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Laparoscopic sleeve gastrectomy is an independent predictor of poor follow-up and reaching ≤ 40% excess body weight loss at 1, 2, and 3 years after bariatric surgery

  • 2019 SAGES Oral
  • Published:
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Abstract

Introduction

Contrary to published literature, our institutional data demonstrated reduced weight loss following laparoscopic sleeve gastrectomy (LSG) compared to gastric bypass (LRYGB). The purpose of this study was to determine if known predictors of poor weight loss accounted for this discrepancy at a large volume center.

Methods

All patients undergoing primary LSG (n = 322) and LRYGB (n = 249), from 2014 to 2016, at a single institution were retrospectively reviewed. Baseline medical, socioeconomic, and follow-up data (6, 12, 24, and 36 months) were obtained. The first aim characterized differences in LSG and LRYGB. The second objective determined predictors of experiencing the lowest or highest quartile of excess body weight loss [(EBWL), (%EBWL-25th, %EBWL-75th)] at 12, 24, and 36 months. Thirdly, predictors of poor weight loss within sleeve gastrectomy were characterized.

Results

In comparison to patients undergoing LRYGB, LSG patients demonstrated lower baseline BMI (47.9 ± 8.2 vs. 51.5 ± 10.1, p < 0.0005), lower incidences of obesity-related comorbidities (p < 0.05), were more likely to have higher education (p = 0.02), and were associated with no-shows up to 2 years post-operatively. LSG remained a strong independent predictor of %EBWL-25th at 12 months (OR = 5.2, p < 0.005), 24 months (OR = 5.3, p < 0.005), and 36 months (OR = 7.3, p = 0.006), after adjusting for comorbidities, education, and no-shows. Predictors of poor weight loss after LSG included hypertension, African American race, major depression, no-shows at 6 and 12 months. Within patients associated with these characteristics, the relative risk of experiencing poor weight loss was significantly higher following LSG compared to LRYGB at 12 months (60% vs. 25.0%, p < 0.05), 24 months (43% vs. 18%, p < 0.05), and 36 months (70% vs. 21%, p < 0.05).

Conclusions

LSG remained an independent predictor of poor weight loss at all post-operative time points. Furthermore, the risk of experiencing poor weight loss was significantly higher following LSG compared to LRYGB for patients with high-risk characteristics.

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Authors and Affiliations

  1. Department of General and Gastrointestinal Surgery, The Ohio State Wexner Medical Center, Columbus, USA

    Anahita Jalilvand, Bradley Needleman & Sabrena Noria

  2. College of Medicine, The Ohio State Wexner Medical Center, Columbus, USA

    Alecia Blaszczak, Jane Dewire & Andrew Detty

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  1. Anahita Jalilvand
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  2. Alecia Blaszczak
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  3. Jane Dewire
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  4. Andrew Detty
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  5. Bradley Needleman
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  6. Sabrena Noria
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Correspondence to Sabrena Noria.

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Anahita Jalilvand, Alecia Blaszczak, Jane Dewire, Andrew Detty, Bradley Needleman, and Sabrena Noria have no conflict of interest or financial ties to disclose.

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464_2019_7023_MOESM1_ESM.jpg

Supplementary material 1 Overall (Right) Institutional Weight Loss Outcomes by Surgical Time Period and Stratified (left) by Surgery Type (JPEG 41 kb)

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Jalilvand, A., Blaszczak, A., Dewire, J. et al. Laparoscopic sleeve gastrectomy is an independent predictor of poor follow-up and reaching ≤ 40% excess body weight loss at 1, 2, and 3 years after bariatric surgery. Surg Endosc 34, 2572–2584 (2020). https://doi.org/10.1007/s00464-019-07023-2

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  • DOI: https://doi.org/10.1007/s00464-019-07023-2

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