %EWL at 1-year follow-up was 47 ± 18%. Weight loss achieved on a 2-week pre-operative diet did not correlate with weight outcomes at 1-year follow-up (r = 0.134, p = 0.40); however, cumulative pre-operative weight loss had a modest correlation (r = 0.443, p < 0.01). Post-operative %EWL at 4 months had the best correlation with longer term weight loss (r = 0.730, p < 0.01).

Conclusions

Pre-operative performance is not a good predictor for 1-year outcomes in LSG. Better correlation was observed in %EWL at post-surgery visits. Following the patient’s trajectory post-operatively may provide a window for intervention to improve weight loss.

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Authors and Affiliations

  1. Department of Surgery, Mount Sinai Hospital, 1500 South Fairfield Avenue, Chicago, IL, USA

    Allison G. McNickle

  2. Division of Minimally Invasive Surgery, Department of Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA

    Steven R. Bonomo

  3. Department of Surgery, University of Nevada School of Medicine, 1701 West Charleston Blvd, Suite 400, Las Vegas, NV, 89102, USA

    Allison G. McNickle

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  1. Allison G. McNickle
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  2. Steven R. Bonomo
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Correspondence to Allison G. McNickle.

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Disclosure

Allison G. McNickle and Steven R. Bonomo have no conflicts of interest or financial ties to disclose.

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McNickle, A.G., Bonomo, S.R. Predictability of first-year weight loss in laparoscopic sleeve gastrectomy. Surg Endosc 31, 4145–4149 (2017). https://doi.org/10.1007/s00464-017-5467-3

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