OBJECTIVE
To evaluate 3-year follow-up data after SLIM-OAGB considering reduction of excess body weight, quality of life and severity of postoperative reflux; to compare these indicators with a representative group of patients who underwent standard mini-gastric bypass (MGB-OAGB).
MATERIAL AND METHODS
To analyze loss of excess body weight, quality of life and severity of reflux, we used the SF-36, BAROS and GERD-HRQL systems to survey patients after SLIM-OAGB. Results were evaluated and compared with literature data on the incidence of reflux and weight loss after other bariatric interventions. Between June 2019 and December 2023, 396 patients aged 18—69 years underwent SLIM-OAGB; 32.3% of patients (n=128) participated in survey. Of these, 6 (4.7%) were men, 122 (95.3%) were women. At baseline, mean body weight was 92.47±11.3 kg (from 67 to 125 kg), BMI — 33.9±3.8 kg/m2 (from 25.46 to 46.07 kg/m2).
RESULTS
In 6 months after surgery, BMI was normal in all patients. After 1 year, this value was 24.4±3.52 kg/m2 (17.79—36.26 kg/m2), in patients with class I obesity — 23.2±2.33 kg/m2 (17.99—27.63 kg/m2). In 2 years after surgery, mean BMI was 23.3±3.38 km/m2 (18.36—31.25 km/m2), in patients with class I obesity — 22.33±2.5 kg/m2 (19.05—26.30 kg/m2). After 3 years, mean BMI was 22.03±2.9 kg/m2 (17.57—25.21 kg/m2), in patients with class I obesity — 22.39±3.1 kg/m2 (18.42—25.21 kg/m2). Mean %EWL value after 1 year was 117.72±46.6% (from 32.41 to 333.42%), in class I obesity— 126.4±33.4% (from 71.13 to 194.33%), after 2 years — 133.15±48.2% (from 69.81 to 254.55%), in class I obesity — 139.9±38.2% (from 82.76 to 207.14%). Mean %TWL after 1 year was 27.97±7.79% (12.96—45.26 %), in class I obesity — 28.44±6.91% (14.77—45.26%), after 2 years — 31.65±8.1% (14.29—45.92%), in class I obesity — 30.10±8.1% (16.67—41.18%), after 3 years — 31.54±6.3% (20.9—40.23), in class I obesity — 32.85±6.4% (26.53—40.23%). Fifty (39.06%) patients rated their health status as excellent, 27 (21.09%) — as very good, 35 (27.34%) — good, 4 (3.13%) — mediocre. Symptoms of reflux were observed in 7 (5.47%) patients. We surveyed 438 patients after MGB-OAGB operated on in 2019—2023. Clinical manifestations of reflux were observed in 25 patients (5.71%). Five (20%) patients after MGB-OAGB and 1 (14.3%) patient after SLIM-OAGB complained of reflux significantly reducing the quality of life (GERD-HRQL score 5).
CONCLUSION
SLIM-OAGB is highly effective in the treatment of obesity class 1 and II with loss of excess body weight in long-term postoperative period (3 years after intervention) and significant improvement of the quality of life. The incidence of biliary gastrointestinal reflux after SLIM-OAGB and MGB-OAGB was almost the same (5.47%).
