Original article
Improvement in quality of life after bariatric surgery: sleeve versus bypass

https://doi.org/10.1016/j.soard.2017.10.008Get rights and content

Abstract

Background

Obesity is steadily growing to be the largest threat to human health in this century, not only increasing prevalence of obesity-related co-morbidity but also impairing health-related quality of life (QoL). Bariatric surgery has shown to improve co-morbidity as well as QoL.

Objectives

To assess the differences in improvement in QoL for the 2 most performed procedures: laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB).

Setting

Obesity center, the Netherlands.

Methods

All patients who underwent either SG or RYGB as a primary operation from January 2012 until January 2017 were eligible. Included, were only those who completed preoperatively and 1-year postoperatively the QoL questionnaire. The RAND 36-item Health Survey was used to assess QoL.

Results

A total of 1184 cases were included in analysis of which 666 patients underwent SG and 518 patients underwent RYGB. Groups significantly differed in body mass index, weight, waist circumference, prevalence of gastroesophageal reflux disease, obstructive sleep apnea syndrome, and hypertension. All QoL domains greatly improved after bariatric surgery. Physical functioning increased more in patients who underwent gastric bypass. This remained significant after correcting for differences between groups. Other domains were not significantly different.

Conclusion

QoL is greatly improved at 1 year after bariatric surgery. The improvement was comparable after SG and RYGB, expect for more increase in physical functioning after RYGB. QoL could influence decision-making between SG and RYGB. So far, no clinically relevant differences were found. Future research should focus on both longer follow-up and more specific questionnaires.

Section snippets

Methods

A retrospective study of prospectively collected data including QoL of patients who underwent a bariatric procedure was conducted at a large obesity center in the Netherlands. Approximately 1000 bariatric procedures are performed in this hospital each year by dedicated bariatric surgeons. In March 2012, QoL assessment with RAND 36-item Health Survey questionnaire was introduced as standard of care. Data was collected from all adult patients who underwent a primary bariatric (i.e., laparoscopic

Demographic characteristics

A total of 3768 unique patients were operated from January 2012 until January 2017. First, the revision procedures, band removal, and 1 anastomosis bypasses were excluded (n = 588). Those operated in the first 3 months of 2012 and those of 2016 without a completed 1-year follow-up were excluded as well (n = 996). A total of 2184 were eligible, follow-up rate at the department was 96%, the rate of completed preoperative and postoperative questionnaires was 55%. A total of 1184 patients were

Discussion

The worldwide increase of obesity has led to an increase in bariatric procedures. While laparoscopic bypass has been the gold standard for several decades, laparoscopic SG has caught up to almost equal amounts of yearly procedures worldwide [7]. Reduction in weight, stabilization in weight, and reduction of obesity-related co-morbidity are mostly considered as primary outcomes in studies differentiating between both procedures, while the differences on health-related QoL remains unclear.

The

Conclusion

Health-related QoL greatly improved after both SG and gastric bypass. The improvement was comparable between the techniques, except for more increase in physical functioning after RYGB. QoL could influence decision-making between SG and gastric bypass. So far no clinically relevant differences were found. Future research should focus on both longer follow-up and more specific questionnaires.

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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