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Obesity Surgery
Published in: Obesity Surgery 4/2019

Open Access 01-04-2019 | Sleep Apnea | Original Contributions

Influence of Preoperative Weight Loss on Outcomes of Bariatric Surgery for Patients Under the Enhanced Recovery After Surgery Protocol

Authors: Tomasz Stefura, Jakub Droś, Artur Kacprzyk, Mateusz Wierdak, Monika Proczko-Stepaniak, Michał Szymański, Magdalena Pisarska, Piotr Małczak, Mateusz Rubinkiewicz, Michał Wysocki, Anna Rzepa, Michał Pędziwiatr, Andrzej Budzyński, Piotr Major

Published in: Obesity Surgery | Issue 4/2019

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Abstract

Introduction

The enhanced recovery after surgery (ERAS) protocol, which emphasizes preoperative interventions, is safely implemented in patients undergoing bariatric surgery. Patients are additionally encouraged to achieve weight loss preoperatively. We aimed to identify factors contributing to preoperative weight loss and assess their influence on outcomes of bariatric surgery among patients under the ERAS protocol.

Materials and Methods

We reviewed a prospectively created database in two bariatric centers with 909 bariatric patients treated in accordance with ERAS principles. The database included demographic characteristics, factors related to the surgery or perioperative period, and short-term outcomes. Our endpoints included analyses of (1) factors potentially contributing to preoperative weight loss and (2) the influence of preoperative weight loss on short-term outcomes of bariatric treatment.

Results

Diabetes mellitus (p = 0.007), obstructive sleep apnea (p < 0.001), and previous surgery (p = 0.012) were identified as predictors of preoperative weight loss. Steatohepatitis (p < 0.001) and respiratory disorder (p = 0.004) decreased the chance of achieving satisfactory preoperative body mass reduction. Except for operative time, early outcomes of bariatric surgery were not influenced by preoperative weight loss. Patients who achieved preoperative weight loss were less likely to be lost to follow-up (p = 0.023). Postoperative weight loss was better in patients who could lose ≥ 5% total weight preoperatively (p = 0.009).

Conclusion

Unsatisfactory preoperative weight loss among patients treated under ERAS principles is not associated with increased risk of complications. Satisfactory preoperative weight loss predicts superior postoperative weight loss and follow-up participation.
Appendix
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Metadata
Title
Influence of Preoperative Weight Loss on Outcomes of Bariatric Surgery for Patients Under the Enhanced Recovery After Surgery Protocol
Authors
Tomasz Stefura
Jakub Droś
Artur Kacprzyk
Mateusz Wierdak
Monika Proczko-Stepaniak
Michał Szymański
Magdalena Pisarska
Piotr Małczak
Mateusz Rubinkiewicz
Michał Wysocki
Anna Rzepa
Michał Pędziwiatr
Andrzej Budzyński
Piotr Major
Publication date
01-04-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-03660-z

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