Background

The association between preoperative weight loss and bariatric surgery outcomes remains unclear. We explored the utility of preoperative weight loss as a predictor of postoperative weight loss success. Additionally, we examined the association of preoperative weight loss with perioperative complication rates.

Methods

Retrospective chart review of patients who underwent primary sleeve gastrectomy or primary Roux-en-Y gastric bypass for weight loss at a single institution between January 2003 and November 2017. Additional follow-up was obtained by a postoperative standardized patient questionnaire. Statistical analysis consisted of bivariate and multivariate logistic regression analysis.

Results

Our study included 427 patients. Majority were female (n = 313, 73.3%) and underwent sleeve gastrectomy (n = 261, 61.1%). Average age was 45.6 years, and average follow-up was 6.3 years. Greater preoperative weight loss was associated with decreased length of stay (1.8 vs 1.3 days) in patients who underwent sleeve gastrectomy. Multivariable regression analysis revealed that preoperative weight loss was not associated with postoperative weight loss.

Conclusions

Preoperative weight loss is not predictive of postoperative weight loss success after bariatric surgery. Greater preoperative weight loss was associated with a mild decreased in length of stay but was not associated with a reduction in operative time, overall complication rates, ICU admissions, or intraoperative complications. The inconclusive literature and our findings do not support the medical necessity of weight loss prior to bariatric surgery for the purpose of reducing surgical complications or predicting successful postoperative weight loss success.

中文翻译：

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术前体重减轻作为减肥手术术后体重减轻和并发症的预测因素

背景

术前体重减轻与减肥手术结果之间的关联仍不清楚。我们探讨了术前减肥作为术后减肥成功的预测因素的效用。此外，我们检查了术前体重减轻与围手术期并发症发生率的关系。

方法

回顾性图表回顾了 2003 年 1 月至 2017 年 11 月期间在单一机构接受原发性袖状胃切除术或原发性 Roux-en-Y 胃旁路术以减轻体重的患者。通过术后标准化患者问卷调查获得了额外的随访。统计分析包括双变量和多变量逻辑回归分析。

结果

我们的研究包括 427 名患者。大多数是女性（n = 313, 73.3%）并接受了袖状胃切除术（n = 261, 61.1%）。平均年龄为 45.6 岁，平均随访时间为 6.3 年。在接受袖状胃切除术的患者中，更大的术前体重减轻与住院时间缩短（1.8 天 vs 1.3 天）有关。多变量回归分析显示，术前体重减轻与术后体重减轻无关。

结论

术前体重减轻并不能预测减肥手术后的术后体重减轻成功率。更大的术前体重减轻与住院时间的轻微减少有关，但与手术时间、总体并发症发生率、ICU入院率或术中并发症的减少无关。无定论的文献和我们的研究结果不支持减肥手术前为了减少手术并发症或预测成功的术后减肥成功而进行减肥手术的医学必要性。