title: Effect of vagotomy during Roux-en-Y gastric bypass surgery on weight loss outcomes.
abstract: BACKGROUND
  During Roux-en-Y gastric bypasses (RYGB), some surgeons elect to perform a vagotomy to reduce symptoms of gastro-oesophageal reflux (GER). Routine vagotomy during RYGB may independently affect weight loss and metabolic outcomes following bariatric surgery. We aimed to determine whether vagotomy augments percent excess weight loss in obese patients after RYGB.
  
  
  METHODS
  We examined the effect of vagotomy in 1278 patients undergoing RYGB at our institution from 2003 to 2009. Weight and percent excess weight loss (%EWL) were modelled at three months and annually up to five years using a longitudinal linear mixed model controlling for differences in age, gender, initial body mass index (BMI), ideal body weight, and presence of vagotomy.
  
  
  RESULTS
  Vagotomy was performed on 40.3% of our cohort. Vagotomy patients had significantly lower initial BMI (46.4±6.2 vs. 48.3±7.7kg/m(2), p<0.001), but there were no other significant differences at baseline. The strongest predictor of %EWL over time was initial BMI, with lower BMI patients exhibiting greater %EWL (p<0.001). Age and gender effects were also significant, with younger patients (p<0.04) and males (p<0.002) attaining greater %EWL. Vagotomy had no effect on %EWL in either simple or multiple regression models.
  
  
  CONCLUSIONS
  Our series suggest that vagotomy does not augment %EWL when performed with RYGB.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. Electronic address: philokafor@gmail.com.
authors.forename: Philip N
authors.initials: PN
authors.lastname: Okafor
authors.affiliation: Department of Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States. Electronic address: chuehlien@gmail.com.
authors.forename: Chueh
authors.initials: C
authors.lastname: Lien
authors.affiliation: Department of Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States. Electronic address: sigrid.bairdain@childrens.harvard.edu.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Bairdain
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, United States. Electronic address: dsimonson@partners.org.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Simonson
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, United States. Electronic address: fhalperin@partners.org.
authors.forename: Florencia
authors.initials: F
authors.lastname: Halperin
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, United States. Electronic address: avernon@partners.org.
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Vernon
authors.affiliation: Pediatric Surgical Associates, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, United States. Electronic address: blinden@pediatricsurgical.com.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Linden
authors.affiliation: Department of Surgery, Emerson-Mass General Hospital, Harvard Medical School, 133 Old Road to Nine Acre Corner, Concord, MA 01742, United States. Electronic address: dlautz@emersonhosp.org.
authors.forename: David B
authors.initials: DB
authors.lastname: Lautz
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D004038:Diet, Reducing; D057286:Electronic Health Records; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000517:prevention & control / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D012727:Sex Characteristics; D014481:United States; D014629:Vagotomy, Proximal Gastric / Q000009:adverse effects; D015431:Weight Loss
keywords: Bariatric surgery; Obesity, Percent excess weight loss