Different criteria for assessment of Roux-en-Y gastric bypass success: does only weight matter?
BACKGROUND
Medium and long-term efficacy of Roux-en-Y gastric bypass (RYGBP) has previously been demonstrated. However, weight-loss success criteria could be influenced by super-obesity prevalence at baseline. Here, we describe a 5-year follow-up concerning weight loss results, comorbidities, and mortality of a RYGBP Brazilian population with a high prevalence (60.6%) of super-obesity.


METHODS
One hundred ninety-three patients (142 female, 51 male) submitted to RYGBP were studied. Preoperative and follow-up body mass index (BMI), percent excess weight loss (%EWL), percent BMI loss (%EBL), and comorbidities were analyzed. Analysis of success was based on %EWL, Reinhold modified by Christou, and Biron criteria.


RESULTS
Five-year follow-up rates were 91.9%, 82.0%, 71.1%, 71.2%, 72.5%, respectively. By 2 years of follow-up, the rates of success based on %EWL, Reinhold modified by Christou, and Biron criteria were 90.4%, 63.4%, and 87.0%, respectively. By 5 years, these rates were 78.0%, 50.0%, and 74.0%, respectively. There was significant and persistent reduction of hypertension, diabetes mellitus, and dyslipidemia. Super-obesity was associated with the worst weight-loss results by modified Reinhold criteria, despite a significant reduction of comorbidities.


CONCLUSIONS
In the super-obese population, RYGBP was very efficient, contributing to significant weight loss and reduction in comorbidities. Mortality was more frequent than international rates, but this was most likely due to the severity of the cohort baseline. Success rates were different according to each criterion, but reaching BMI < 35 kg/m(2) was not necessary for improvement in comorbidities.
Diniz
Maria de Fátima Haueisen Sander
Mde F
Departamento de Clínica Médica, Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. mfhsdiniz@ufmg.br
Passos
Valéria Maria de Azeredo
VM
Barreto
Sandhi Maria
SM
Linares
Daniela Barreto
DB
de Almeida
Soraya Rodrigues
SR
Rocha
Alexandre Lages Savassi
AL
Diniz
Marco Túlio Costa
MT