Abstract
Background
Extreme obesity leads to increased health risks and perioperative complications. The results of bariatric surgery in patients with super-super obesity (SSO) are presented in this study.
Methods
From April 2008 to August 2019, 60 patients with SSO underwent bariatric surgery. Their weight loss and surgical outcome were analyzed. The mean follow-up time was 7.2 years.
Results
At baseline, the mean age was 41.5 years old, the mean BMI was 63.8 kg/m2, 80% of the patients suffered from co-morbidities, and 23.33% were revisional surgeries. Weight loss continued for up to two years after surgery. The percentage of EBW lost at two years was 62.27%, from two to five years: 61.48%, from five to 10 years: 36.82% and after ten years it was 31.89%, the differences in weight change over the time is significative (P<.001). The mean BMI at last visit (Mean 7.2 years) was 45.1 kg/m2 and 48.33% of the patients failed to lose at least 50% of EBW. Patients with fatty liver, diabetes, sleep apnea and hyperlipidemia had a remission or improvement in more than 70% of the cases. There were 5% perioperative complications, one perioperative death (1.67%) and other patient died in a motor vehicle accident, overall mortality 3.33%.
Conclusion
In the long term, almost half of the patients failed to lose 50% of their EBW. However, the metabolic effects of bariatric surgery were maintained during the follow-up time with a high remission of comorbidities. Revisional bariatric surgery increased the risk of mortality.
Bariatric Surgery in Super-Superobese Patients Maintains Metabolic Improvement Beyond The Failure in Expected Weight Loss.
