An overweight woman with a computer rendering of a gastric bypass superimposed on her stomach

Seven years after surgery, a laparoscopic Roux-en-Y stomach lost better weight than a gastrectomy, according to new data from the SLEEVEPASS randomized trial.

People with morbid obesity who underwent gastric bypass surgery lost an average of 55% of their body weight (95% CI 52% -59%) compared to 47% of patients with gastrectomy (95% CI 43% -50%) within 7 years : Dr. Paulina Salminen, PhD, doctor at Turku University Hospital in Finland և colleagues wrote JAMA surgery.

This difference of almost nine percentage points means that the two types of surgery do not meet the set standards of equivalence, said Turkun և colleagues.

Multicenter, multi-surgeon testing in Finland of these procedures1. Included 240 patients randomized by 1. The average BMI of the participants was 45.9 on average.

In the seventh year, both groups had similar complications. 24.0% in patients with gastrectomy և 28.6% in gastric bypass (Q:= 0.42): As for the main complications that occur 5-7 years after surgery, gastroesophageal reflux was the only one that affected gastrectomy patients, while hernias and removals were the only cases of gastric bypass grafting.

None of the surgeries surpasses the other in terms of disease quality of life. Overall-standard scores for the Bariatric Analysis and Reporting Outlook System Moorehead-Ardelt Quality of Life Questionnaire, average 0.50 և 0.49, for gastrectomy շրջ gastric bypass, respectively (Q:= 0.63): This tool examines self-esteem և daily activities such as social life, work և sexual activity.

The disease-specific quality of life has been improved by two procedures, from initial to seven years. And it is not surprising that greater weight loss was associated with better disease quality of life (ռ:= 0.26, Q:<0.001):

Patients with gastrectomy անց gastric bypass’s in the seventh year saw average mean health-related mean scores (0.88 և 0.87, respectively). Q:= 0.37), without any significant change from the initial value of each group. This result was measured by a 15-item questionnaire that looked at factors such as respiration, mental function, speech / communication, vision, mobility, normal activities, vitality, hearing, eating, elimination, sleep, restlessness, anxiety and symptoms, and sexual activity. , և depression.

Salminen’s team suggested that GERD և Barrett’s esophageal frequency after gastrectomy may affect how patients assess their quality of life. They called for these complications to be reversed in future randomized trials, and said their own study would examine them over a 10-year study, “allowing comparisons with preoperative esophageal status.”

In the accompanying commentary, Ann Arbor from the University of Michigan, Ph.D. According to them, one of the possible explanations is that “fluctuations are expected [versus] Real weight loss after surgery can affect how satisfied patients are with the outcome of surgery և how they assess their health problems [quality of life]”

While commentators praise the authors for using validated quality of life measures, they emphasize that the main limitation of these findings is the lack of more detailed data on mental health outcomes, particularly depression, anxiety, and bipolar disorder.

“As such, physicians need to be prepared not only to consider the short-term, long-term risks and benefits of each intervention, but also to realize that patients may have different goals, expectations, and each other,” the affair group wrote. “To this end, this study adds much-needed insights into the impact of bariatric surgery on QoL measures, which may be the most important outcome for some patients.”

Last updated: December 09, 2020.

  • Kristen Monaco is a staff writer focusing on endocrinology, psychiatry and dermatology news. Outside of New York, he worked for the company for almost five years.

Discoveries:

The SLEEVEPASS trial was supported by the Mary և Georg Ernroot Foundation, the EVO Foundation Government Research Grant, and the Gastroenterology Research Foundation.

Grönroos և co-authors reported on relationships with EVO Foundation, Turku University Foundation, Finnish Medical Foundation, Gastroests Disorders Research Foundation, Orion Pharma, Merck և Lilly.

Commentators have reported on the relationship between the veterans’ case and the Michigan Blue Cross Blue Shield’s Health Research և Patient-Based Research Institute.

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