Roux-en-Y Gastric Bypass: Ten-year Results in a Cohort of 658 Patients. Issue 6 (December 2018)

• Record Type: Journal Article
• Authors: Duvoisin, Céline; Favre, Lucie; Allemann, Pierre; Fournier, Pierre; Demartines, Nicolas; Suter, Michel
• Is Part Of: Annals of surgery. Volume 268:Issue 6(2018:Dec.)
• Publication Date: 2018-12
• Subjects: bariatric surgery -- comorbidity -- complications -- long-term -- obesity -- Roux-en-Y gastric bypass -- weight loss; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000002538
• Languages: English
• ISSNs: 0003-4932

Abstract

Abstract : Objective: The aim of this paper is to report, with a high follow-up rate, 10-year results in a large cohort of patients after Roux-en-Y gastric bypass (RYGBP) done essentially by laparoscopy. Background: RYGBP has been performed for 50 years, including 20 years by laparoscopy, yet very few long-term results have been reported, mostly after open surgery. Methods: Prospective bariatric database established since the introduction of bariatric surgery. Retrospective data analysis on weight loss, long-term complications, quality of life, and comorbidities. Results: In all, 658 consecutive patients (515 women/143 men) were included: 554 with primary RYGBP, 104 with reoperative RYGBP. There was 1 (0.15%) postoperative death. Thirty-two (5%) patients died during follow-up from causes unrelated to surgery. Ten years after primary RYGBP, patients lost 28.6 ± 10.5% of their initial weight, corresponding to a mean of 13.2 body mass index (BMI) units. Among them, 72.8% achieved a BMI <35. Weight loss ≥20% was seen in 80.3% and <10% in 3.9% of patients. Results were similar in patients undergoing primary or reoperative RYGBP, but were better in patients who were initially less obese (BMI <50 kg/m 2 ) than in superobese patients. Quality of life and comorbidities significantly improved with 80% resolution or improvement of metabolic comorbidities. All patients required supplementations, and 14.6% required long-term reoperation. Conclusions: RYGBP provides long-term satisfactory weight loss up to 10 years, and significantly improves quality of life and comorbidities. Long-term complications requiring reoperation can develop. Mineral and vitamin supplementation are universally necessary. Other more effective surgical options should be discussed in patients with very severe obesity. Abstract : Supplemental Digital Content is available in the text