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Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data

2015; Elsevier BV; Volume: 12; Issue: 1 Linguagem: Inglês

10.1016/j.soard.2015.04.011

1878-7533

Nabeel R. Obeid, Waqas Malick, Seth J. Concors, George Fielding, Marina Kurian, Christine Ren-Fielding,

Esophageal and GI Pathology

Background Short- and mid-term data on Roux-en-Y gastric bypass (RYGB) indicate sustained weight loss and improvement in co-morbidities. Few long-term studies exist, some of which are outdated, based on open procedures or different techniques. Objectives To investigate long-term weight loss, co-morbidity remission, nutritional status, and complication rates among patients undergoing RYGB. Setting An academic, university hospital in the United States. Methods Between October 2000 and January 2004, patients who underwent RYGB≥10 years before study onset were eligible for chart review, office visits, and telephone interviews. Revisional surgery was an endpoint, ceasing eligibility for study follow-up. Outcomes included weight loss measures and rates of co-morbidity remission, complications, and nutritional deficiencies. Results RYGB was performed in 328 patients with a mean preoperative body mass index of 47.5 kg/m2. Of 294 eligible patients, 134 (46%) were contacted for follow-up at≥10 years (10+Year follow-up). Mean percentage excess weight loss (%EWL) was 58.9% at 10+Year. Higher %EWL was achieved by non–super-obese versus super-obese (61.3% versus 52.9%, P = .034). Blood pressure, lipid panel, and hemoglobin A1c improved significantly. At 10 years, remission of co-morbidities was 46% for hypertension and hyperlipidemia and 58% for diabetes mellitus. Thirty patients (9%) had revisional surgery for weight regain. Sixty-four patients (19.5%) had long-term complications requiring surgery. All-cause mortality was 2.7%. Nutritional deficiencies were seen in 87% of patients. Conclusions Weight loss after RYGB appears to be significant and sustainable, especially in the non–super-obese. Co-morbidities are improved, with a substantial number in remission a decade later. Nutritional deficiencies are almost universal.