A 7-Year Study of the Durability of Improvements in Pain, Physical Function, and Work Productivity After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Abstract

IMPORTANCEBariatric surgical procedures are associated with clinically important improvements (CIIs) in pain and physical function. However, there are declines in initial improvement by the third postoperative year, and the long-term durability of improvements are not well-described. OBJECTIVE To evaluate the durability of improvements in pain and physical function through 7 years after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). DESIGN, SETTING, AND PARTICIPANTS This study is part of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2), a cohort study at 10 US hospitals. Adults with severe obesity (ie, body mass index of 35 or greater) undergoing bariatric surgery were assessed preoperatively (2006-2009) and followed up annually for as long as 7 years or until 2015. Of 1829 participants who underwent RYGB or SG in LABS-2, 338 were excluded from this study because they had a follow-up period of less than 5 years. Analysis of participants who underwent RYGB or SG and completed research assessments preoperatively and postoperatively for 5 to 7 years was conducted from March to April 2022. MAIN OUTCOMES AND MEASURES Preoperative-to-postoperative CIIs in pain and physical function scores from the 36-Item Short Form Health Survey and the Western Ontario McMasterOsteoarthritis Index, and 400-meter walk time, using previously established thresholds; and remission of mobility deficit, ie, inability to walk 400 meters in 7 minutes or less. RESULTSA total of 1491 individuals were included, with 1194 (80%) women; 59 (4%) Hispanic, 164 (11%) non-Hispanic Black, and 1205 (82%) non-Hispanic White individuals; a preoperative median (IQR) age of 47 (38-55) years; and a preoperative median (IQR) body mass index of 47 (42-52).

Quality of life change seen after Diverted Mini Gastric Bypass Surgery in Obese Population: Retrospective research analysis

“…Patients experience more mobility due to fewer complications like joint pain. The current findings are also similar to earlier research reports 51,52 . We noticed that the scores were low for the group between 6 to 9 months, probably when the initial euphoria of weight loss settles down, and some of them might have issues with food intake and static weight.…”

Postoperative pain-related outcomes and perioperative pain management in China: a population-based study

“…Since most patients undergoing bariatric surgery are young women with obesity, the pain in such patients is also very significant. 44 , 45 Postoperative pain in patients undergoing thoracic and abdominal surgery, open fractures, and cesarean section, which are traditionally traumatic and painful stimuli, remains poorly controlled. There are also procedures that are considered less invasive, such as appendectomy (93% of which are laparoscopic appendectomy) and laparoscopic cholecystectomy, where postoperative pain is not as low as expected, Similar observation was described by Gerbershagen et al.…”

Opioid Analgesics after Bariatric Surgery: A Scoping Review to Evaluate Physiological Risk Factors for Opioid-Related Harm

“…Unfortunately, several variables are still insufficiently known, such as the pain’s etiology pathways [ 41 ], as well as how they affect opiate consumption and addiction of patients after a bariatric procedure. Data on health-related quality-of-life factors show an improvement in bodily pain and physical function after bariatric surgery [ 77 , 78 ], but the incidence of these factors remains high at long-term follow-ups (range 41–72% at 7 years post-intervention) [ 77 ]. A study by Björklund et al described a counterintuitive effect of morphine on the muscular tone in the Roux limb of RYGB patients, potentially causing abdominal pain.…”