Alfadda Assim A, Al-Naami Mohammed Y, Masood Afshan, Elawad Ruba, Isnani Arthur, Ahamed Shaik Shaffi, Alfadda Nora A
Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh 11461, Saudi Arabia.
Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (38), Riyadh 11461, Saudi Arabia.
J Clin Med. 2021 Oct 25;10(21):4922. doi: 10.3390/jcm10214922.
Obesity is considered a global chronic disease requiring weight management through lifestyle modification, pharmacotherapy, or weight loss surgery. The dramatic increase in patients with severe obesity in Saudi Arabia is paralleled with those undergoing bariatric surgery. Although known to be beneficial in the short term, the long-term impacts of surgery within this group and the sustainability of weight loss after surgery remains unclear.
We aimed to assess the long-term weight outcomes after bariatric surgery.
The study was conducted at King Khalid University Hospital (KKUH), King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia.
An observational prospective cohort study on adult patients with severe obesity undergoing bariatric surgery (sleeve gastrectomy (SG) or Roux-en Y gastric bypass (RYGB)) during the period between 2009 and 2015 was conducted. Weight loss patterns were evaluated pre- and post-surgery through clinical and anthropometric assessments. Absolute weight loss was determined, and outcome variables: percent excess weight loss (%EWL), percent total weight loss (%TWL), and percent weight regain (%WR), were calculated. Statistical analysis using univariate and multivariate general linear modelling was carried out.
A total of 91 (46 males and 45 females) patients were included in the study, with the majority belonging to the SG group. Significant weight reductions were observed at 1 and 3 years of follow-up ( < 0.001) from baseline. The %EWL and %TWL were at their maximum at 3 years (72.4% and 75.8%) and were comparable between the SG and RYGB. Decrements in %EWL and %TWL and increases in %WR were seen from 3 years onwards from bariatric surgery until the study period ended. The yearly follow-up attrition rate was 20.8% at 1 year post-surgery, 26.4% at year 2, 31.8% at year 3, 47.3% at year 4, 62.6% at year 5, and 79.1% at end of study period (at year 6).
The major challenge to the successful outcome of bariatric surgery is in maintaining weight loss in the long-term and minimizing weight regain. Factors such as the type of surgery and gender need to be considered before and after surgery, with an emphasis on the need for long-term follow-up to enssure the optimal benefits from this intervention.
肥胖被视为一种全球性慢性病，需要通过生活方式改变、药物治疗或减肥手术来控制体重。沙特阿拉伯重度肥胖患者数量急剧增加，同时接受减肥手术的人数也在增加。尽管已知减肥手术在短期内有益，但该群体手术后的长期影响以及术后体重减轻的可持续性仍不明确。
我们旨在评估减肥手术后的长期体重结局。
该研究在沙特阿拉伯利雅得的沙特国王大学医学城国王哈立德大学医院（KKUH）进行。
对2009年至2015年期间接受减肥手术（袖状胃切除术（SG）或 Roux-en Y 胃旁路术（RYGB））的成年重度肥胖患者进行了一项观察性前瞻性队列研究。通过临床和人体测量评估在手术前后评估体重减轻模式。确定绝对体重减轻情况，并计算结局变量：超重减轻百分比（%EWL）、总体重减轻百分比（%TWL）和体重反弹百分比（%WR）。使用单变量和多变量一般线性模型进行统计分析。
共有91名患者（46名男性和45名女性）纳入研究，大多数属于SG组。在随访1年和3年时观察到与基线相比体重显著降低（<0.001）。%EWL和%TWL在3年时达到最大值（分别为72.4%和75.8%），SG组和RYGB组之间具有可比性。从减肥手术到研究期结束，从3年起%EWL和%TWL下降，%WR增加。术后1年的年度随访流失率为20.8%，第2年为26.4%，第3年为31.8%，第4年为47.3%，第5年为62.6%，研究期末（第6年）为79.1%。
减肥手术成功的主要挑战在于长期维持体重减轻并尽量减少体重反弹。手术前后需要考虑手术类型和性别等因素，强调需要进行长期随访以确保从该干预措施中获得最佳益处。
