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Weight loss outcomes and complications from bariatric surgery in the super super obese

Abstract

Background

Bariatric surgery has been established as the most effective long-term treatment for morbid obesity.

Methods

We performed a retrospective review of SSO patients treated at our institute between 2008 and 2013 who underwent a laparoscopic gastric bypass (LGBP) or sleeve gastrectomy (LSG). The primary end point for this study was excess weight loss (EWL) at 1, 3, 6, and 12 months. Secondary end points included procedure length (PL), length of stay (LOS), diabetes management and postoperative complications.

Results

We identified 135 SSO patients who underwent bariatric surgery (93 LGBP, 42 LSG) at our institute from 2008 to 2013 with a median follow-up of 49 months. The incidence of EWL > 30 % for patients in the LGBP group was 3.9, 29.0, 72.2 and 94.6 % at 1, 3, 6 and 12 months, respectively, while the incidence of EWL > 30 % in patients in the LSG group was 4.2, 25.0, 59.1 and 100 % at 1, 3, 6 and 12 months, respectively. PL was 124 ± 49 min for the LGBP group and 98 + 51 min for the LSG group (p < 0.005). LOS was on average 3.0 days (range 1–21) for the LGBP group and 3.4 days (range 1–13) for the LSG group (p = 0.41). Patients experienced a decrease in their hemoglobin A1C level by 10 % for the LGBP group and 9 % for the LSG group at 1 year (p = 0.89). Postoperative complications were seen in 15.1 % of LGBP patients and 4.8 % of LSG patients.

Conclusions

Bariatric surgery is feasible in the SSO patients with comparable EWL outcomes and postoperative complications to historical non-SSO patients.

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Fig. 1

Abbreviations

SSO:

Super super obese

SO:

Super obese

BMI:

Body mass index

EWL:

Estimated weight loss

PL:

Procedure length

LOS:

Length of stay

SBO:

Small bowel obstruction

PE:

Pulmonary embolism

UGIB:

Upper gastrointestinal bleed

Hgb A1C:

Hemoglobin A1C

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Author information

Correspondence to Oscar K. Serrano.

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Disclosures

Oscar K. Serrano, MD, MBA, Jonathan E. Tannebaum, MD, Lindsay Cumella, BS, Jenny Choi, MD, Pratibha Vemulapalli, MD, W. Scott Melvin, MD, Diego R. Camacho, MD, report no conflict of interest.

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Serrano, O.K., Tannebaum, J.E., Cumella, L. et al. Weight loss outcomes and complications from bariatric surgery in the super super obese. Surg Endosc 30, 2505–2511 (2016). https://doi.org/10.1007/s00464-015-4509-y

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Keywords

  • Super super obese
  • Excess weight loss
  • Bariatric surgery
  • Laparoscopic Roux-en-Y gastric bypass
  • Laparoscopic sleeve gastrectomy