The Newfoundland and Labrador Bariatric Surgery Cohort Study: Rational and Study Protocol

Abstract

BackgroundIn Canada, there has been a disproportionate increase in adults with Class II (BMI 35.0–39.9 kg/m2) or Class III obesity (BMI ≥ 40 kg/m2) affecting 9 % of Canadians with increases projected. Individuals affected by severe obesity (BMI ≥ 35) are at increased risk of high blood pressure, cardiovascular disease, diabetes, cancer, impaired quality of life, and premature mortality. Bariatric surgery is the most effective treatment for severe obesity. Laparoscopic sleeve gastrectomy (LSG), a relatively new type of bariatric surgery, is growing in popularity as a treatment. The global prevalence of LSG increased from 0 to 37.0 % between 2003 and 2013. In Canada and the US, between 2011 and 2013, the number of LSG surgeries increased by 244 % and LSG now comprises 43 % of all bariatric surgeries. Since 2011, Eastern Health, the largest regional health authority in Newfoundland and Labrador (NL), Canada has performed approximately 100 LSG surgeries annually.MethodsA population-based prospective cohort study with pre and post surgical assessments at 1, 3, 6, 12, 18, 24 months and annually thereafter of patients undergoing LSG. This study will report on short - to mid-term (2–4 years) outcomes. Patients (n = 200) followed by the Provincial Bariatric Surgery Program between 19 and 70 years of age, with a BMI between 35.0 and 39.9 kg/m2 and an obesity-related comorbidity or with a BMI ≥ 40 kg/m2 are enrolled. The study is assessing the following outcomes: 1) complications of surgery including impact on nutritional status 2) weight loss/regain 3) improvement/resolution of comorbid conditions and a reduction in prescribed medications 4) patient reported outcomes using validated quality of life tools, and 5) impact of surgery on health services use and costs. We hypothesize a low complication rate, a marked reduction in weight, improvement/resolution of comorbid conditions, a reduction in related medications, improvement in quality of life, and a decrease in direct healthcare use and costs and indirect costs compared to pre-surgery.DiscussionLimited data on the impact of LSG as a stand-alone procedure on a number of outcomes exist. The findings from this study will help to inform evidence-based practice, clinical decision-making, and the development of health policy.

The usefulness and costs of routine contrast studies after laparoscopic sleeve gastrectomy for detecting staple line leaks

“…The present study is part of a larger study, the Newfoundland and Labrador Bariatric Surgey Cohort Study, which has been described else where. 23,25 For the present study, we examined data from 200 consecutive laparoscopic sleeve gastrectomies per formed between May 11, 2011, and May 5, 2014. This study was approved by the provincial Health Research Ethics Authority (No.…”

“…25 Throughout this process, they were seen by a nurse practitioner, dietician, appropriate medical specialists, and 1 of the 3 bariatric surgeons. Patients were excluded if they were pregnant or planning a pregnancy within 2 years of surgical treatment; had a medi cal condition that would make surgery too risky, such as endstage organ disease; or had a BMI greater than 60.…”

Innovative Approaches to Address the Technical Challenge of Hernial Sac Distension Due to Pneumoperitoneum in the Synchronous Management of Complex Hernias in Individuals With Morbid Obesity

“…The prevalence of obesity continues to rise worldwide and has already reached pandemic proportions [1][2][3]. Bariatric surgery (BS) has proven to be highly efficacious in treating obesity and its comorbidities and has rapidly become a treatment option for severe obesity [2][3][4][5]. In terms of surgical intervention, three procedures mainly comprise the major bariatric volume across the globe.…”

“…In terms of surgical intervention, three procedures mainly comprise the major bariatric volume across the globe. The common procedures include sleeve gastrectomy (SG), Roux-en-Y gastric bypass, and adjustable gastric banding, with SG being the most popular bariatric operation [3][4][5][6]. Ventral hernia (VeH) is a common comorbidity seen in patients with obesity compared to the non-obese population.…”