Long Term follow up after Bariatric Surgery

Introduction

Bariatric surgery (BS) is considering an effective treatment for morbid obesity.

Long-term follow-up after patients is essential for the success of the procedure and includes several aspects: medical monitoring and managing comorbid conditions, nutritional monitoring and deficiencies that may occur, assessment for surgical complications and monitoring of weight loss.

Methods

Data on patients undergoing BS was extracted from the Israeli National Bariatric Surgery Registry (NBSR) Including: demographics, BMI, comorbidities, and type of BS. Follow-up data (blood tests, BMI, dietician visits) from the HMO`s was reported six months, one- year, two years and three years after BS.

Results

During the study period 2014-2017 34,702 patients underwent BS, and were identified in the NBSR. 86.4% of whom were primary BS patients and 68.3% of which were females. The mean age and preoperative BMI were 41.6±12.6 years (range: 18.0-79.4 years) and 42.0±5.4 kg/m², respectively. Most of the procedures were sleeve gastrectomy 67.2%. The vast majority performed laparoscopically (99.0%)

The mean excess weight loss three years after BS was 74.7% after primary BS and 52.9% after revisional BS.

After two years an improvement was observed in most of the blood test measures ​​for assessing liver function, anemia, blood lipid levels, blood glucose test, HbA1c and renal function.

The rates of follow up after BS patients are, however, low and is declining over time. After 3 years only 14.0% of the patients contacted a dietician, 47.1% performed a blood test and 36.7% measured their weight.

Conclusions

Based on the NBSR, bariatric surgery is an effective treatment for morbid obesity.

However, the low follow up rates do not allow for straightforward conclusions or for learning about the effectiveness of BS over time.

It is necessary to improve the follow-up phase after bariatric surgery is performed to learn about the long-term impact of this procedure.