Preoperative change in 6-minute walk distance correlates with early weight loss after sleeve gastrectomy.
BACKGROUND
The 6-minute walk test (6MWT) is an objective preoperative measure of functional capacity and response to intervention in patients with heart or lung disease. In bariatric surgery, there has been no reliable preoperative measure predictive of postoperative success. Here we investigated the impact of bariatric surgery on changes in distance traveled in the 6MWT (the 6MWD) and whether preoperative changes in 6MWD correlated with weight change after surgery.


METHODS
This is a retrospective study of consecutive patients in which the 6MWT was performed before and after laparoscopic sleeve gastrectomy for weight loss. 6MWD and total weight were measured. Pearson correlation was used to determine association between variables.


RESULTS
Of 100 patients who underwent laparoscopic sleeve gastrectomy, 31 patients had a preoperative 6MWT. Thirty patients (97%) were available for follow-up after surgery. Percentage of excess weight loss was 45.7% over an average of 7 months after surgery. There was a weak correlation between the postoperative weight loss and the change in preoperative and postoperative 6MWD (r=0.28; P=.13). In a subset of patients who demonstrated a change in distance traveled in 2 separate preoperative 6MWD measurements (average 18.5% increase in distance), there was a strong correlation with postoperative weight loss (r=0.82; P=.02).


CONCLUSIONS
A demonstrated increase in 6MWD before surgery correlates strongly with early postoperative weight loss after laparoscopic sleeve gastrectomy. A multidisciplinary team that includes a physical therapist is useful in preparing bariatric patients for surgery.
Department of Surgery, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Nathan
N
Hansen
Department of Physical Medicine and Rehabilitation, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Eric
E
Hardin
Department of Medicine, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Cheryl
C
Bates
Department of Surgery, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Nina
N
Bellatorre
Department of Surgery, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Dan
D
Eisenberg
D005080:Exercise Test / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D057234:Preoperative Period; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D015431:Weight Loss
6-minute walk test; Bariatric surgery; Sleeve gastrectomy; Weight loss