Definition determines weight regain outcomes after sleeve gastrectomy
Definition determines weight regain outcomes after sleeve gastrectomy
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DOI：
10.1016/j.soard.2017.02.029
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发表时间：
2017-07-01
影响因子：
3.1
通讯作者：
MacCormick, Andrew D.
中科院分区：
文献类型：
--
作者：
Lauti, Melanie;Lemanu, Daniel;MacCormick, Andrew D.
背景：袖状胃切除术是最常见的减肥手术之一。减肥手术后体重恢复，如果显着，可能与糖尿病复发和生活质量恶化有关。此外，SG术后可能比搭桥手术更常见。目标：阐明缺乏标准定义如何显著改变已报道的体重恢复结果，并对如何定义体重恢复做出贡献。背景：县马努考健康医院，一家公立教学医院，每年进行150多例减肥手术。方法：使用5年随访的SG患者的回顾队列来说明文献中存在的多种定义如何显著影响体重恢复的结果报告。结果：采用6种体重恢复的定义对SG患者进行回顾性队列分析，结果显示6种不同的体重恢复率从9%到91%不等。事后分析显示体重变化与减肥分析报告结果系统(Baros)评分以及患者意见显著相关。结论：体重恢复的不一致报告似乎显著影响SG结果报告。制定协商一致的声明和准则将改善这一问题。理想情况下，能够访问大型稳健数据库的研究小组将帮助制定任何拟议的体重恢复定义。在此期间，减肥文献将受益于所有出版的系列文章，这些系列清楚地报告了研究人群中体重恢复的定义。(C)2017年美国新陈代谢和减肥外科学会。版权所有。
Background: Sleeve gastrectomy (SG) is one of the most commonly undertaken bariatric procedures. Weight regain after bariatric surgery, when significant, may be associated with recurrence of diabetes and deterioration in quality of life. Furthermore, it may be more common after SG than bypass procedures. Yet the understanding of the significance of weight regain is hampered by poor reporting and no consensus statements or guidelines.Objectives: To illustrate how the lack of a standard definition significantly alters reported SG outcomes and to contribute to the discussion of how weight regain should be defined.Setting: Counties Manukau Health, a public teaching hospital that performs over 150 bariatric procedures per year.Methods: A retrospective cohort of SG patients followed up at 5 years was used to illustrate how the presence of multiple definitions in the literature significantly affects outcome reporting for weight regain. Post hoc analyses were used to explore the relationship between weight change and clinical outcomes.Results: Applying 6 definitions of weight regain to a retrospective cohort of SG patients resulted in 6 different rates ranging from 9%-91%. Post hoc analyses revealed significant associations between weight change and the Bariatric Analysis Reporting Outcome System (BAROS) score as well as patient opinion.Conclusion: The nonuniform reporting of weight regain appears to significantly affect SG outcome reporting. Development of consensus statements and guidelines would ameliorate this problem. Ideally, research groups with access to large robust databases would aid in the development of any proposed weight regain definitions. In the interim, bariatric literature would benefit by all published series clearly reporting how weight regain is defined in the study population. (C) 2017 American Society for Metabolic and Bariatric Surgery. All rights reserved.