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. 2022 Jan;26(1):86-93.
doi: 10.1007/s11605-021-05055-5. Epub 2021 Jun 18.

Preoperative Weight Loss as a Predictor of Bariatric Surgery Postoperative Weight Loss and Complications

Jamil S Samaan  1 , Jasmine Zhao  2 , Elaine Qian  2 , Angelica Hernandez  2 , Omar Toubat  2 , Evan T Alicuben  2 , Yousaf Malik  2 , Kulmeet Sandhu  2 , Adrian Dobrowolsky  2 , Kamran Samakar  3
Affiliations

Preoperative Weight Loss as a Predictor of Bariatric Surgery Postoperative Weight Loss and Complications

Jamil S Samaan et al. J Gastrointest Surg. 2022 Jan.

Abstract

Background: The association between preoperative weight loss and bariatric surgery outcomes remains unclear. We explored the utility of preoperative weight loss as a predictor of postoperative weight loss success. Additionally, we examined the association of preoperative weight loss with perioperative complication rates.

Methods: Retrospective chart review of patients who underwent primary sleeve gastrectomy or primary Roux-en-Y gastric bypass for weight loss at a single institution between January 2003 and November 2017. Additional follow-up was obtained by a postoperative standardized patient questionnaire. Statistical analysis consisted of bivariate and multivariate logistic regression analysis.

Results: Our study included 427 patients. Majority were female (n = 313, 73.3%) and underwent sleeve gastrectomy (n = 261, 61.1%). Average age was 45.6 years, and average follow-up was 6.3 years. Greater preoperative weight loss was associated with decreased length of stay (1.8 vs 1.3 days) in patients who underwent sleeve gastrectomy. Multivariable regression analysis revealed that preoperative weight loss was not associated with postoperative weight loss.

Conclusions: Preoperative weight loss is not predictive of postoperative weight loss success after bariatric surgery. Greater preoperative weight loss was associated with a mild decreased in length of stay but was not associated with a reduction in operative time, overall complication rates, ICU admissions, or intraoperative complications. The inconclusive literature and our findings do not support the medical necessity of weight loss prior to bariatric surgery for the purpose of reducing surgical complications or predicting successful postoperative weight loss success.

Keywords: Bariatric surgery; Postoperative weight loss; Preoperative weight loss; Surgical complications.

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