title: Getting the most from the sleeve: the importance of post-operative follow-up.
abstract: BACKGROUND
  Bariatric approach to obesity provides substantial weight loss and comorbidity resolution. Our unique service includes pre- and postoperative visits to the Health and Nutrition Clinic headed by a specialist in gastroenterology and nutrition. We compared patients attending regular clinic routine with those who were lost to follow-up with regard to anthropometry, comorbidity, quality of life, and food tolerance and determined who benefited most from the operation.
  
  
  METHODS
  A retrospective review was performed on patients 30 months after undergoing sleeve gastrectomy. Body mass index was used to report weight loss. Bariatric Analysis and Reporting Outcome System (BAROS) and Food Tolerance Score were (FTS) completed by all patients at the 30-month follow-up visit and compared between two groups (group I-30 months of active postoperative follow-up; group II-without).
  
  
  RESULTS
  A total of 119 patients participated in the study. For groups I and II, the mean percentage of excess BMI loss at 30 months was 82.08 ± 9.83 and 74.88 ± 8.75, respectively, with better comorbidity improvement in group I. BAROS scores were 7.62 ± 0.72 and 6.92 ± 0.92. FTS was 24.30 ± 2.09 and 22.55 ± 2.27, respectively.
  
  
  CONCLUSIONS
  From our experience, getting the most from the sleeve is attributed to two main factors: surgery and nutrition. Surgery results in optimal restriction and improved satiety, whereas nutrition relies on a professional medical team providing constant, ongoing patient support throughout all the bariatric process stages. These teams of surgeons and gastroenterologists specializing in nutrition, working side by side, each in their area of specialty, are the main pillars leading to the success of the sleeve.
authors.affiliation: Bnai-Zion Medical Center, Technion Institute of Technology, Haifa, Israel. Dean.keren@b-zion.org.il
authors.forename: Dean
authors.initials: D
authors.lastname: Keren
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Matter
authors.forename: Tova
authors.initials: T
authors.lastname: Rainis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lavy
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D011182:Postoperative Care; D012189:Retrospective Studies; D055815:Young Adult