[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
Skip to main content
Springer Nature Link
Log in

Weight Regain After Bariatric Surgery—A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

There is little robust data on weight regain (WR) after bariatric surgery making it difficult to counsel patients regarding long-term outcomes of different bariatric procedures. The purpose of this study was to see WR in medium and long term after SG, RYGB, and OAGB in Indian population.

Methods

In a multicentre study, data on preoperative and postoperative weights over 5 years were collected. Multiple definitions were applied to find the proportion of patients with significant WR increase of 25% of lost weight from nadir (definition 1), weight gain of > 10 kg from nadir (definition 2), and BMI gain of > 5 kg/m2 from nadir (definition 3). The proportion of those with significant WR was compared across sub-groups.

Results

A total of 9617 patients were included. Median WR at 5 years was 14.1% of lost weight, 1.92 kg/m2, and 5 kg. Significant WR using definition 1 was 35.1%, 14.6%, and 3% after sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and mini-one anastomosis gastric bypass (OAGB) respectively. Severe albumin deficiency was highest in OAGB (5.9%) patients followed by SG (2.9%) and RYGB (2.2%) at 5 years(p = 0.023). Haemoglobin levels < 10 g/dL were seen in 8.2%, 9.0%, and 13.9% of SG, RYGB, and OAGB patients respectively (p = 0.041).

Conclusions

In the first comparative study of WR, OAGB had lesser WR in comparison to SG and RYGB but had the most impact on Hb and albumin levels in the long term. Definition selection for reporting WR has a significant impact on the results. There is a need for standardising the reporting of WR in bariatric literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
£29.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Juodeikis Ž, Brimas G. Long-term results after sleeve gastrectomy: a systematic review. Surg Obes Relat Dis. 2017;13:693–9.

    Article  PubMed  Google Scholar 

  2. Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13:170–80.

    Article  PubMed  Google Scholar 

  3. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.

    Article  PubMed  Google Scholar 

  4. Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11:321–6.

    Article  PubMed  Google Scholar 

  5. Alkhalifah N, Lee W-J, Hai TC, et al. 15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures. Surg Endosc. 2018;32:3024–31.

    Article  PubMed  Google Scholar 

  6. Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses—first study from Indian subcontinent. Obes Surg. 2014;24:1430–5.

    Article  CAS  PubMed  Google Scholar 

  7. Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-en-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26(5):926–32

  8. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017;27:2279–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Parikh M, Eisenberg D, Johnson J, et al. American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery review of the literature on one-anastomosis gastric bypass. Surg Obes Relat Dis. 2018;14:1088–92.

    Article  PubMed  Google Scholar 

  10. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Mahawar KK, Graham Y, Carr WRJ, et al. Revisional Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review of comparative outcomes with respective primary procedures. Obes Surg. 2015;25:1271–80.

    Article  PubMed  Google Scholar 

  12. Lauti M, Lemanu D, Zeng ISL, et al. Definition determines weight regain outcomes after sleeve gastrectomy. Surg Obes Relat Dis. 2017;13:1123–9.

    Article  PubMed  Google Scholar 

  13. Bailly L, Schiavo L, Sebastianelli L, Fabre R, Pradier C, Iannelli A. Anemia and bariatric surgery: results of a national French survey on administrative data of 306,298 consecutive patients between 2008 and 2016. Obes Surg. 2018;28(8):2313–20

  14. Karimi M, Kabir A, Nejatifar M, et al. Trend of changes in serum albumin and its relation with sex, age, and BMI following laparoscopic mini-gastric bypass surgery in morbid obese cases. Obes Surg. 2018;28:671–80.

    Article  PubMed  Google Scholar 

  15. Liu SY-W, Wong SK-H, Lam CC-H, et al. Long-term results on weight loss and diabetes remission after laparoscopic sleeve gastrectomy for a morbidly obese Chinese population. Obes Surg. 2015;25:1901–8.

    Article  CAS  PubMed  Google Scholar 

  16. Abdallah E, El Nakeeb A, Yousef T, et al. Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study). Obes Surg. 2014;24:1587–94.

    Article  PubMed  Google Scholar 

  17. Braghetto I, Csendes A, Lanzarini E, et al. Is laparoscopic sleeve gastrectomy an acceptable primary bariatric procedure in obese patients? early and 5-year postoperative results. Surg Laparosc Endosc Percutan Tech. 2012;22:479–86.

    Article  PubMed  Google Scholar 

  18. Casella G, Soricelli E, Giannotti D, et al. Long-term results after laparoscopic sleeve gastrectomy in a large monocentric series. Surg Obes Relat Dis. 2016;12:757–62.

    Article  PubMed  Google Scholar 

  19. Ritz P, Becouarn G, Douay O, et al. Gastric bypass is not associated with protein malnutrition in morbidly obese patients. Obes Surg. 2009;19:840–4.

    Article  PubMed  Google Scholar 

  20. Obeidat F, Shanti H, Mismar A, et al. The magnitude of antral resection in laparoscopic sleeve gastrectomy and its relationship to excess weight loss. Obes Surg. 2015;25:1928–32.

    Article  PubMed  Google Scholar 

  21. Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20:535–40.

    Article  PubMed  Google Scholar 

  22. Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258:1.

    Article  Google Scholar 

  23. Mahawar KK, Kular KS, Parmar C, et al. Perioperative practices concerning one anastomosis (mini) gastric bypass: a survey of 210 surgeons. Obes Surg. 2018;28:204–11.

    Article  PubMed  Google Scholar 

  24. Young MT, Phelan MJ, Nguyen NT. A decade analysis of trends and outcomes of male vs female patients who underwent bariatric surgery. J Am Coll Surg. 2016;222:226–31.

    Article  PubMed  Google Scholar 

  25. Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for the treatment of morbid obesity in China: a 5-year outcome. Obes Surg. 2014;24:1617–24.

    Article  PubMed  Google Scholar 

  26. Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity. JAMA. 2018;319:241.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Alkhalifah N, Lee W-J, Hai TC, Ser K-H, Chen J-C, Wu C-C. 15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures. Surg Endosc. 2018;32(7):3024–31

  28. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, Prospective Trial. Obes Surg. 2012;22:740–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Braghetto I, Cortes C, Herquiñigo D, et al. Evaluation of the radiological gastric capacity and evolution of the BMI 2-3 years after sleeve gastrectomy. Obes Surg. 2009;19:1262–9.

    Article  PubMed  Google Scholar 

  30. Lauti M, Kularatna M, Hill AG, et al. Weight regain following sleeve gastrectomy—a systematic review. Obes Surg. 2016;26:1326–34.

    Article  PubMed  Google Scholar 

  31. Cooper TC, Simmons EB, Webb K, et al. Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery. Obes Surg. 2015;25:1474–81.

    Article  PubMed  Google Scholar 

  32. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient-2013 update: cosponsored by American Association Of Clinical Endocrinologists, The Obesity Society, And American Society Fo. Obesity. 2013;21:S1–27.

    Article  CAS  PubMed  Google Scholar 

  33. Mahawar K, Parmar C, Carr WJ, et al. Impact of biliopancreatic limb length on severe protein–calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass. J Minim Access Surg. 2018;14:37.

    Article  PubMed  PubMed Central  Google Scholar 

  34. King WC, Hinerman AS, Belle SH, et al. Comparison of the performance of common measures of weight regain after bariatric surgery for association with clinical outcomes. JAMA. 2018;320:1560.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Puzziferri N, Roshek TB, Mayo HG, et al. Long-term follow-up after bariatric surgery. JAMA. 2014;312:934.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Blencowe NS, Brown JM, Cook JA, et al. Interventions in randomised controlled trials in surgery: issues to consider during trial design. Trials. 2015;16:392.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

We are thankful to Dr. Aparna Govil Bhasker for the help in organising the study as well as guidance in writing the manuscript, Kankona Dey for the help in data compilation, Dr. Laila Baig for organising the consensus meeting, Manjari Agarwal for data compilation, and Mr. Souvik Dutta for statistical analysis.

Author information

Author notes

  1. Sarfaraz J. Baig and Pallawi Priya contributed equally to this work.

Authors and Affiliations

  1. Belle Vue Clinic, Kolkata, India

    Sarfaraz J. Baig & Pallawi Priya

  2. Sunderland Royal Hospital, Sunderland, SR4 7TP, UK

    Kamal K. Mahawar

  3. Max Smart Superspeciality Hospital, New Delhi, India

    Sumeet Shah

Authors
  1. Sarfaraz J. Baig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pallawi Priya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kamal K. Mahawar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sumeet Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the Indian Bariatric Surgery Outcome Reporting (IBSOR) Group

Contributions

SJB, KM, and SS conceived the idea for the topic. SJB initiated the research and wrote the manuscript. PP collected most of the data and wrote the manuscript. SJB and PP contributed equally to the manuscript. KM and SS wrote and edited parts of the manuscript. All authors participated in the discussions on the topic. All authors have seen the final version and approve of it.

Corresponding author

Correspondence to Pallawi Priya.

Ethics declarations

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Statement of Human and Animal Rights

Not applicable.

Statement of Informed Consent

For this type of study, formal consent is not required.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

IBSOR Collaborators

Dr. Abhay Agarwal - Apollo Hospitals, Mumbai, India; Hinduja Hospitals, Mumbai, India; Sevenhills Hospitals, Mumbai, India

Dr. Arun Prasad - Manipal Hospitals, Dwarka, New Delhi, India

Dr. Atul Peters - Apollo Institute of Metabolic and Bariatric Surgery, New Delhi, India

Dr. Deep Goel - BLK Superspeciality Hospital, New Delhi, India

Dr. Digvijaysingh Bedi - Hope Obesity Centre, Ahmedabad, India

Dr. Jaydeep H. Palep - Nanavati Superspeciality Hospital, Mumbai, India

Dr. Lakshmi Kona Kumari - Gleneagles Global Hospital, Hyderabad

Dr. Mahendra Narwaria - Asian Bariatrics Pvt ltd, Ahmedabad, India

Dr. Manish Baijal - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Manish Khaitan - Columbia Asia Hospital, Ahmedabad, India

Dr. Mathias Fobi - Mohak Bariatrics and Robotics, Indore, India

Dr. Mohit Bhandari - Mohak Bariatrics and Robotics, Indore, India

Dr. Nandkishore Dukipatti - Livlife Hospitals, Hyderabad, India

Dr. Nidhi Khandelwal - Nanavati Superspeciality Hospital, Mumbai, India

Dr. Om Tantia - ILS Hospitals, Kolkata

Dr. P. Pravin Raj - Gem Hospital and Research Centre, Coimbatore, India

Dr. Pallawi Priya - Belle Vue Clinic, Kolkata, India

Dr. Parveen Bhatia - Bhatia Global Hospital, Sir Ganga Ram Hospital, New Delhi, India

Dr. Pradeep Chowbey - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Rajkumar Palaniappan - Apollo Hospitals, Chennai, India

Dr. Rajkumar JS - Lifeline Hospitals, Chennai, India

Dr. Rajesh Khullar - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Ramen Goel - Wockhardt Hospital, Mumbai, India

Dr. Randeep Wadhawan - Fortis Hospitals, Vasan Kunj, New Delhi, India

Dr. Sarfaraz J. Baig - Belle Vue Clinic, Kolkata, India

Dr. Shivaram HV - Aster CMI Hospital, Bengaluru, India

Dr. Sreejoy Pattnaik - Shanti Memorial Hospital, Cuttack, India

Dr. Sudheer Kalhan - Sir Ganga Ram Hospital, New Delhi, India

Dr. Sumeet Shah - Max Smart Superspeciality Hospital, New Delhi, India

Dr. Surendra Ugale - Kirloskar Hospitals, Hyderabad, India

Dr. Vandana Soni - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Vivek Bindal - Sir Ganga Ram Hospital, New Delhi, India

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baig, S.J., Priya, P., Mahawar, K.K. et al. Weight Regain After Bariatric Surgery—A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group. OBES SURG 29, 1583–1592 (2019). https://doi.org/10.1007/s11695-019-03734-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-019-03734-6

Keywords

Search

Navigation