Skip to main content

Advertisement

SpringerLink
Log in

Getting the Most from the Sleeve: The Importance of Post-Operative Follow-up

  • Clinical Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Bariatric approach to obesity provides substantial weight loss and comorbidity resolution. Our unique service includes pre- and postoperative visits to the Health and Nutrition Clinic headed by a specialist in gastroenterology and nutrition. We compared patients attending regular clinic routine with those who were lost to follow-up with regard to anthropometry, comorbidity, quality of life, and food tolerance and determined who benefited most from the operation.

Methods

A retrospective review was performed on patients 30 months after undergoing sleeve gastrectomy. Body mass index was used to report weight loss. Bariatric Analysis and Reporting Outcome System (BAROS) and Food Tolerance Score were (FTS) completed by all patients at the 30-month follow-up visit and compared between two groups (group I—30 months of active postoperative follow-up; group II—without).

Results

A total of 119 patients participated in the study. For groups I and II, the mean percentage of excess BMI loss at 30 months was 82.08 ± 9.83 and 74.88 ± 8.75, respectively, with better comorbidity improvement in group I. BAROS scores were 7.62 ± 0.72 and 6.92 ± 0.92. FTS was 24.30 ± 2.09 and 22.55 ± 2.27, respectively.

Conclusions

From our experience, getting the most from the sleeve is attributed to two main factors: surgery and nutrition. Surgery results in optimal restriction and improved satiety, whereas nutrition relies on a professional medical team providing constant, ongoing patient support throughout all the bariatric process stages. These teams of surgeons and gastroenterologists specializing in nutrition, working side by side, each in their area of specialty, are the main pillars leading to the success of the sleeve.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. James PT, Rigby N, Leach R. International Obesity Task Force—The obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil. 2004;11(1):3–8.

    Article  PubMed  Google Scholar 

  2. Overweight, obesity, health risk: National Task Force on the prevention and treatment of obesity. Arch Intern Med 2000;160:898–904.

  3. Mizuno T, Shu IW, Makimura H, et al. Obesity over the life course. Sci Aging Knowledge Environ. 2004;16(24):4.

    Google Scholar 

  4. Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA. 2003;289(2):187–93.

    Article  PubMed  Google Scholar 

  5. Goodrick GK, Poston 2nd WS, Foreyt JP. Methods for voluntary weight loss and control: update. Nutrition. 1996;12:672–6.

    Article  PubMed  CAS  Google Scholar 

  6. Oluseun AS, Yood SM, Courtney J, et al. Natural history of morbid obesity without surgical intervention. Surg Obes Relat Dis. 2007;3:73–7.

    Article  Google Scholar 

  7. Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes Lond. 2007;31:1248–61.

    Article  PubMed  CAS  Google Scholar 

  8. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery, a systematic review and meta-analysis. JAMA. 2004;292:1724–8.

    Article  PubMed  CAS  Google Scholar 

  9. Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg. 2007;17:1069–74.

    Article  PubMed  CAS  Google Scholar 

  10. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):408–10.

    Article  Google Scholar 

  11. Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18(10):1323–9.

    Article  PubMed  Google Scholar 

  12. Oria HE. Moorehead MK Updated Bariatric Analysis and Reporting Outcome System (BAROS). Surg Obes Relat Dis. 2009;5(1):60–6.

    Article  PubMed  Google Scholar 

  13. Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.

    Article  PubMed  Google Scholar 

  14. Suter M, Calmes JM, Paroz A, et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg. 2007;17:2–8.

    Article  PubMed  Google Scholar 

  15. World Health Organization. Overweight and obesity. Factsheet no. 311. Geneva: World Health Organization; 2006.

    Google Scholar 

  16. Avenell A, Broom J, Brown TJ, et al. Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess. 2004;8:1–194.

    Google Scholar 

  17. Avenell A, Sattar N, Lean M. Management: part I—behaviour change, diet, and activity. BMJ. 2006;333:740–3.

    Article  PubMed  Google Scholar 

  18. Kral JG. Management: part III—surgery. BMJ. 2006;333:900–3.

    Article  PubMed  Google Scholar 

  19. US Preventive Services Task Force. Screening for obesity in adults: recommendations and rationale. Ann Intern Med. 2003;139:930–2.

    Google Scholar 

  20. Deitel M, Gawdat K, Melissas J. Reporting weight loss. Obes Surg. 2007;17:565–8.

    Article  PubMed  Google Scholar 

  21. Greenstein R. Reporting weight loss. Obes Surg. 2007;17:1275–6.

    Article  PubMed  Google Scholar 

  22. Baltasar A, Deitel M, Greenstein R. Letter to the Editor. Weight loss reporting. Obes Surg. 2008;18:761–2.

    Article  PubMed  Google Scholar 

  23. Dixon J, Phail T, O’Brien PE. Minimal reporting requirements for weight loss: current methods not ideal. Obes Surg. 2005;15:1034–9.

    Article  PubMed  Google Scholar 

  24. National Institute for Health and Clinical Excellence. Obesity—guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. London: The Stationery Office; 2006. Clinical Guideline 43.

  25. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.

    Article  PubMed  CAS  Google Scholar 

  26. Stroh C, Birk D, Flade-Kuthe R, et al. Results of sleeve gastrectomy—data from a nationwide survey on bariatric surgery in Germany. Obes Surg. 2009;19:105–12.

    Article  PubMed  Google Scholar 

  27. Vidal J, Ibarzabal A,Romero, et al. Type 2 diabetes mellitus and the severely obese subjects. Obes Surg 2008;18(9):1077e82.

  28. Sánchez-Santos R, Masdevall C, Baltasar A, et al. Short and midterm outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg 2009;19:1203–1210.

    Google Scholar 

  29. Mejía-Rivas M, Remes-Troche J, Montaño-Loza A, et al. Gastric capacity is related to body mass index in obese patients. A study using the water load test. Rev Gastroenterol Mex. 2009;74(1):71–3.

    PubMed  Google Scholar 

  30. Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.

    Article  PubMed  Google Scholar 

  31. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15:1024–9.

    Article  PubMed  CAS  Google Scholar 

  32. Abu-Jaish W, Ramirez A, Patel S et al. Prevalence of nutritional deficiencies after laparoscopic sleeve gastrectomy as a final step in morbidly obese patients. Presented at the ASMBS 26th Annual Meeting. Grapevine, TX, USA, 21–26 June, 2009.

  33. John Melissas IFSO Guidelines for Safety, Quality, and Excellence in Bariatric Surgery Obes Surg 2008;18:497–500.

    Google Scholar 

  34. Kafri N, Valfer R, Nativ O, et al. Health behavior, food tolerance, and satisfaction after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2011;7(1):82–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bnai-Zion Medical Center, Technion Institute of Technology, Haifa, Israel

    Dean Keren, Ibrahim Matter, Tova Rainis & Alexandra Lavy

  2. Gastroenterology Unit, Health and Nutrition Clinic, Bnai-Zion Medical Center, 47 Golomb Ave, POB 4840, Haifa, 31048, Israel

    Dean Keren

Authors
  1. Dean Keren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ibrahim Matter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tova Rainis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexandra Lavy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dean Keren.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Keren, D., Matter, I., Rainis, T. et al. Getting the Most from the Sleeve: The Importance of Post-Operative Follow-up. OBES SURG 21, 1887–1893 (2011). https://doi.org/10.1007/s11695-011-0481-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-011-0481-3

Keywords

Search

Navigation