Changes in quality of life 5 years after sleeve gastrectomy: a prospective cohort study

Flølo, Tone Nygaard; Tell, Grethe S.; Kolotkin, Ronette L.; Aasprang, Anny; Norekvål, Tone M.; Våge, Villy; Hufthammer, Karl Ove; Andersen, John Roger

doi:10.1136/bmjopen-2019-031170

Cited by 20 publications

(23 citation statements)

References 49 publications

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“…QOL assessed at three different levels showed considerable improvements at 1–2 years and a gradual decline thereafter yielding bi-phasic patterns of parallel changes in BMI and QOL, as previously reported in RCTs and in our observational study after SG [ 13 , 21 , 38 ]. To our knowledge, a comprehensive assessment of QOL at different levels has not been done in other comparative trials of bariatric procedures.…”

Section: Discussionsupporting

confidence: 83%

“…We therefore prospectively compared long-term outcomes after surgery in patients with severe obesity in a real-world clinical setting in Western Norway. To better capture the impact of bariatric surgery on patients’ QOL, we differentiated between narrow QOL concepts associated with changes of body weight, and broader aspects of QOL employing obesity-specific-, generic health-related and overall QOL questionnaires [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

et al. 2022

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Background/objectives There is limited long-term data comparing the outcomes of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) for severe obesity, both with respect to body weight, quality of life (QOL) and comorbidities. We aimed to determine 7-year trajectories of body mass index (BMI), QOL, obesity-related comorbidities, biomarkers of glucose and lipid metabolism, and early major complications after SG and RYGB. Subjects/methods Patients scheduled for bariatric surgery at two Norwegian hospitals, preferentially performing either SG or RYGB, were included consecutively from September 2011 to February 2015. Data was collected prospectively before and up to 7 years after surgery. Obesity-specific, generic and overall QOL were measured by the Impact of Weight on Quality of Life-Lite, Short-Form 36 and Cantril’s ladder, respectively. Comorbidities were assessed by clinical examination, registration of medication and analysis of glucose and lipid biomarkers. Outcomes were examined with linear mixed effect models and relative risk estimates. Results Of 580 included patients, 543 (75% women, mean age 42.3 years, mean baseline BMI 43.0 kg/m2) were operated (376 SG and 167 RYGB). With 84.2% of participants evaluable after 5–7 years, model-based percent total weight-loss (%TWL) at 7 years was 23.4 after SG versus 27.3 after RYGB (difference 3.9%, p = 0.001). All levels of QOL improved similarly after the two surgical procedures but remained below reference data from the general population at all timepoints. Remission rates for type 2 diabetes, dyslipidemia, obstructive sleep-apnea and gastroesophageal reflux disease (GERD) as well as the rate of de novo GERD significantly favored RYGB. SG had fewer major early complications, but more minor and major late complications combined over follow-up. Conclusion In routine health care, both SG and RYGB are safe procedures with significant long-term weight-loss, improvement of QOL and amelioration of comorbidities. Long-term weight-loss and remission rates of main obesity-related comorbidities were higher after RYGB.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

et al. 2022

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“…Several studies of bariatric surgery have used more comprehensive patient reported outcome measures (PROMs). Weight loss after bariatric surgery is strongly associated with improvement in QoL [ 22 , 23 ]. However several other studies have found a negative association between GI symptoms and QoL [ 9 , 10 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Self-rated health (SRH) is a good predictor of morbidity, mortality, and healthcare use [ 18 ], and chronic pain is independently associated with SRH [ 19 ]. Most patients experience improvement of quality of life (QoL) after RYGBP or LSG surgery [ 20 , 21 ], often related to WL [ 22 , 23 ] but also to reduced prevalence and intensity of GI symptoms and abdominal pain [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Gastrointestinal Symptoms Two To Four Years After Bariatric Surgery. A Cross-Sectional Study Comparing Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy

et al. 2021

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Background Roux-en-Y gastric bypass (RYGBP) and laparoscopic sleeve gastrectomy (LSG) are efficient methods for weight loss (WL) and WL maintenance in severe obesity. However, the knowledge of gastrointestinal (GI) symptoms after surgery is limited. This study aimed to compare the severity of GI symptoms, pain, and self-rated health 2 to 4 years after RYGBP and LSG surgery. Methods In this cross-sectional study, RYGBP and LSG patients answered a questionnaire including the Gastrointestinal Symptom Rating Scale (GSRS), questions from the Brief Pain Inventory (BPI), and self-rated health (SRH). Results A total of 172/303 (57%) responded, RYGBP (n=73) and LSG (n=99). The mean age was 45.3 (SD 11.1) years (74% females). There was no evidence of a difference in total GSRS scores between the surgical methods (p=0.638). There were higher scores of reflux symptoms in LSG vs. RYGBP (both median 1, 75-percentile 2.5 vs. 1.0, p <0.001) and higher consumption of acid-reducing medication after LSG (32% vs. 12%, p <0.001). Pain scores were low in both groups; however, average abdominal pain was higher for RYGBP, median 2 (IQR 0–4) vs. median 1 (IQR 0–3) for LSG (p = 0.025). There was no significant difference in SRH. Conclusions Patients undergoing RYGBP and LSG surgery reported similar total GSRS scores and low pain scores 2 to 4 years after surgery. However, reflux symptoms and use of acid-reducing medication occurred more frequently after LSG surgery, while abdominal pain was more frequent in RYGBP surgery. These findings are important for surgical decision-making and follow-up. Graphical abstract

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“…Obesity is a disease not only through the risk of associated comorbidities but it is also cause of daily difficulties, leading to a decrease in QoL. Surgical treatment of obesity in addition to improving the QoL offers the individual a social, family, emotional and psychological reintegration [ 23 , 24 ]. Changes in self-image and self-esteem after bariatric surgery have a positive influence on QoL [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic sleeve gastrectomy as a primary bariatric procedure: postoperative outcomes

Mocian

Coroș

2021

Medicine and Pharmacy Reports

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Background and aims. Laparoscopic sleeve gastrectomy is at present the most popular bariatric procedure due to its significant effect on weight loss, resolution of comorbidities and improvement in the quality of life. However, there are not many studies showing its medium and long term efficacy and safety in Eastern Europe. We aim to report the outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure from a single surgical department. Methods. This is a retrospective analysis of obese patients who underwent laparoscopic sleeve gastrectomy between 2009 - 2016 in our department. Outcomes were analyzed in terms of weight loss, comorbidity resolution and quality of life changes. Results. A number of 70 patients were included in the study, with a mean age of 47.6 ± 9.8 years. Mean initial Body Mass Index was 47.4 ± 6.4 kg/m2. The mean percentage of excess weight loss during follow-up was 78.2% at 12 months, 80.2%, 76.7%, 74.7%, 72.8%, 73.3%, 74.1%, 67.2%, 64.07%, 69.7% at 24, 36, 48, 60, 72, 84, 96, 108 and 120 months, respectively. Weight regain occurred in 61 (87.1%) patients during the postoperative period. The mean weight regained was 8.1 ± 4.8 kg at 24 months postoperatively. Regarding the quality of life, 83% of patients declared an increase in self-esteem. Resolution of diabetes, arterial hypertension, and obstructive sleep apnea syndrome occurred in 80%, 42.5% and 70.1% of patients respectively. Conclusions. Laparoscopic sleeve gastrectomy is an effective procedure, with good outcomes in the medium and long term, although a tendency for weight regain was noted after 2 years. Resolution of comorbidities is comparable with that reported in the literature, namely an improvement of the quality of life.

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Changes in quality of life 5 years after sleeve gastrectomy: a prospective cohort study

Cited by 20 publications

References 49 publications

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

Self-Reported Gastrointestinal Symptoms Two To Four Years After Bariatric Surgery. A Cross-Sectional Study Comparing Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy as a primary bariatric procedure: postoperative outcomes

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