Preoperative Weight Change as a Predictor of Postoperative Weight Loss Following Laparoscopic Sleeve Gastrectomy

Vanessa Falk, MD, David Pace, MD, FRCSC, Simon Tewes, MD, Felicia Pickard, MD, Brad Evans, MD, Raleen Murphy, Deborah Gregory, PhD, Laurie Twells, PhD. Memorial University of Newfoundland

Introduction: At our bariatric surgery center, patients are required perform food journaling and a trial of liquid diet for two weeks prior to their bariatric procedure. They are encouraged to lose weight, however, this does not impact their eligibility for surgery. The purpose of this study is to determine if preoperative weight gain affects postoperative weight loss following laparoscopic sleeve gastrectomy (LSG).

Methods: This is a retrospective chart review of patients who underwent LSG at a single bariatric center from May 2011 to February 2014. Data on patient demographics, preoperative weight change, postoperative weight loss at 6 and 12 months, comorbidities, and postoperative complications were collected. Two groups of patients were compared, those who gained weight in the preoperative period and those who either maintained or lost weight during this period. Paired Student t-tests and independent Student t-tests were used to compare continuous variables and Chi-squared analysis was used for categorical variables. Statistical analysis was performed using SPSS (Version 21).

Results: One hundred and eighty seven patients underwent LSG (n=187).  There were 77 patients who gained weight and 110 patients who maintained or lost weight prior to LSG. There was no difference in mean age (44 years), gender (>80% female), preoperative weight (135 kg), preoperative body mass index (49.2 kg/m2), or obesity associated comorbidities between groups. There was a significant difference in mean weight loss at 6 months (26.3±8.5kg vs. 32.3±9.9kg, p<0.001) favoring the group that maintained or lost weight prior to surgery but no difference in mean weight loss at 12 months was noted (36.5±13.9kg vs. 38.7±14.2kg, p=0.381). Similarly, there was no difference in % estimated BMI loss between groups at 12 months (56.6±16.4%kg/m2 vs. 61.9±18.4%kg/m2, p=0.744). There was no difference in the overall 30-day postoperative complication rate between groups (13% vs. 20%, p=0.241).

Conclusion: Preoperative weight gain does not predict postoperative weight loss following laparoscopic sleeve gastrectomy at 12 months. 

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