Zoumpou Theofano, Fleishman Aaron, Jones Daniel B, Wee Christina C
Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess 207, 185 Pilgrim Road, Boston, MA, 02215, USA.
Surg Endosc. 2023 Dec;37(12):9381-9392. doi: 10.1007/s00464-023-10364-8. Epub 2023 Aug 31.
Sleeve gastrectomy (SG) is one of the most popular types of weight loss surgery today but is neither risk-free nor universally effective. We previously demonstrated that 5% of Roux-en-Y gastric bypass (RYGB) patients and up to 20% of gastric banding patients report overall regret 4 years after surgery. This study explores patients' attitudes toward their decision to have SG and decision regret rates up to 6 years postoperatively.
We surveyed 185 patients who were at least 6 months post-SG (response rate 30%). We used a modified version of the Decision Regret Scale developed by Brehaut et al. We converted responses to a 0-100 scale so that higher scores (> 50) reflect greater regret. We characterized patients who expressed having overall decision regret (score > 50) vs. those who did not (≤ 50). Demographic and preoperative clinical information was extracted from the online medical records.
Of 185 SG patients, only 13 (7%) reported regret scores > 50 (i.e. high decision regret). Mean time from SG to survey completion was 41 months (range 6-76 months). Unadjusted comparisons between the two groups revealed that patients with high regret scores had lower mean weight loss (32.1% vs. 48.9% EBMIL), and reported less improvement in quality-of-life (QoL), such as physical health (46.2% vs. 93.5% "somewhat" or "significantly" improved). The two groups were similar in short-term complications, but those reporting overall regret were more likely to report GI complaints such as bloating (61.5% vs. 30.4%). Finally, patients with regret scores > 50 were more likely to be further out from SG (median time since surgery 61.8 vs. 41.1 months).
In our study, very few patients reported regret (7%) up to 6 years postoperatively, in line with prior reports after RYGB. Those with regret reported poorer QoL.
袖状胃切除术（SG）是当今最流行的减肥手术之一，但并非没有风险，也并非对所有患者都有效。我们之前证明，5%的Roux-en-Y胃旁路术（RYGB）患者以及高达20%的胃束带术患者在术后4年表示总体上感到后悔。本研究探讨了患者对接受SG手术这一决定的态度以及术后长达6年的决定后悔率。
我们对185例SG术后至少6个月的患者进行了调查（应答率30%）。我们使用了Brehaut等人开发的决策后悔量表的修改版。我们将应答转换为0至100分的量表，以便更高的分数（>50）反映更大的后悔程度。我们对表示有总体决策后悔（分数>50）的患者与没有后悔（≤50）的患者进行了特征描述。人口统计学和术前临床信息从在线医疗记录中提取。
在185例SG患者中，只有13例（7%）报告后悔分数>50（即高决策后悔）。从SG手术到调查完成的平均时间为41个月（范围6至76个月）。两组之间的未调整比较显示，后悔分数高的患者平均体重减轻较低（32.1%对48.9%的预期体重减轻百分比），并且报告生活质量（QoL）改善较少，如身体健康方面（“有所”或“显著”改善的比例为46.2%对93.5%）。两组在短期并发症方面相似，但表示总体后悔的患者更有可能报告胃肠道不适，如腹胀（61.5%对30.4%）。最后，后悔分数>50的患者距离SG手术时间更长（术后中位时间为61.8个月对41.1个月）。
在我们的研究中，术后长达6年只有极少数患者表示后悔（7%），这与RYGB术后的先前报告一致。表示后悔的患者报告的生活质量较差。
