Baig Sarfaraz J, Priya Pallawi, Mahawar Kamal K, Shah Sumeet
Belle Vue Clinic, Kolkata, India.
Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
Obes Surg. 2019 May;29(5):1583-1592. doi: 10.1007/s11695-019-03734-6.
There is little robust data on weight regain (WR) after bariatric surgery making it difficult to counsel patients regarding long-term outcomes of different bariatric procedures. The purpose of this study was to see WR in medium and long term after SG, RYGB, and OAGB in Indian population.
In a multicentre study, data on preoperative and postoperative weights over 5 years were collected. Multiple definitions were applied to find the proportion of patients with significant WR increase of 25% of lost weight from nadir (definition 1), weight gain of > 10 kg from nadir (definition 2), and BMI gain of > 5 kg/m from nadir (definition 3). The proportion of those with significant WR was compared across sub-groups.
A total of 9617 patients were included. Median WR at 5 years was 14.1% of lost weight, 1.92 kg/m, and 5 kg. Significant WR using definition 1 was 35.1%, 14.6%, and 3% after sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and mini-one anastomosis gastric bypass (OAGB) respectively. Severe albumin deficiency was highest in OAGB (5.9%) patients followed by SG (2.9%) and RYGB (2.2%) at 5 years(p = 0.023). Haemoglobin levels < 10 g/dL were seen in 8.2%, 9.0%, and 13.9% of SG, RYGB, and OAGB patients respectively (p = 0.041).
In the first comparative study of WR, OAGB had lesser WR in comparison to SG and RYGB but had the most impact on Hb and albumin levels in the long term. Definition selection for reporting WR has a significant impact on the results. There is a need for standardising the reporting of WR in bariatric literature.
关于减肥手术后体重反弹(WR)的可靠数据很少,这使得难以就不同减肥手术的长期结果向患者提供咨询。本研究的目的是观察印度人群中袖状胃切除术(SG)、Roux-en-Y胃旁路术(RYGB)和单吻合口胃旁路术(OAGB)后中长期的体重反弹情况。
在一项多中心研究中,收集了5年期间术前和术后体重的数据。应用多种定义来确定体重显著反弹的患者比例,即体重从最低点增加25%(定义1)、体重从最低点增加超过10 kg(定义2)以及体重指数(BMI)从最低点增加超过5 kg/m²(定义3)。比较各亚组中体重显著反弹患者的比例。
共纳入9617例患者。5年时的体重反弹中位数为减重的14.1%、1.92 kg/m²和5 kg。采用定义1时,袖状胃切除术后(SG)、Roux-en-Y胃旁路术后(RYGB)和单吻合口胃旁路术后(OAGB)的显著体重反弹率分别为35.1%、14.6%和3%。5年时,OAGB患者中严重白蛋白缺乏率最高(5.9%),其次是SG(2.9%)和RYGB(2.2%)(p = 0.023)。SG、RYGB和OAGB患者中血红蛋白水平<10 g/dL的比例分别为8.2%、9.0%和13.9%(p = 0.041)。
在第一项关于体重反弹的比较研究中,与SG和RYGB相比,OAGB的体重反弹较少,但长期对血红蛋白和白蛋白水平影响最大。报告体重反弹的定义选择对结果有显著影响。减肥文献中需要规范体重反弹的报告。