PUBLICAÇÕES científicas

Prognostic factors of weight loss after sleeve gastrectomy: Multi centre study in Spain and Portugal.

Sanchez Santos R (1), Corcelles R (2), Vilallonga Puy R (3), Delgado Rivilla S (4), Ferrer JV (5), Foncillas Corvinos J (6), Masdevall Noguera C (7), Socas Macias M (8), Gomes P (9), Balague Ponz C (10), de Tomas Palacios J (11), Ortiz Sebastian S (12), Sanchez Pernaute A (13), Puche Pla JJ (14), Sabench Pereferrer F (15), Abasolo Vega J (16), Suñol Sala X (17), Garcia Navarro A (18), Duran Escribano C (19), Cassinello Fernandez N (20), Perez N (21), Gracia Solanas JA (22), Garcia-Moreno Nisa F (23), Hernández Matias A (24), Valentí Azcarate V (25), Perez Folques JE (26), Navarro Garcia I (27), Dominguez-Adame Lanuza E (28), Martinez Cortijo S (29), González Fernández J (30).

(1) Complejo Hospitalario y Universitario de Pontevedra, Pontevedra, España.
(2) Hospital Clinic Barcelona, Barcelona, España.
(3) Hospital Universitario Vall d́Hebron, Barcelona, España.
(4) Hospital Clinic de Barcelona, Barcelona, España.
(5) Clínica Obesitas, Valencia, España.
(6) Quiron Salud-Hospital Universitari Sagrat Cor, Barcelona, España.
(7 Clínica Diagonal, Barcelona, España.
(8) Hospital Universitario Virgen del Rocío, Sevilla, España.
(9) Hospital Geral, Centro Hospitalar Univertario Coimbra, Coimbra, Portugal.
(10) Hospital Sant Pau, UAB, Barcelona, España.
(11) Hospital Gregorio Marañón, Madrid, España.
(12) Hospital General de Alicante, Alicante, España.
(13) Hospital Clínico San Carlos, Madrid, España.
(14) Hospital General Universitario de Valencia, Valencia, España.
(15) Hospital Universitario de Reus, Reus (Barcelona), España.
(16) Hospital de Basurto, Bilbao, España.
(17) Hospital de Mataró, Mataró (Barcelona), España.
(18) Hospital Virgen de las Nieves, Granada, España.
(19) Hospital Virgen de la Paloma, Madrid, España.
(20) Hospital Clínico Universitario de Valencia, Valencia, España.
(21) Hospital Virgen de los Lirios, Alcoy (Alicante), España.
(22) Hospital Clínico de Zaragoza, Zaragoza, España.
(23) Hospital Ramón y Cajal, Madrid, España.
(24) Hospital Universitario de Getafe, Getafe (Madrid), España.
(25) Clínica Universitaria de Navarra, Pamplona, España.
(26) Hospital Virgen del Castillo, Yecla (Murcia), España.
(27) Hospital Santa Lucía, Cartagena (Murcia), España.
(28) Hospital Universitario Virgen Macarena, Sevilla, España.
(29) Hospital de Talavera de la Reina, Talavera de la Reina (Toledo), España.
(30) Centro Médico Asturias, Oviedo, España. 

Revisão:Cirugía Española

Data: 18/Mar/2017

Área de Obesidade Cirurgia Geral e Digestiva

INTRODUCTION:
Sleeve gastrectomy (SG) has become a technique in its own right although a selective or global indication remains controversial. The weight loss data at 5 years are heterogeneous. The aim of the study is to identify possible prognostic factors of insufficient weight loss after SG.

METHODS:
A SG retrospective multicenter study of more than one year follow-up was performed. Failure is considered if EWL>50%. Univariate and multivariate study of Cox regression were performed to identify prognostic factors of failure of weight loss at 1, 2 and 3 years of follow up.

RESULTS:
A total of 1,565 patients treated in 29 hospitals are included. PSP per year: 70.58±24.7; 3 years 69.39±29.2; 5 years 68.46±23.1. Patients with EWL<50 (considered failure): 17.1% in the first year, 20.1% at 3 years, 20.8% at 5 years.

Variables with influence on the weight loss failure in univariate analysis were: BMI>50kg/m2, age>50years, DM2, hypertension, OSA, heart disease, multiple comorbidities, distance to pylorus> 4cm, bougie>40F, treatment with antiplatelet agents. The reinforcement of the suture improved results. In multivariate study DM2 and BMI are independent factors of failure.

CONCLUSION:
The SG associates a satisfactory weight loss in 79% of patients in the first 5 years; however, some variables such as BMI>50, age>50, the presence of several comorbidities, more than 5cm section of the pylorus or bougie>40F can increase the risk of weight loss failure.

CITAÇÃO DO ARTIGO  Cir Esp. 2017 Mar 18. pii: S0009-739X(17)30033-7. doi: 10.1016/j.ciresp.2017.02.002

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