The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them.
| Autor: | Medas F; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Moroni E; Obesity Surgery Unit, Surgical Department, 'ARNAS G. Brotzu' Hospital, Cagliari, Italy., Deidda S; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Zorcolo L; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Restivo A; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Canu GL; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Cappellacci F; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Calò PG; Department of Surgical Sciences, University of Cagliari, Cagliari, Italy., Pintus S; Obesity Surgery Unit, Surgical Department, 'ARNAS G. Brotzu' Hospital, Cagliari, Italy., Fantola G; Obesity Surgery Unit, Surgical Department, 'ARNAS G. Brotzu' Hospital, Cagliari, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in surgery [Front Surg] 2023 Feb 02; Vol. 10, pp. 1100483. Date of Electronic Publication: 2023 Feb 02 (Print Publication: 2023). |
| DOI: | 10.3389/fsurg.2023.1100483 |
| Abstrakt: | Introduction: Superobesity (SO) is defined as a BMI > 50 Kg/m 2 , and represents the extreme severity of the disease, resulting in a challenge for the surgeons. Methods: In this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients. Results: We included in this study 154 MO patients, with a median preoperative BMI of 40.8 kg/m 2 , and 19 SO patients with median preoperative BMI of 54.9 kg/m 2 . The MO patients underwent sleeve gastrectomy (SG) in 62 (40.3%) cases, laparoscopic Roux-and-Y gastric bypass (LRYGBP) in 85 (55.2%) cases and One-Anastomosis Gastric Bypass (OAGB) in 7 (4.5%) cases. underwent OAGB. The patients in the SO group were submitted to SG in 11 (57.9%) cases, LRYGBP in 5 (26.3%) cases, and OAGB in 3 (15.8%). At 24-month follow-up, an excess weight loss (EWL) >50% was achieved in 129 (83.8%) patients in the MO group and in 15 (78.9%) in the SO group ( p = 0.53). A BMI < 35 kg/m 2 was achieved in 137 (89%) patients in the MO group and from 8 (42.2%) patients in the SO group ( p < 0.001). The total weight loss was significantly directly related to the initial BMI. Superobesity was identified as independent risk factor for surgical failure when considering the outcome of BMI < 35 kg/m 2 . Discussion: Our study confirms that, although SO patients tend to gain a greater weight loss than MO patients, they less frequently achieve the desired BMI target. In this setting, it should be necessary to re-consider malabsorptive procedures as first choice. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Medas, Moroni, Deidda, Zorcolo, Restivo, Canu, Cappellacci, Calò, Pintus and Fantola.) |
| Databáze: | MEDLINE |
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