Daniel Lomelin, MPH1, Priscila R Armjo, 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: There is debate in the field of bariatric surgery regarding the use of Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) for weight loss. The goal of this research study was to determine how weight loss trajectories differed for patients that had SG or RYGB and had or had not attained 50% excess weight loss (EWL) or greater by 1 year at our institution.
Methods: Post-operative follow-up was categorized by 6 weeks, 3, 6, 9, and 12 months. Percent EWL at each point was calculated. Patients were classified into those with EWL <50% and ≥50% by 12 months for both surgical approaches. Plateaued weight loss was defined as the time at which consecutive follow-up intervals did not statistically differ in EWL and were identified using ANOVA with post-hoc Tukey comparisons.
Results: A total of 63 RYGB and 95 SG patients completed 1 year of follow-up at our institution. Overall, SG patients had a mean EWL of 46.6 ± 18.6%, while RYGB patients achieved 61.8 ± 19.0% (p<0.001). Within SG patients, those that reached EWL of ≥50% by 12 months had reached non-significant change in weight by 9 -12 months (p=0.748), and averaged a final EWL of 61.5 ± 12.1%. SG patients with <50% EWL achieved an average of 32.4% EWL by 12 months, with non-significant change in %EWL between 6, 9, and 12 months (p=0.999, and p=0.969). RYGB patients with ≥50% EWL had an average of 71.5 ± 15.6% EWL at their final follow-up with non-significant weight loss occurring between 9-12 months (p=0.236), while those that achieved <50% EWL by 12 months achieved an average of 42.3 ± 5.1% EWL, and experienced weight loss plateau starting at 6 months (p=0.702, and p=0.970).
Conclusions: It is evident that regardless of approach, weight loss trajectory differs greatly between patients that did and did not reach the final goal of 50% EWL. In patients that met the threshold, there is marked difference in their weight loss trajectory, such that in both approaches, patients with <50% EWL attainment experienced a plateau in weight loss months in advance of those that continued to lose significant excess weight. It may be possible to increase the accuracy of expectations for both the surgeon and patient by identifying preoperative patient characteristics that are common to each weight loss group and improve the prediction of weight loss outcomes for both surgeries.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79116
Program Number: P521
Presentation Session: Poster (Non CME)
Presentation Type: Poster