Predictors of insufficient weight loss after sleeve gastrectomy.

Abstract

Background: Laparoscopic sleeve gastrectomy is a restrictive procedure that excises the greater curvature leaving a smallgastric tube. This procedure has been approved as an isolated bariatric procedure.Aim: To assess and predict causes of insufficient weight loss (IWL) within 1 year after sleeve gastrectomy.Patients and Methods: This randomized study was conducted on 80 patients with morbid obesity who presented forlaparoscopic sleeve gastrectomy at Gastroenterology Surgical Center, Mansoura University. Retrospective study wasconducted on 50 patients from January 2021 to July 2022 and prospective study was conducted on 30 patients from August 2022 to February 2023 and were followed-up till February 2024. The study was approved by the ethical committee at Mansoura Gastroenterology Surgical Center.Results: Regarding 12 months follow-up results, there was a statistically significant relation between dietary conditionsand insufficient weight loss. For sufficient weight loss; 37.8% Full bulk diet (as carbohydrates, fat, and protein diet), nosugars (sweets), 27% protein diet (as meat, chicken, fish and eggs), no sugars (sweets), 27% full bulk diet with increasesugars and 8.1% protein diet with increase sugars versus 100% of cases with IWL have full bulk diet with increase sugars.A statistically significant relation was detected also between physical activity and insufficient weight loss. For caseswith sufficient weight loss; 24.3% do exercise and 31.1% walk versus 100% of cases with IWL are physically inactive.Between cases with sufficient and insufficient weight loss, there was a statistically significant difference as regardspreoperative attempts of weight loss while there was no statistically significant difference as regards operative duration,amount of blood loss, and hospital stay per day.Conclusion: IWL can be predicted by dietary conditions and physical activity. This can help surgeons direct surgical ormedical interventions for patients at 3 months rather than at 1 year or beyond.