How Sustained is Roux-en-Y Gastric Bypass Long-term Efficacy?

Abstract

Abstract Purpose The rate of weight regain after Roux-en-Y Gastric Bypass (RYGB) can hamper the procedure long-term efficacy for obesity treatment and related comorbidities. To evaluate the rate of weight loss and comorbidity remission failure 10 years or more after RYGB surgery. Materials and methods Retrospective observational cohort study. Patients submitted to RYGB for obesity treatment at a single centre with 10 years or more after surgery underwent a clinical reassessment. Results Among the subjects invited for clinical revaluation (n = 585), only those who performed RYGB and attended the hospital visit were included in the study (n = 281). The pre-operative mean body mass index (BMI) was 44.4 ± 6.1 kg/m2. Mean post-operative time was 12.2 ± 1.1 years. After surgery, mean BMI was significantly lower 33.4 ± 5.8 kg/m2 (p < 0.0001), 29.5% with a BMI < 30 kg/m2. Mean Total Weight Lost (%TWL) was 24.3 ± 11.4%, reaching a %TWL ≥ 20% in 70.1% with a mean %TWL of 30.0 ± 7.0%. Co-morbidities remission rate was 54.2% for type 2 diabetes, 34.1% for hypertension, 52.4% for hyperlipidemia and 50% for obstructive sleep apnea. Early complications rate was 13.2% and revision surgery occurred in 2.8% of patients. Four patients died of RYGB complications within the first 90 days after surgery. Conclusion RYGB has a high rate of long-term successful weight loss and obesity-associated comorbidity improvement. Weight loss failure requiring revision surgery occurs in a small proportion of patients. Our data confirms the long-term effectiveness of RYGB as primary bariatric intervention. Graphical abstract