Different criteria for assessment of Roux-en-Y gastric bypass success: does only weight matter?

Abstract:

BACKGROUND:Medium and long-term efficacy of Roux-en-Y gastric bypass (RYGBP) has previously been demonstrated. However, weight-loss success criteria could be influenced by super-obesity prevalence at baseline. Here, we describe a 5-year follow-up concerning weight loss results, comorbidities, and mortality of a RYGBP Brazilian population with a high prevalence (60.6%) of super-obesity. METHODS:One hundred ninety-three patients (142 female, 51 male) submitted to RYGBP were studied. Preoperative and follow-up body mass index (BMI), percent excess weight loss (%EWL), percent BMI loss (%EBL), and comorbidities were analyzed. Analysis of success was based on %EWL, Reinhold modified by Christou, and Biron criteria. RESULTS:Five-year follow-up rates were 91.9%, 82.0%, 71.1%, 71.2%, 72.5%, respectively. By 2 years of follow-up, the rates of success based on %EWL, Reinhold modified by Christou, and Biron criteria were 90.4%, 63.4%, and 87.0%, respectively. By 5 years, these rates were 78.0%, 50.0%, and 74.0%, respectively. There was significant and persistent reduction of hypertension, diabetes mellitus, and dyslipidemia. Super-obesity was associated with the worst weight-loss results by modified Reinhold criteria, despite a significant reduction of comorbidities. CONCLUSIONS:In the super-obese population, RYGBP was very efficient, contributing to significant weight loss and reduction in comorbidities. Mortality was more frequent than international rates, but this was most likely due to the severity of the cohort baseline. Success rates were different according to each criterion, but reaching BMI < 35 kg/m(2) was not necessary for improvement in comorbidities.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Diniz Mde F,Passos VM,Barreto SM,Linares DB,de Almeida SR,Rocha AL,Diniz MT

doi

10.1007/s11695-008-9669-6

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1384-92

issue

10

eissn

0960-8923

issn

1708-0428

journal_volume

19

pub_type

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