Gender Influence on Long-Term Weight Loss and Comorbidities After Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: a Prospective Study With a 5-Year Follow-up

Perrone, Federico; Bianciardi, Emanuela; Benavoli, Domenico; Tognoni, Valeria; Niolu, Cinzia; Siracusano, Alberto; Gaspari, Achille; Gentileschi, Paolo

doi:10.1007/s11695-015-1746-z

Cited by 65 publications

(26 citation statements)

References 30 publications

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“…Comparable outcomes in terms of weight loss over a 5-year period were reported at the 3 rd International Summit of Sleeve Gastrectomy[3], with a mean percentage of excess weight loss of 62.7%, 64.7%, 64.0%, 57.3%, and 60.0% after 1, 2, 3, 4, and 5 years, respectively. These data are all consistent with other studies published to date[16,25-38] (Table 4). LSG outcomes are comparable to the gold standard procedure in bariatric surgery, the RYGB[6], thus supporting the role of LSG as a stand-alone bariatric operation for morbid obesity.…”

Section: Discussionsupporting

confidence: 93%

Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study

Hoyuela¹

2017

WJGS

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AIMTo prospectively evaluate the postoperative morbi-mortality and weight loss evolution of patients who underwent a laparoscopic sleeve gastrectomy (LSG) as a primary bariatric procedure during 5 years of follow-up.METHODSSince 2006, data from patients undergoing a highly restrictive primary LSG have been prospectively registered in a database and analysed. Preoperative co-morbid conditions, operating time, hospital stay, early and late complications rate and evolution of weight loss after 5 years of follow-up were analysed.RESULTSA total of 156 patients were included, 74.3% of whom were women. The mean age was 43.2 ± 13.1 years and the mean body mass index (BMI) was 41.5 ± 7.9 kg/m2. Seventy patients (44.8%) presented a BMI under 40 kg/m2. The mortality rate was 0%. The leakage rate was 1.2%, and the total 30-d morbidity rate was 5.1% (8/156). With a mean follow-up of 32.7 ± 28.5 (range 6-112) mo, the mean percent of excess of weight loss (%EWL) was 82.0 ± 18.8 at 1 year, 76.7 ± 21.3 at 3 years and 60.3 ± 28.9 at 5 years. The mean percent of excess of BMI loss (%EBMIL) was 94.9 ± 22.4 at 1 year, 89.4 ± 27.4 at 3 years and 74.8 ± 29.4 at 5 years. Patients with preoperative BMI less than 40 kg/m2 achieved greater weight loss than did the overall study population. Diabetes remitted in 75% of the patients and HTA improved in 71.7%. CPAP masks were withdrawn in all patients with obstructive sleep apnoea.CONCLUSIONLSG built with a narrow 34 F bougie and starting 3 cm from the pylorus proved to be safe and highly effective in terms of weight loss as a stand-alone procedure, particularly in patients with a preoperative BMI lower than 40 kg/m2.

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Section: Discussionsupporting

confidence: 93%

Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study

Hoyuela¹

2017

WJGS

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“…A previous study observed that obese female patients had higher body fat and lower muscle percentages than males [ 24 ]. Additionally, several studies have tested for gender differences in weight and fat loss after bariatric surgery [ 25 , 26 ]. One study found no significant differences in the BMIs of males and females after bariatric surgery, although male patients continued to weigh significantly more than females and lost significantly more pounds than did females after bariatric surgery [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Bioelectrical Impedance Analysis Results for Estimating Body Composition Are Associated with Glucose Metabolism Following Laparoscopic Sleeve Gastrectomy in Obese Japanese Patients

et al. 2018

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We investigated the association between body composition and changes in glucose metabolism following laparoscopic sleeve gastrectomy (LSG) in obese Japanese patients. Thirty-two Class III obese patients were assessed before LSG and 3, 6, and 12 months postoperatively. Variables including fat mass (FM), % body fat (%FM), total and skeletal muscle mass (MM), the ratio of lower extremity MM to body weight (BW) (L/W), and the ratio of upper extremity MM to BW (U/W) were measured while using bioelectrical impedance analysis (BIA). LSG significantly decreased BW, FM, and %FM in all time periods observed after surgery with concomitant improvements in metabolic markers. MM was decreased at three months but maintained from 3–12 months post-surgery. Importantly, %MM, U/W, and the L/W ratio increased after LSG. Furthermore, change in FM was positively correlated with change in BW 12 months after LSG, whereas changes in %MM were negatively correlated with fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). Finally, multivariable stepwise regression analyses showed that changes in % total MM was an independent determinant of FPG and change in % skeletal MM was a significant independent determinant of HbA1c in Class III obese Japanese patients after LSG.

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“…Perrone et al described better outcomes in terms of %EB-MIL in males than in females after LSG in 5-year follow-up, which is opposite to our results. However, we observed our patients for a shorter time and the male group had a higher BMI preoperatively [7]. Study conducted by Binda et al showed that lower age and preoperative weight loss are conducive to achieving higher %EWL, but no differences between genders have been found to be essential for the results [8].…”

Section: Discussionmentioning

confidence: 56%

Gender-related metabolic outcomes of laparoscopic sleeve gastrectomy in 6-month follow-up.

Groth

Woźniewska

Olszewska

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: Laparoscopic sleeve gastrectomy (LSG) is recently a leading method in surgical treatment of morbid obesity. The metabolic outcome of intervention may be a result of many factors such as age, gender, preoperative weight loss and dietary restrictions. Aim: To evaluate gender-related differences in the results of LSG in 6-month follow-up. Material and methods: The study included 101 patients who underwent LSG at the University Clinical Hospital of Bialystok. Patients were divided and analyzed in 2 groups: males (n = 48) and females (n = 53). The primary analysis included the influence of gender on postoperative weight loss calculated using the percentage of excess weight loss (%EWL) and excess BMI loss (%EBMIL). For secondary outcomes the levels of glucose, insulin, glycated hemoglobin, aspartate transaminase, alanine transaminase, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides and C-reactive protein were analyzed. Results: A significant influence of patients' gender was proved for both %EWL (p = 0.026) and %EBMIL (p = 0.001). Females had significantly higher %EWL in 6-month follow-up than males (p = 0.0034). The analysis also showed significantly higher %EBMIL for women at 3 and 6 months observation (p = 0.022 and p < 0.001 respectively). Conclusions: Laparoscopic sleeve gastrectomy is an effective method of obesity treatment especially in terms of postoperative weight loss. Females seem to benefit more from the procedure when analyzing the parameters of body mass reduction. However, further research is needed to provide strong evidence of an association between gender and the results of LSG.

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Gender Influence on Long-Term Weight Loss and Comorbidities After Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: a Prospective Study With a 5-Year Follow-up

Abstract: LSG was more effective in obese male than in female patients in terms of %EBMIL, with no difference in comorbidities. LRYGB elicited similar results in both genders in terms of %EBMIL and comorbidities.

Cited by 65 publications

References 30 publications

Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study

Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study

Bioelectrical Impedance Analysis Results for Estimating Body Composition Are Associated with Glucose Metabolism Following Laparoscopic Sleeve Gastrectomy in Obese Japanese Patients

Gender-related metabolic outcomes of laparoscopic sleeve gastrectomy in 6-month follow-up.

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