Minimally Invasive Surgery Research Center; Iran University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Obes Facts. 2023;16(6):540-547. doi: 10.1159/000533586. Epub 2023 Aug 18.
Bariatric surgery may lead to unsatisfactory weight loss, weight loss plateau, and even weight regain after various types of surgery. Despite the numerous studies, the mid-term results of surgery, after repetitive weight fluctuations remain a major concern. The aim of the present study was to determine the key time points of weight changes after three types of bariatric procedures, as well as to determine 5-year weight loss outcome after surgery.
This is a retrospective cohort study including patients with morbid obesity conducted in the Minimally Invasive Surgery Research Center. The patients underwent one of the three types of bariatric surgeries including laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB), who had been followed up for weight loss trend during 5 years postoperatively.
The mean excessive weight loss (%EWL) and total weight loss (%TWL) of 2,567 participants with obesity (mean age = 39.03, mean BMI = 45.67) in the first 6 months after surgery was independent of the type of surgery (p > 0.05). OAGB and RYGB showed significantly higher weight loss compared to LSG in ninth and 24th month after surgery, respectively (p < 0.05). The 5 years %WL could be comparable with %WL in 6, 9, and 12 months after LSG, RYGB, and OAGB, respectively.
OAGB provides the fastest and highest %EWL and %TWL, while LSG induced the earliest and largest weight plateau and weight regain during 5-years post-surgery. The pattern of early weight loss could predict the mid-term outcome of bariatric surgery. So, early identification of suboptimal weight loss could enhance long-term weight loss.
减重手术可能导致各种手术后体重减轻不满意、体重减轻平台期，甚至体重反弹。尽管进行了大量研究，但手术中期结果在反复体重波动后仍然是一个主要关注点。本研究旨在确定三种减重手术后体重变化的关键时间点，并确定手术后 5 年的减重结果。
这是一项回顾性队列研究，纳入了在微创外科研究中心接受肥胖治疗的患者。这些患者接受了三种减重手术中的一种，包括腹腔镜袖状胃切除术（LSG）、胃旁路术（RYGB）和单吻合口胃旁路术（OAGB），术后随访 5 年以了解体重减轻趋势。
2567 名肥胖患者（平均年龄为 39.03 岁，平均 BMI 为 45.67）在手术后 6 个月内的平均超重体重减轻率（%EWL）和总体重减轻率（%TWL）与手术类型无关（p > 0.05）。OAGB 和 RYGB 在手术后第 9 个月和第 24 个月的体重减轻率明显高于 LSG（p < 0.05）。5 年的%WL 可以与 LSG、RYGB 和 OAGB 术后 6、9 和 12 个月的%WL 相媲美。
OAGB 提供最快和最高的%EWL 和%TWL，而 LSG 在术后 5 年内诱导最早和最大的体重平台期和体重反弹。早期体重减轻的模式可以预测减重手术的中期结果。因此，早期识别体重减轻不理想可能会增强长期减重效果。
