Daniel Lomelin, MPH1, Priscila R Armijo, MD2, Austin Wheeler1, Tammy L Kindel, MD, PhD3, Vishal Kothari, MD2. 1University Of Nebraska College Of Medicine, 2University of Nebraska Medical Center, 3Medical College of Wisconsin
Introduction: Patients undergoing sleeve gastrectomy (SG) and Roux-n-Y gastric bypass (RYGB) have great variations in weight loss. The aim of this study is to evaluate the effect of preoperative BMI on the excess weight loss (EWL) at 12 months of patients who underwent SG and RYGB, and its trends over time.
Methods: A Single institution’s patients who underwent SG an RYGB were stratified by pre-operative (BMI <50 kg/m2 vs BMI >50 kg/m2), and followed at 6 weeks, 3, 6, 9 and 12 months. Trends in EWL over time were analyzed using ANOVA with post-hoc Tukey tests. Plateau of EWL was established when consecutive follow up EWL measurements showed non-statistically significant differences. Obstructive sleep apnea, gastroesophageal reflux disease, hyperlipidemia, hypertension and diabetes were assessed preoperatively and at 1-year for complete resolution.
Results: A total of 158 patients were included in the study (RYGB: N=63, SG: N=95). For all patients with start BMI of <50 kg/m2, RYGB had a mean EWL of 66.9 ± 19.3% at 12 months, and plateaued by 9 months with 63.5 ± 16.5% EWL (p=0.789); whereas SG patients plateaued by 6 months with 45% of EWL (9 mo.: 50%, p=0.362; 12 mo.: 51%, p=0.220). For pre-operative BMI >50 kg/m2, both SG and RYGB plateaued by 12 months with mean EWL of 39% (9 mo.: 35%, p=0.544) and 49% (9 mo.: 45%, p=0.793) respectively. Regardless of the BMI, RYGB patients had better resolution of all assessed comorbidities compared to SG, although only obstructive sleep apnea showed a statistical significant improvement (SG: 35.5%, RYGB: 57.9%, p=0.014).
Conclusion: Our study shows a wide variation of weight loss trajectories among RYGB and SG patients. RYGB patients with a lower pre-operative BMI reached plateau 3 months later than SG patients, and had better percentages of EWL by 12 months. Additionally, higher pre-operative BMI patients tended to have a slower weight loss progression after bariatric surgery, and were likely to plateau sooner. RYGB significantly outperformed SG for weight loss and comorbidities resolution by 12 months.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79049
Program Number: P569
Presentation Session: Poster (Non CME)
Presentation Type: Poster
