Resolution of comorbidities and outcomes after revision of sleeve gastrectomy to duodenal switch for patients with body mass index more than 60 kg/m2.

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2023
Authors
Ghosh, A.
Hussein, A.
Askari, A.
Jain, V.
Adil, M.T.
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Abstract
Patients with body mass index (BMI) more than 60 kg/m2 pose unique challenges in management and their ability to lose significant weight after a single-stage bariatric procedure is debatable. The aim of this study is to explore resolution of comorbidities and report quality of life (QoL) in patients who have a laparoscopic sleeve gastrectomy (LSG) revised to duodenal switch (DS). Methods Patients who completed two-stage DS from 1 January 2011 to 31 December 2017 were analysed for excess weight loss (EWL), total weight loss (TWL), resolution of comorbidities and QoL. Validated questionnaires were used to assess QoL. Results A total of 9/1975 bariatric patients underwent two-stage DS during the study period, all of whom had had a previous LSG. The median preoperative weight before the first stage was 207.0 kg [interquartile range (IQR) 175.3-278.9 kg] and the median BMI was 75.0 kg/m2 (IQR 65.1-92.0 kg/m2). Length of hospital stay following the first stage (ie, LSG) was a median of 1 day (IQR 1-2 days) and 2 days (IQR 1-3 days) after revision to DS. The median EWL following LSG was 58.0% (IQR 33.3%-100.8%) and the median TWL was 16.1% (IQR 13.7%-25.2%). Following DS, the median EWL was 57.1% (IQR 47.1%-60.8%) and the median TWL was 21.2% (IQR 19.5%-26.7%). Significant improvement in obesity-related comorbidities were observed. QoL improved in overall feeling, physical activity, social life, work and approach to food. No immediate postoperative complications were observed. Long-term outcome of all patients was rated to be ‘very good’, ‘good’ or ‘fair’. Conclusions Two-stage DS leads to sustained weight loss, resolution of comorbidities and improvement in QoL in carefully selected patients with BMI more than 60 kg/m2.
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Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Gastroenterology
Citation
Y - JOUR AU - Ghosh, Anirban AU - Hussein, Adam AU - Askari, Alan AU - Jain, Vigyan AU - Adil, Md Tanveer TI - Resolution of comorbidities and outcomes after revision of sleeve gastrectomy to duodenal switch for patients with body mass index more than 60 kg/m2 JO - Surgical Practice JA - Surg Pract VL - 27 IS - 2 SN - 1744-1625 UR - https://doi.org/10.1111/1744-1633.12615