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Predicting Weight Loss and Comorbidity Improvement 7 Years Following Laparoscopic Sleeve Gastrectomy: Does Early Weight Loss Matter?

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Abstract

Background

Predicting the variables that affect the outcomes following laparoscopic sleeve gastrectomy (LSG) would allow focused resource allocation with a view to improving results. Whilst greater early post-operative weight loss following LSG is associated with greater short-term weight loss, the relationship between early results and long-term outcomes has not been described.

Methods

A retrospective cohort analysis was performed on patients who underwent LSG 7 years before a follow-up telephone interview was performed. Multivariate regression analysis was used to explore the relationship between early weight loss at 4 weeks following surgery and weight loss at 7 years. A non-inferiority analysis assessed whether early weight loss was associated with either improvement or resolution of hypertension or type 2 diabetes mellitus (T2DM) at 7 years after surgery.

Results

Of the 156 patients identified between April and October 2012, 130 (83.3%) met the inclusion criteria and were included in the analysis. The average preoperative BMI was 42.5 kg/m2 (standard deviation 5.2). The change in BMI was 4.6 kg/m2 (4.0) at 4 weeks and 12.2 kg/m2 (5.4) at 7 years. There was improvement or resolution in 19/31 (61.3%) patients with T2DM and 14/26 (53.8%) patients with hypertension. Whilst younger age was associated with greater weight loss at 7 years follow-up, no such relationship was identified with early post-operative weight loss. Early post-operative weight loss was also not associated with long-term improvement or resolution in hypertension or T2DM.

Conclusions

Early weight loss does not appear to be associated with greater weight loss nor comorbidity improvement 7 years following LSG.

Trial Registration

ClinicalTrials.gov (SZMC-95/19)

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Author notes

  1. James Tankel and Omer Shlezinger contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Shaare Zedek Medical Centre, 12 Shmeul Habayit Street, Jerusalem, Israel

    James Tankel, Omer Shlezinger, Michael Neuman, Anat Ahuva Hershko Moshe, Noa Ben Nachum, Noa Hurvitz & Ram Spira

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  1. James Tankel
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  2. Omer Shlezinger
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  3. Michael Neuman
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  4. Anat Ahuva Hershko Moshe
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Correspondence to James Tankel.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (reference SZMC-19/95) and within the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was also listed with clinicaltrails.gov.

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

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Tankel, J., Shlezinger, O., Neuman, M. et al. Predicting Weight Loss and Comorbidity Improvement 7 Years Following Laparoscopic Sleeve Gastrectomy: Does Early Weight Loss Matter?. OBES SURG 30, 2505–2510 (2020). https://doi.org/10.1007/s11695-020-04462-y

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