Elsevier

Surgery for Obesity and Related Diseases

Volume 3, Issue 6, November–December 2007, Pages 627-630
Surgery for Obesity and Related Diseases

Original article
Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass

Presented at the 24th Annual Meeting of the American Society for Bariatric Surgery, June 11–16, 2007, San Diego, California
https://doi.org/10.1016/j.soard.2007.07.005Get rights and content

Abstract

Background

Weight loss after gastric bypass varies among patients. It is difficult to maintain contact with patients who have undergone surgery several years previously. Continued and long-term follow-up care at a bariatric surgery clinic might be a factor affecting long-term excess weight loss (EWL).

Methods

Patients with 3–4 years of follow-up data after laparoscopic gastric bypass were included in this retrospective analysis. The patients were divided into 3 groups: group 1 patients had attended every scheduled postoperative appointment, group 2 patients had attended every appointment for 1 year before being lost to follow-up, and group 3 patients had been lost to follow-up before 1 year. Comparisons were made to determine the relationship between the length of follow-up and EWL.

Results

We identified 34 group 1 patients and 51 group 2 or 3 patients of 130 patients eligible to be included as determined by their date of surgery. The interval since surgery was similar at approximately 3 years. Although the EWL did not differ at 1 year of follow-up (mean EWL 70% for group 1 versus 65% for group 2, P >.05), a significant difference in the EWL was observed at 3–4 years (74% for group 1 versus 61% for group 2 versus 56% for group 3; P <.05). The distance traveled to the clinic was similar for all 3 groups. The most common explanation for missed follow-up appointments was a lack of insurance coverage.

Conclusion

Laparoscopic gastric bypass patients who attended all scheduled follow-up appointments experienced greater long-term weight loss than those who did not. On-going, multidisciplinary care is likely a critical component in maintaining the benefit after surgery. Patients must be encouraged to continue to attend their bariatric medical appointments, and payors should provide coverage for these visits.

Section snippets

Methods

In an effort to bring our 5-year follow-up rates to >75%, as required by the Surgical Review Corporation and the American Society of Bariatric Surgery to be designated as a Bariatric Surgery Center of Excellence, we reached out to many of our patients who had been lost to follow-up for several years. We were able to track down by telephone a large number of patients who had not been seen in our clinic for >2 years. Patients were invited to return to our clinic for a visit. If a patient was

Results

Before November 1, 2003, our program had performed 130 laparoscopic gastric bypass procedures. These 130 patients represented the population eligible to be included in this study. From our prospectively maintained clinical database, we identified 34 patients who had undergone surgery >3 years earlier who had attended every routinely scheduled clinic visit since surgery (group 1). An additional 51 patients who had been lost to follow-up for >2 years were identified and reached by telephone. Of

Discussion

The results of this study have demonstrated that patients who routinely attend their scheduled clinic visits after laparoscopic gastric bypass have significantly greater weight loss 3 years postoperatively than those who are lost to follow-up soon after surgery. Our results also suggest that 1 year of follow-up visits, which is routine in some programs, is not enough to ensure the durable weight loss that patients need. What remains to be demonstrated is whether continued follow-up, beyond even

Conclusion

Laparoscopic gastric bypass patients who attended all scheduled follow-up appointments experienced greater long-term weight loss after surgery than those who did not. On-going, multidisciplinary follow-up care is likely a critical component in maximizing and maintaining benefit after surgery. Patients must be encouraged to continue to attend their bariatric medical appointments, and payors should provide insurance coverage for these visits.

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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Copyright © 2007 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.