Abstract
Background:
Obesity is associated to elevated surgical and anesthetic risk due to the multiple pathologies related to it. Some authors consider that preoperative weight loss can improve health status, thus reducing peri and postoperative morbimortality, especially in bariatric surgery. If such weight loss should be indispensable before bariatric surgery continues to be a matter of debate.
Methods:
Prospective study included all patients submitted to bariatric surgery from January 2013 to January 2015. A preoperative diet (1200 kcal for women and 1500 kcal for men) was prescribed and surgery was performed only to patients presenting >10% of excess weight loss (%EWL). The primary objective was to analyze changes in weight loss (body mass index and %EWL) and their preoperative impact over biochemical (glucose, HbA1c%, total cholesterol, high density lipoprotein [HDL], low density lipoprotein, triglycerides, alanine aminotransferase, aspartate aminotransferase, and uric acid) and clinical parameters (systolic and diastolic blood pressure). Secondarily, a perioperative and morbidity analysis was performed.
Results:
A total of 200 patients were enrolled. The mean time between diet onset and surgery was 102.9 ± 40.9 days, resulting in a mean EWL of 22.2%. There was a significant improvement in every parameter, except for the HDL cholesterol and uric acid. There were 20 (10%) early complications without mortality. Reoperation by any cause was observed in two patients.
Conclusion:
A loss of >10% of excess weight before bariatric surgery ensures an optimal health status of candidates based on the significant improvement of their metabolic, lipid, hepatic, and clinical profiles and is independent of any parallel medical treatment.
Get full access to this article
View all access options for this article.