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Do Complications Affect Weight Loss Following Sleeve Gastrectomy
Tara Mokhtari*, Archana Nair, John M. Morton
Surgery, Stanford University, Stanford, CA
INTRODUCTION
Bariatric surgery is an effective and enduring treatment for morbid obesity. In recent years, laparoscopic sleeve gastrectomy (LSG) has increased in popularity as an effective surgery. While several studies have examined postoperative complications following LSG, the relationship between complications and weight loss in this population has yet to be investigated.
METHODS
288 patients undergoing LSG at a single academic institution were prospectively enrolled. Preoperative demographic and anthropometric data were collected. Postoperative complications were recorded during a 12-month window and patient weight loss was tracked during this time. Major complications included: leak, GI bleeding, bowel obstruction, deep venous thrombosis/pulmonary embolism, intra-abdominal abscess, myocardial infarction, cerebrovascular incident, and pneumonia/respiratory insufficiency. Minor complications included: wound infection/dehiscence, vitamin deficiency/dehydration, arrhythmia, and ulcer/stricture formation. Student t-test and Fisher's exact analyses were used to compare continuous and dichotomous variables, respectively. Analysis performed with GraphPad Prism 6 and STATA, release 13.
RESULTS
Of 288 patients undergoing LSG, 6.6% experienced post-surgical complications with 5.21% experiencing one and 1.39% experiencing two complications. There were no differences observed between those with vs. without complications in regard to age (p=0.82), gender (0.58), race (p=0.16), income (p=0.25), type of insurance (p=0.23), or mean number of preoperative comorbidities (p=0.81). Study participants with subsequent complications had a significantly higher BMI at pre-op (47.2 vs 43.7, p=0.03) as well as at 12-months post-op (37.2 vs. 32.9, p=0.01). However, no significant difference in the percent of excess weight loss (%EWL) was observed at 3-, 6-, or 12-months after LSG between patients with vs. without post-surgical complications (all p's >0.13). Multivariate logistic regression showed post-surgical complications had no association with %EWL at 12-months (OR=0.24, 95% CI: 0.029-1.99, p=0.19). Pearson and Spearman correlation analyses did not demonstrate a significant relationship between complications and %EWL at the 12-month time point (p=0.28, p=0.13 respectively).
CONCLUSIONS
Postoperative complications are uncommon following LSG and warrant swift recognition and appropriate management. Utilizing broad inclusion criteria for all complications in a 12-month period, this study found that complications do not affect weight loss after LSG. The present findings suggest patients who experience complications following LSG can still achieve meaningful long-term weight loss.
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