Improved Obesity Reduction and Co-morbidity Resolution in Patients Treated with 40-French Bougie Versus 50-French Bougie Four Years after Laparoscopic Sleeve Gastrectomy. Analysis of 294 Patients

Atkins, Emily; Preen, David; Jarman, Catherine; Cohen, Leon
January 2012
Obesity Surgery;Jan2012, Vol. 22 Issue 1, p97
Academic Journal
Background: We compared percent excess body mass index loss (%EBMIL) and resolution of dyslipidaemia, hypertension, and type 2 diabetes mellitus in the 4 years following laparoscopic sleeve gastrectomy (LSG) between patients calibrated with a 40-French (40F) or a 50-French (50F) bougie. Methods: We conducted a longitudinal retrospective descriptive study of routinely collected pre- and post-surgical data from 294 patients who underwent LSG at a single surgical centre (50F- n = 106, 40F- n = 185). Obesity measurements were taken prior to surgery and at regular intervals until 48 months post-surgery. Co-morbidity resolution was also assessed across the 48-month observation period. Multivariate regression modelling was used to control analyses for baseline obesity and sociodemographic variables. Results: At 48 months post-surgery mean (±SD) %EBMIL was 60.2 ± 27.6% and 45.4 ± 38.4% for those treated with the 40F and 50F bougie, respectively. After controlling for sociodemographic variables and baseline excess weight, mean %EBMIL was 15.5% greater with a 40F bougie compared with a 50F bougie at the end of follow-up. The likelihood of dyslipidaemia resolution within 48 months post-LSG was 19.0 times greater ( p = 0.006), hypertension resolution 3.6 times greater ( p = 0.005) and type 2 diabetes mellitus resolution 5.2 times greater ( p = 0.034) by 4 years post-surgery in patients treated with the 40F bougie compared with a 50F bougie. Conclusion: Improved obesity reduction and resolution of dyslipidaemia, hypertension and type 2 diabetes mellitus is experienced during the 4 years following surgery by patients treated with a 40F bougie compared with the 50F. These findings remain when controlling for potential confounding clinical and sociodemographic factors.


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