Preoperative weight loss and postoperative short and long-term results in Bariatric Surgery

Abstract

Abstract IntroductionChange in lifestyle and diets is a part of the bariatric surgery process. Preoperative weight loss is still considered obligatory in some programs, but its benefits remain controversial. This study aimed to evaluate the influence of the preoperative weight loss on the postoperative results, in terms of long-term weight loss and perioperative morbidity.Methods.A retrospective review from the prospective collected database was performed. Patients operated for Roux-n-Y Gastric bypass (RYGB) or Sleeve Gastrectomy (SG) as a primary procedure with at least 5 years of follow-up were analysed. Two group of patients were defined depending on if any preoperative weight loss was achieved or not. Patients with 5% or more weight loss were independently evaluated too. Weight loss up to 5 years, nadir weight loss and early postoperative morbidity were analysed.Results.419 Patients were included (225 RYGB and 194 SG), 324 (77.3%) were women, with a mean age of 45.85 years (ranging 15 to 69). 178 patients (42.5%) achieved any weight loss prior to surgery, and just 26 (13.4%) more than 5%. Preoperative weight loss did not correlate with less morbidity, leak o reoperation rate after SG. In the RYGB preoperative weight loss patients showed a trend to higher morbidity.In terms of weight loss, preoperative weight loss patients did not achieve better nadir BMI (27.99kg/m2 vs 28.55kg/m2, p=0.213) nor final BMI (31.56kg/m2 vs 32.04kg/m2, p=0.412). Those results were repeated when RYGB and SG patients were analysed independently. Univariate and multivariate analyses did not find that PWL had any relationship to nadir BMI, final BMI nor postoperative morbidity, leak or reoperation risk.Conclusions.Preoperative weight loss did not correlate to better postoperative results nor to better weight loss results in our series.