Hany Mohamed, Hafez Mohammad Marwa Khalil, Abd Elhafeez Naglaa Abdallah, Shafiq Agayby Ann Samy, Torensma Bart
Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.
Medical-Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt.
Obes Pillars. 2022 Jul 31;3:100029. doi: 10.1016/j.obpill.2022.100029. eCollection 2022 Sep.
Bariatric surgery offers long-term weight loss and maintenance for patients with obesity. Several factors may be associated with patients' inability to achieve successful excess weight loss (EWL) after the surgery. The purpose of this study was to identify factors associated with improved or in-progress EWL among patients who had undergone laparoscopic sleeve gastrectomy (LSG).
This original clinical investigation was conducted at the Outpatient Surgical Department-Medical Research Institute Hospital at Alexandria University in Egypt. A sample size of 100 adult surgical patients who had undergone LSG was selected from patients who attended follow-up in the study setting. Group A had an EWL% ≥50 and group B had an EWL <50. Body Mass Index (BMI) classes were defined as 25-30 kg/m, >30-35 kg/m, >35-40 kg/m, >40 ≥ 45 kg/m.
Post-operatively, after six months, 100% of the patients in group A had a BMI between 25 and 30 mg/m2, compared to 0% in group B. Nevertheless, patients in group EWL<50 (group B) who had pre-operatively BMI class ≥45 mg/m2, had a reduction in weight of 89.5% post-operatively, (n = 2 still had a BMI >45 kg/m post operatively), In total, 63.9% of the patients in group B managed to get towards a BMI of 30-35 kg/m post-operatively. The main factors associated with group B (less %EWL after 6 months) were found to be related to higher preoperative BMI, the onset of obesity started in childhood, less preoperative weight loss, longer postoperative duration towards weight reduction, and lower postoperative compliance to dietary instructions (P = 0.0001, 0.048, 0.0001, 0.017, and 0.016, respectively).
Routine cross-sectional surveying can help clinicians in understanding patients' post-operative follow-up routines. Special attention to pre-operative BMI, weight-loss regimens, and childhood-onset as well as post-operative duration, low responders, and compliance with clinical assessment can improve weight loss outcomes.
减肥手术可为肥胖患者带来长期的体重减轻及维持效果。若干因素可能与患者术后无法成功实现超重减轻（EWL）相关。本研究的目的是确定接受腹腔镜袖状胃切除术（LSG）的患者中与EWL改善或正在改善相关的因素。
这项原始临床研究在埃及亚历山大大学医学研究所医院门诊外科进行。从在该研究机构接受随访的患者中选取100例接受LSG的成年手术患者作为样本。A组的EWL%≥50，B组的EWL<50。体重指数（BMI）类别定义为25 - 30kg/m²、>30 - 35kg/m²、>35 - 40kg/m²、>40≥45kg/m²。
术后6个月，A组100%的患者BMI在25至30mg/m²之间，而B组为0%。然而，术前BMI类别≥45mg/m²的EWL<50（B组）患者术后体重减轻了89.5%（n = 2术后BMI仍>45kg/m²）。总体而言，B组63.9%的患者术后BMI设法达到了30 - 35kg/m²。发现与B组（6个月后EWL百分比更低）相关的主要因素与术前BMI较高、肥胖始于儿童期、术前体重减轻较少、术后体重减轻持续时间较长以及术后对饮食指导的依从性较低有关（分别为P = 0.0001、0.048、0.0001、0.017和0.016）。
常规横断面调查有助于临床医生了解患者的术后随访程序。特别关注术前BMI、减肥方案、儿童期发病情况以及术后持续时间、低反应者和临床评估的依从性可改善减肥效果。
