Long-Term Outcomes of Bariatric Surgery: A Systematic Review

Abstract

Roux-en-Y gastric bypass (RYGB) is a minimally invasive procedure that usually takes two hours. It is commonly performed in refractory cases to help morbidly obese patients (BMI ≥ 40 kg/m2) lose weight. It is well known that morbid obesity accompanies other comorbid conditions such as atherosclerotic diseases, strokes, cancers, and mental health issues such as anxiety and depression. It is crucial to treat this category of patients to improve their quality of life and minimize the chance of mortality in these patients. Given the importance of treating this group, we explored the long-term outcomes of patients who underwent bariatric surgery for cardiovascular diseases, cancer, and depression compared to those who did not. This systematic review utilized articles identified through PubMed using the following search terms: (morbidly obese OR obesity OR obese) AND (bariatric surgery OR metabolic surgery OR gastric bypass OR gastrectomy) AND (chronic disease OR chronic diseases OR cardiovascular diseases OR heart diseases OR cancer OR neoplasms OR stroke OR depressive disorder OR depression). The filter used was observational studies, which yielded 217 studies. Out of these results, eight citations were included in an observational study that met our eligibility criteria. From our search, the articles showed a clinically significant decrease in the incidence of cardiovascular disease, cancer, and depressive disorders after treatment with bariatric surgery. Furthermore, there was also a correlation between bariatric surgery and remission of type 2 diabetes. The surgery has an apparent protective effect on the development and progression of comorbid conditions accompanying morbid obesity. Overall, the quality of life has improved in patients who have undergone the procedure compared to those who have not. Bariatric surgery must be recommended as a beneficial option in managing morbidly obese patients (BMI ≥ 40 kg/m2) who have responded poorly to first-line management plans.

Keywords: bariatric surgery; cancer; cardiovascular diseases; depression; gastric bypass; morbidly obese; roux-en-y gastric bypass.

Figure 1. PRISMA flowchart

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.