PMID- 38519610
OWN - NLM
STAT- MEDLINE
DCOM- 20240509
LR  - 20240509
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 38
IP  - 5
DP  - 2024 May
TI  - Intensive pre-operative information course (IPIC) and pre-operative weight loss 
      results in long-term sustained weight loss following bariatric surgery: 11 years 
      results from a tertiary referral centre.
PG  - 2689-2698
LID - 10.1007/s00464-024-10791-1 [doi]
AB  - INTRODUCTION: Outcomes of long-term (5-10-year) weight loss have not been 
      investigated thoroughly and the role of pre-operative weight loss on long-term 
      weight loss, among other factors, are unknown. Our regional bariatric service 
      introduced a 12 week intensive pre-operative information course (IPIC) to 
      optimise pre-operative weight loss and provide education prior to bariatric 
      surgery. The present study determines the effect of pre-operative weight loss and 
      an intense pre-operative information course (IPIC), on long-term weight outcomes 
      and sustained weight loss post-bariatric surgery. METHODS: Data were collected 
      prospectively from a bariatric center (2008-2022). Excess weight loss (EWL) >/= 50% 
      and >/= 70% were considered outcome measures. Survival analysis and logistic 
      regression identified variables associated with overall and sustained EWL >/= 50% 
      and >/= 70%. RESULTS: Three hundred thirty-nine patients (median age, 49 years; 
      median follow-up, 7 years [0.5-11 years]; median EWL%, 49.6%.) were evaluated, 
      including 158 gastric sleeve and 161 gastric bypass. During follow-up 273 
      patients (80.5%) and 196 patients (53.1%) achieved EWL >/= 50% and >/= 70%, 
      respectively. In multivariate survival analyses, pre-operative weight loss 
      through IPIC, both < 10.5% and > 10.5% EWL, were positively associated with 
      EWL >/= 50% (HR 2.23, p < 0.001) and EWL >/= 70% (HR 3.24, p < 0.001), respectively. 
      After a median of 6.5 years after achieving EWL50% or EWL70%, 56.8% (154/271) had 
      sustained EWL50% and 50.6% (85/168) sustained EWL70%. Higher pre-operative weight 
      loss through IPIC increased the likelihood of sustained EWL >/= 50% (OR, 2.36; 
      p = 0.013) and EWL >/= 70% (OR, 2.03; p = 0.011) at the end of follow-up. 
      CONCLUSIONS: IPIC and higher pre-operative weight loss improve weight loss 
      post-bariatric surgery and reduce the likelihood of weight regain during 
      long-term follow-up.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Lucocq, James
AU  - Lucocq J
AUID- ORCID: 0000-0002-6979-7818
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Thakur, Vikram
AU  - Thakur V
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Geropoulos, Georgios
AU  - Geropoulos G
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Stansfield, Daniel
AU  - Stansfield D
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Irvine, Laura
AU  - Irvine L
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Duxbury, Mhairi
AU  - Duxbury M
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - de Beaux, Andrew C
AU  - de Beaux AC
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Tulloh, Bruce
AU  - Tulloh B
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Wallace, Beverley
AU  - Wallace B
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Joyce, Brian
AU  - Joyce B
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Harrow, Lisa
AU  - Harrow L
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Drummond, Gillian
AU  - Drummond G
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Lamb, Peter J
AU  - Lamb PJ
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK.
FAU - Robertson, Andrew G
AU  - Robertson AG
AD  - Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary 
      Edinburgh, Edinburgh, UK. Andrew.gn.robertson@nhslothian.scot.nhs.uk.
AD  - Department of Clinical Surgery, NHS Lothian, University of Edinburgh, Edinburgh, 
      UK. Andrew.gn.robertson@nhslothian.scot.nhs.uk.
LA  - eng
PT  - Journal Article
DEP - 20240322
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Humans
MH  - *Weight Loss
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - *Bariatric Surgery/methods
MH  - *Obesity, Morbid/surgery
MH  - Adult
MH  - *Tertiary Care Centers
MH  - Prospective Studies
MH  - Patient Education as Topic/methods
MH  - Preoperative Care/methods
MH  - Treatment Outcome
MH  - Follow-Up Studies
MH  - Time Factors
OTO - NOTNLM
OT  - Bariatric
OT  - Preoperative
OT  - Weight loss
EDAT- 2024/03/23 20:43
MHDA- 2024/05/09 06:42
CRDT- 2024/03/23 00:36
PHST- 2023/12/08 00:00 [received]
PHST- 2024/03/09 00:00 [accepted]
PHST- 2024/05/09 06:42 [medline]
PHST- 2024/03/23 20:43 [pubmed]
PHST- 2024/03/23 00:36 [entrez]
AID - 10.1007/s00464-024-10791-1 [pii]
AID - 10.1007/s00464-024-10791-1 [doi]
PST - ppublish
SO  - Surg Endosc. 2024 May;38(5):2689-2698. doi: 10.1007/s00464-024-10791-1. Epub 2024 
      Mar 22.