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Do Complications Alter Postoperative Weight Loss 1 Year After Primary and Revisional Roux-en-Y Gastric Bypass?

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Abstract

Background

Around 10 % of the bariatric surgery patients experience postoperative complications (<30 days). It could be hypothesized that complications influence postoperative weight loss, which is one of the most important endpoints of bariatric surgery. Therefore, this study inventoried the effect of complications on postoperative weight loss.

Methods

A consecutive database including patients who were operated from November 2007 onwards was retrospectively reviewed. All short-term complications were classified according to the Clavien-Dindo classification. Weight loss was assessed at 6 and 12 months postoperatively.

Results

A total of 1130 patients underwent either primary (n = 907, 80.3 %) or revisional (n = 233, 19.7 %) surgery till October 2013. Short-term complications occurred in 115 (10.2 %) patients, of whom 48 (41.7 %) had a severe (Clavien-Dindo ≥ 3) complication. One year post surgery, 184 patients (16.3 %) were lost to follow-up. Patients with a short-term complication had a higher percentage of excess weight loss (%EWL) at 6 months (58.6 (SD 16.6) versus 52.9 (SD 17.6), p = 0.003) and 1 year (71.9 (SD 22.3) versus 65.9 (SD 21.3), p = 0.017) of follow-up. Although a trend was seen toward higher BMI loss and total weight loss (TWL) after 6 months, no effect was seen 1 year postoperatively. In multivariable linear regression analysis, complications were not a significant predictor for 1-year %EWL.

Conclusions

Although short-term complications alter 1-year %EWL, no effect was seen on BMI loss and TWL. In addition, complications were not a predictor in a multivariable linear regression model for 1-year %EWL. It can be concluded that short-term complications do not impair weight loss after Roux-en-Y gastric bypass.

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Abbreviations

AHI:

Apnea-hypopnea index

BMI:

Body mass Index

CPAP:

Continuous positive airway pressure

EW:

Excess weight

(%)EWL:

Percentage of excess weight loss

GJ:

Gastrojejunostomy

ICU:

Intensive care unit

IFSO:

International Federation for the Surgery of Obesity and Metabolic Disorders

LAGB:

Laparoscopic adjustable gastric banding

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

LSG:

Laparoscopic sleeve gastrectomy

OSA:

Obstructive sleep apnea

SD:

Standard deviation

TWL:

Total weight loss

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Funding

There was no funding source for this study.

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Author notes

    Authors and Affiliations

    1. Department of Surgery, Sint Lucas Andreas Ziekenhuis, Usha Coblijn, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

      U. K. Coblijn, C. A. L. de Raaff, B. C. Vrouenraets & B. A. van Wagensveld

    2. Department of Surgery, Academisch Medisch Centrum, Amsterdam, Netherlands

      S. M. Lagarde

    3. Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands

      S. M. M. de Castro

    Authors
    1. U. K. Coblijn
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    2. C. A. L. de Raaff
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    3. S. M. Lagarde
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    4. S. M. M. de Castro
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    5. B. C. Vrouenraets
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    6. B. A. van Wagensveld
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    Corresponding author

    Correspondence to U. K. Coblijn.

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    Conflict of Interest

    All authors declare no conflict of interest. S.M. Lagarde was supported by the Koningin Wilhelmina Fonds (KWF, Dutch Cancer Society) Fellowship, UVA 2013-5853, which does not create a conflict of interest.

    Ethical Approval

    “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.”

    Informed Consent

    As this is a retrospective study, no formal consent was required.

    Additional information

    U. K. Coblijn and C. A. L. de Raaff contributed equally to this work.

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    Coblijn, U.K., de Raaff, C.A.L., Lagarde, S.M. et al. Do Complications Alter Postoperative Weight Loss 1 Year After Primary and Revisional Roux-en-Y Gastric Bypass?. OBES SURG 26, 2213–2220 (2016). https://doi.org/10.1007/s11695-016-2094-3

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    • DOI: https://doi.org/10.1007/s11695-016-2094-3

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