Original articleComparison of weight loss and body composition changes with four surgical procedures
Section snippets
Methods
At their initial surgical consultation requesting weight loss surgery, all patients who qualified according to National Institutes of Health guidelines [4] were asked to review and sign an informed consent form describing the research protocol, which had institutional review board approval. The patients were weighed and measured, and underwent body composition analysis by the bioimpedance method using the Tanita 310 (Tanita Corporation of America, Arlington Heights, IL). This bioimpedance
Results
After surgery, 101, 49, 41, and 30 patients who had undergone GB, BPD/DS, AGB, and SG were evaluated at 19.1 ± 10.6, 27.5 ± 16.3, 21.4 ± 9.2, and 16.7 ± 5.6 months, respectively (P <.0001 by analysis of variance). No statistically significant differences were found among the 4 groups in age or gender (Table 1). The preoperative mean BMI was significantly different (P <.0001) at 61.4, 53.2, 46.7, and 44.3 kg/m2 for the SG, BPD/DS, GB, and AGB group, respectively (Fig. 1). For comparison in Fig. 1
Discussion
Because surgical procedures are continually evolving, the process of evaluating efficacy is an ongoing process. In 2004, when Buchwald et al. [2] published their meta-analysis, they combined laparoscopic and open procedures. Because the benefits of laparoscopic procedures have been defined and surgical competence has been developed to routinely use laparoscopic techniques, the focus of the present analysis was restricted to laparoscopic procedures performed as the first bariatric surgery. The
Conclusion
After 4 surgical procedures, the patients, who had no differences in age or gender distribution, demonstrated significant differences in BMI change and percentage of fat loss with lean body mass retention. Adjusting for baseline differences in the surgical groups did not change the statistical significance. For all patients, a high correlation was found for BMI change and fat loss. Larger patients who underwent SG and BPD/DS had greater changes in BMI, which did not have a high correlation with
Disclosures
The authors claim no commercial associations that might be a conflict of interest in relation to this article.
Acknowledgments
The authors wish to acknowledge the support of the Tanita Healthy Weight Community Trust as a grant-in-aid providing for the completion of the data collection, statistical consultations involved in the analysis of the data, and the preparation of this report.
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