1- and 2-year outcomes and predictors of weight loss after gastric sleeve to Roux-en-Y gastric bypass conversion: a retrospective cohort study.

Autor: Marwaha JS; Department of Surgery, Georgetown University Medical Center, Washington, DC, USA.; Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, USA., Belayneh M; Georgetown University School of Medicine, Washington, DC, USA., Bloomfield GC; Georgetown University School of Medicine, Washington, DC, USA., Clarke N; Department of Surgery, Georgetown University Medical Center, Washington, DC, USA.; Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, USA., Vadlamudi C; Department of Surgery, Georgetown University Medical Center, Washington, DC, USA.; Department of Surgery, Medstar Washington Hospital Center, Washington, DC, USA.; Department of Surgery, Medstar Southern Maryland Hospital, Washington, DC, USA., Pardo Lameda IL; Department of Surgery, Georgetown University Medical Center, Washington, DC, USA.; Department of Surgery, Medstar Washington Hospital Center, Washington, DC, USA., Alimi YR; Department of Surgery, Georgetown University Medical Center, Washington, DC, USA. Yewande.R.Alimi@gunet.georgetown.edu.; Department of Surgery, Medstar Washington Hospital Center, Washington, DC, USA. Yewande.R.Alimi@gunet.georgetown.edu.; Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, USA. Yewande.R.Alimi@gunet.georgetown.edu.; 3800 Reservoir Rd NW, PHC4, Washington, DC, 20007, USA. Yewande.R.Alimi@gunet.georgetown.edu.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Oct 06. Date of Electronic Publication: 2024 Oct 06.
DOI: 10.1007/s00464-024-11280-1
Abstrakt: Background: Sleeve gastrectomy to Roux-en-Y bypass conversion is a commonly performed procedure, yet data are limited on outcomes and their predictors. The purpose of this study is to characterize the long-term outcomes of patients after sleeve-to-bypass conversion and identify predictors of post-conversion outcomes.
Methods: We performed a retrospective cohort study of patients who underwent sleeve-to-bypass conversion for obesity across four hospitals from 06/2017 to 04/2023. Predictors of the below-average percent excess weight loss (%EWL; relative to pre-conversion weight) at 1 and 2 years following conversion were identified using multivariate logistic regression models adjusting for comorbidities, demographics, and neighborhood socioeconomic status.
Results: 150 Patients undergoing sleeve-to-bypass conversion were identified. 99 had 1-year data and 63 had 2-year data. Mean %EWL at 1- and 2-years following conversion were 40.2% and 37.4%, respectively. EWL > 40% after sleeve gastrectomy was an independent predictor of the below-average %EWL 1-year post-conversion (OR 10.0, 95% CI 2.2-63.0, p < 0.01), and BMI > 40 kg/m 2 at the time of conversion was an independent predictor of both 1- and 2-year below-average %EWL post-conversion (p = 0.01 and 0.05, respectively). Insignificant predictors of the below-average %EWL after conversion included: weight regain after sleeve, time between sleeve and conversion, alimentary limb length, and any bariatric surgery prior to sleeve gastrectomy.
Conclusion: Patients should be counseled that the typical expected %EWL for sleeve-to-bypass conversion is less than the 50% EWL benchmark of success for index bariatric operations. The main predictors of a suboptimal conversion outcome are > 40% EWL after sleeve or > 40 BMI kg/m 2 at the time of conversion. Most variables in our analysis were not predictors of post-conversion %EWL, including weight regain between sleeve and conversion, alimentary limb length, and time interval between procedures, which suggests that these factors should not play a large role when considering sleeve-to-bypass conversion.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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