title: Influence of reoperations on long-term quality of life after restrictive procedures: a prospective study.
abstract: Quality of life improves after bariatric surgery. However, long-term results and the influence of reoperations are not well known. A prospective quality of life assessment before, 1 and 7 years after laparoscopic adjustable gastric banding (LAGB) and vertical banded gastroplasty (VBG) was performed in order to determine the influence of reoperations during follow-up. One hundred patients were included in the study. Fifty patients underwent VBG and 50 LAGB. Patients completed the quality of life questionnaires prior to surgery and two times during follow-up. Health-related quality of life (HRQoL) questionnaires included the Nottingham Health Profile I and II and the Sickness Impact Profile 68. Follow-up was 84% with a mean duration of 84 months (7 years). During follow-up, 65% of VBG patients underwent conversion to Roux-en-Y gastric bypass while 44% of LAGB patients underwent a reoperation or conversion. One year after the procedure, nearly all quality-of-life parameters significantly improved. After 7 years, the Nottingham Health Profile (NHP)-I domain "physical ability", the NHP-II and the SIP-68 domains "mobility control", "social behavior", and "mobility range" were still significantly improved in both groups. The domains "emotional reaction", "social isolation" (NHP-I), and "emotional stability" (SIP-68) remained significantly improved in the VBG group while this was true for the domain "energy level" (NHP-I) in the LAGB group. Both the type of procedure and reoperations during follow-up were not of significant influence on the HRQoL results. Weight loss and decrease in comorbidities were the only significant factors influencing quality of life. Restrictive bariatric surgery improves quality of life. Although results are most impressive 1 year after surgery, the improvement remains significant after long-term follow-up. Postoperative quality of life is mainly dependent on weight loss and decrease in comorbidities and not on the type of procedure or surgical complications.
authors.affiliation: Department of Surgery, Atrium Medical Centre Parkstad, P.O. Box 4446, 6401, CX, Heerlen, The Netherlands. schoutenruben@hotmail.com
authors.forename: Ruben
authors.initials: R
authors.lastname: Schouten
authors.forename: Dorothee C M S
authors.initials: DC
authors.lastname: Wiryasaputra
authors.forename: Francois M H
authors.initials: FM
authors.lastname: van Dielen
authors.forename: Wim G
authors.initials: WG
authors.lastname: van Gemert
authors.forename: Jan Willem M
authors.initials: JW
authors.lastname: Greve
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D015391:Gastroplasty / Q000379:methods / Q000523:psychology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation; D011795:Surveys and Questionnaires; D015431:Weight Loss