Comparison of the efficacy of standard bariatric surgical procedures on Saudi population using the bariatric analysis and reporting outcome system (BAROS)

A Al-Kadi, MD, FRCSC, M Al-Naami, MD, FRCSC, Zr Siddiqui, MD. Qassim University

Obesity is a chronic disease that has reached epidemic proportions globally. WHO estimated that 700 million population will be obese worldwide in 2015 compared to 300 million reported in 2005. In Saudi Arabia, an overall obesity prevalence is progressively increasing from 20% in 1996, to 35% in 2005, up to 52% in 2013 with 20,000 deaths per year due to obesity and related comorbidities. Compared to different weight loss methods and programs, bariatric surgery proved to be the most effective and sustainable weight loss procedures, in addition to improvement of co-morbidities and quality of life. The aim of this study is to assess outcomes of standard bariatric surgical procedures using the Bariatric Analysis and Reporting Outcome System (BAROS).

Methods:

The questionnaire of BAROS was translated into Arabic language and validated before its use to collect the data from the patients who had bariatric surgeries from March 2010 to December 2012 at two institutions. Data was analyzed and scored against three outcomes; excess weight loss, cure or improvement of comorbidities, and quality of life changes.

Results:

A total of the 270 patients were included; 79 underwent Laparoscopic Roux-en-Y gastric Bypass Procedure (LRYGBP), 159 had Laparoscopic Sleeve Gastrectomy (LSG), and 32 had Laparoscopic Adjustable Gastric Banding (LAGB); with an overall female to male ratio of 2.5:1, 0.8:1, 1.3:1; and an average age of 36.41±8.87, 31.87±9.83, 34.75±11.24 for the three procedures respectively. The average excess weight loss (EWL) was 67.94%, 75.82 %, and 81.65 % against each procedure respectively. In patients with more than 1 year of follow-up, comorbidities were improved (64.0%, 48.8% & 57.1% ) or resolved (36.0%, 51.2% & 42.9%) with 95% reported significant improvement in quality of life . Overall excellent\very good\good outcomes group scoring was achieved in 62 (78.5%), 133(83.65%), and 18 (56.25%) patients, with failure reported only by 4 (5%) patients. Major complications were noted in 7.8%, 5.7%, and 6.25% patients; and minor complications in 5.1%, 11.3%, and 12.5% patients against the three procedures respectively; with no reported mortality.

Conclusion:

Standard bariatric procedures are very effective in reducing and sustaining excess body weight, for cure and improvement of co-morbidities, and quality of life improvement in morbidly obese Saudi population with different degrees of impact and outcome that can be beneficial in selecting appropriate procedure for appropriate indications and patients. LRYGB seems to work better for co-morbid diseases, LSG works well for excess weight loss as well as LAGB in selected patients.