Dutch Obesity Clinic West (Nederlandse Obesitas Kliniek West), NOK West, Den Haag, The Netherlands; Dutch Obesity Clinic (Nederlandse Obesitas Kliniek), NOK, Huis ter Heide, The Netherlands.
Dutch Obesity Clinic West (Nederlandse Obesitas Kliniek West), NOK West, Den Haag, The Netherlands.
Surg Obes Relat Dis. 2021 Apr;17(4):718-725. doi: 10.1016/j.soard.2020.11.033. Epub 2020 Dec 9.
In the Netherlands, patients only qualify for bariatric surgery when they have followed a 6-month mandatory weight loss program (MWP), also called the "last resort" criterion. One of the rationales for this is that MWPs result in greater weight loss.
To determine weight loss during MWPs and the effect of delayed versus immediate qualification on weight loss 3 years after bariatric surgery.
Outpatient clinic.
This is a nationwide, retrospective study with prospectively collected data. All patients who underwent a primary bariatric procedure in 2016 were included. We compared weight loss between patients who did not qualify according to the last resort criterion at screening (delayed group) with patients that qualified (immediate group).
In total 2628 patients were included. Mean age was 44.4 years, 81.3% were female, and baseline BMI was 42.3 kg/m. Roux-en-Y gastric bypass (RYGB) was the most frequently performed surgery (77.0%), followed by sleeve gastrectomy (15.8%) and banded RYGB (7.3%). The delayed group (n = 831; 32%) compared with immediate group (n = 1797; 68%), showed less percentage of total weight loss (%TWL) during the MWP (1.7% versus 3.9%, P < .001) and time between screening and surgery was longer (42.3 versus 17.5 wk, P < .001). Linear mixed model analysis showed no significant difference in %TWL at 18- (P = .291, n = 2077), 24- (P = .580, n = 1993) and 36-month (P = .325, n = 1743) follow-up.
This study shows that delayed qualification for bariatric surgery compared with immediate qualification does not have a clinically relevant impact on postoperative weight loss 3 years after bariatric surgery.
在荷兰，患者只有在参加了为期 6 个月的强制性减重计划（MWP）后，才有资格接受减重手术，该计划也被称为“最后的手段”标准。这样做的一个原因是 MWP 会导致更大程度的体重减轻。
确定 MWP 期间的体重减轻情况，以及延迟与即时资格对减重手术 3 年后体重减轻的影响。
门诊诊所。
这是一项全国性的回顾性研究，数据是前瞻性收集的。所有于 2016 年接受初次减重手术的患者均被纳入研究。我们比较了在筛查时不符合最后手段标准（延迟组）的患者与符合标准的患者（即时组）之间的体重减轻情况。
共纳入 2628 例患者。患者平均年龄为 44.4 岁，81.3%为女性，基线 BMI 为 42.3kg/m。胃旁路手术（RYGB）是最常施行的手术（77.0%），其次是袖状胃切除术（15.8%）和带囊 RYGB（7.3%）。与即时组（n=1797，68%）相比，延迟组（n=831，32%）在 MWP 期间的总体重减轻百分比（%TWL）较低（1.7%对 3.9%，P<.001），且筛查与手术之间的时间间隔较长（42.3 对 17.5 周，P<.001）。线性混合模型分析显示，在 18 个月（P=0.291，n=2077）、24 个月（P=0.580，n=1993）和 36 个月（P=0.325，n=1743）随访时，%TWL 无显著差异。
与即时资格相比，延迟资格接受减重手术不会对减重手术后 3 年的体重减轻产生临床相关影响。
