Abstract
Background
Short- and mid-term data on Roux-en-Y gastric bypass (RYGB) indicate sustained weight
loss and improvement in co-morbidities. Few long-term studies exist, some of which
are outdated, based on open procedures or different techniques.
Objectives
To investigate long-term weight loss, co-morbidity remission, nutritional status,
and complication rates among patients undergoing RYGB.
Setting
An academic, university hospital in the United States.
Methods
Between October 2000 and January 2004, patients who underwent RYGB≥10 years before
study onset were eligible for chart review, office visits, and telephone interviews.
Revisional surgery was an endpoint, ceasing eligibility for study follow-up. Outcomes
included weight loss measures and rates of co-morbidity remission, complications,
and nutritional deficiencies.
Results
RYGB was performed in 328 patients with a mean preoperative body mass index of 47.5
kg/m2. Of 294 eligible patients, 134 (46%) were contacted for follow-up at≥10 years (10+Year
follow-up). Mean percentage excess weight loss (%EWL) was 58.9% at 10+Year. Higher
%EWL was achieved by non–super-obese versus super-obese (61.3% versus 52.9%, P = .034). Blood pressure, lipid panel, and hemoglobin A1c improved significantly. At 10 years, remission of co-morbidities was 46% for hypertension
and hyperlipidemia and 58% for diabetes mellitus. Thirty patients (9%) had revisional
surgery for weight regain. Sixty-four patients (19.5%) had long-term complications
requiring surgery. All-cause mortality was 2.7%. Nutritional deficiencies were seen
in 87% of patients.
Conclusions
Weight loss after RYGB appears to be significant and sustainable, especially in the
non–super-obese. Co-morbidities are improved, with a substantial number in remission
a decade later. Nutritional deficiencies are almost universal.
Keywords
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Article info
Publication history
Published online: April 23, 2015
Accepted:
April 18,
2015
Received:
March 7,
2015
Identification
Copyright
© 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
