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Erschienen in: Obesity Surgery 1/2019

24.09.2018 | Original Contributions

Comparative Effectiveness of Different Bariatric Procedures in Super Morbid Obesity

verfasst von: Rita Bettencourt-Silva, João Sérgio Neves, Jorge Pedro, Vanessa Guerreiro, Maria João Ferreira, Daniela Salazar, Pedro Souteiro, Daniela Magalhães, Sofia Castro Oliveira, Joana Queirós, Sandra Belo, Ana Varela, Paula Freitas, Davide Carvalho, AMTCO Group

Erschienen in: Obesity Surgery | Ausgabe 1/2019

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Abstract

Background

Super obesity (BMI ≥ 50 kg/m2) is associated with significant morbidity and mortality. The best procedure to treat super obesity is not completely established. Our aim was to compare the effectiveness of bariatric procedures (adjustable gastric band [AGB], Roux-en-Y gastric bypass [RYGB], sleeve gastrectomy [SG]) in super obesity.

Methods

Retrospective observational study of super obese patients who underwent bariatric surgery. Data was assessed preoperatively and in the 1st and 2nd years of follow-up.

Results

We evaluated 213 individuals, 77.9% female, age of 43.38 ± 11.49 years, and preoperative BMI of 54.53 ± 4.54 kg/m2; 19 submitted to AGB, 127 to RYGB, and 67 to SG. In the pre-surgical assessment, there were no significant differences in age, anthropometric parameters, blood pressure, glycemic profile, and lipid profile between the three surgical groups. The percentage of excess weight loss (%EWL) in the 1st year was 67.58% in RYGB, 58.74% in SG, and 38.71% in AGB (p < 0.001), and the percentage of total weight loss (%TWL) was 36.29%, 31.59%, and 21.07%, respectively (p < 0.001). Two years after surgery (n = 147; follow-up rate of 69%), the %EWL and %TWL were significantly higher in the RYGB group (p < 0.001). RYGB had a higher success rate (%EWL ≥ 50% and %TWL ≥ 20%) in both years of follow-up (p < 0.001). In multiple linear regression, after adjusting for other covariates, RYGB was the only strong predictive factor of %EWL and %TWL (p < 0.001).

Conclusion

RYGB proved to be more effective in super obesity. The beneficial effects in weight loss were evident both 1 and 2 years after the procedure, regardless of pre-surgical anthropometric characteristics.
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Metadaten
Titel
Comparative Effectiveness of Different Bariatric Procedures in Super Morbid Obesity
verfasst von
Rita Bettencourt-Silva
João Sérgio Neves
Jorge Pedro
Vanessa Guerreiro
Maria João Ferreira
Daniela Salazar
Pedro Souteiro
Daniela Magalhães
Sofia Castro Oliveira
Joana Queirós
Sandra Belo
Ana Varela
Paula Freitas
Davide Carvalho
AMTCO Group
Publikationsdatum
24.09.2018
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 1/2019
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3519-y

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