Long‐term risk of adult overweight and obesity among achalasia patients who underwent Heller Myotomy
| Autor: | Miguel Angel Valdovinos-Diaz, Emilio Sánchez-García Ramos, Enrique Coss-Adame, Gonzalo Torres-Villalobos, Fidel Lopez-Verdugo, Andric C. Perez-Ortiz, Sofia Narvaez-Chavez, Jose Peralta-Figueroa, Hector Olvera-Prado, Janette Furuzawa-Carballeda |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Time Factors Physiology Achalasia Heller Myotomy Overweight Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Weight loss Humans Medicine Obesity Postoperative Care Heller myotomy Endocrine and Autonomic Systems business.industry Proportional hazards model Incidence (epidemiology) Gastroenterology Middle Aged medicine.disease Esophageal Achalasia 030220 oncology & carcinogenesis Cohort Body-Weight Trajectory Female 030211 gastroenterology & hepatology medicine.symptom business Body mass index |
| Zdroj: | Neurogastroenterology & Motility. 32 |
| ISSN: | 1365-2982 1350-1925 |
| DOI: | 10.1111/nmo.13921 |
| Popis: | BACKGROUND It is unknown whether surgically treated achalasia cases regain or surpass their usual weight into obesity or overweight in the long-term post-operative period. Here, we aimed to assess the incidence of overweight/obesity (Ob/Ow) and the risk for reoccurrence up to 48 months post-laparoscopic Heller myotomy (LHM). METHODS We performed a cohort of 114 achalasia cases undergoing LHM. All patients had a confirmed diagnosis of achalasia and had no added comorbidities. We followed up the body mass index (BMI) at the immediate post-operative period, and at one-, six-, 12-, 24-, and 48 months after LHM. We measured the incidence of Ob/Ow and its reoccurrence risk with Cox regression. KEY RESULTS AND CONCLUSIONS In the immediate post-operative period, the incidence of Ob/Ow was significantly less than the usual BMI (before the onset of symptoms) (28.2% vs 66.3%). From the sixth to the 48th month, there was a progressive increase in the incidence of Ob/Ow and at this timepoint the percent of Ob/Ow was not statistically different from the usual BMI. The most significant hazard for Ob/Ow reoccurrence in the long term following LHM is a usual BMI with obesity grade I or III and males lacking pre-surgical weight loss. INFERENCES Achalasia cases undergoing surgical treatment should be monitored closely in the post-operative period for weight regain, regardless of their pre-operative BMI. Notably, males who before the onset of symptoms were obese or overweight are at significantly increased risk of regaining or surpassing their weight, despite most having lost weight pre-surgically. |
| Databáze: | OpenAIRE |
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