Does weight loss after laparoscopic sleeve gastrectomy contribute to reduction in blood pressure?

INTRODUCTION: Obesity­related hypertension is a life threatening medical condition that significantly increases the risk of cardiovascular diseases and premature mortality. Effective treatment of obesity may be achieved by laparoscopic sleeve gastrectomy (LSG). This surgical method contributes not only to sustained weight loss but also to normalization of blood pressure. OBJECTIVES: To evaluate the effect of weight loss after LSG on partial or full control of blood pressure. PATIENTS AND METHODS: A retrospective analysis of medical and clinical data of 305 patients who had undergone LSG was performed. The bariatric effect of LSG was assessed by calculating percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL). Blood pressure status after surgery was categorized as partial or full hypertension resolution. RESULTS: A total of 143 patients (46.9%) were diagnosed with hypertension preoperatively with median (IQR) hypertension duration of 7.52 (1.88-13.16) years. Hypertensive patients were older (49 vs 38.5 years) and had higher prevalence of coexisting diseases (type 2 diabetes, dyslipidemia, and obstructive sleep apnea) than patients with normal blood pressure. During 1­year follow up, 90 patients (63%) used lower doses of antihypertensive medications and 33 patients (23%) discontinued the therapy. Twelve months after the surgery, median (IQR) %TWL in the control group was 32.5% (28.1%-37.7%), while in the hypertensive group, 29.1% (25.9%-33.6%) (P <0.001); %EWL was 62.9% (53%-74.6%) and 54.8% (47.4%-68.2%), respectively (P = 0.001), and %EBMIL 73.9% (59.5%-91.2%) and 63% (55%-80.5%), respectively (P = 0.002). CONCLUSIONS: Laparoscopic sleeve gastrectomy is an effective method for the treatment of obesity­ related hypertension. However, weight loss induced by LSG does not affect the blood pressure status after the surgery.

Complications associated with laparoscopic sleeve gastrectomy - a review.

Laparoscopic sleeve gastrectomy (LSG) is an essential bariatric procedure performed in obese patients, which provides significant weight loss and has a positive impact on obesity-related diseases. However, as with any surgical procedure, it carries the risk of complications. The complications that can arise in patients following LSG are divided into acute (diagnosed within 30 days after the surgery) and late. Early complications that require rapid management include haemorrhage (intraluminal or extraluminal), leak in the staple line, and abscess formation. Late complications include gastric stenosis, nutrient deficiencies, mediastinal pouch migration, and the development or exacerbation of gastroesophageal reflux diseases. In this review, we present the basic information about most common complications following LSG, and their symptoms, diagnostic tools, and management.

Impact of COVID-19 pandemic on bariatric patients in Podlaskie Voivodeship in Poland.

The research shows that despite the pandemic and higher risk of mortality and complications after SARS-CoV-2 infection, bariatric patients declare a high level of willingness to undergo the bariatric procedure, and the impact of COVID-19 pandemic does not play an important role in their decision-making process concerning the bariatric procedure. </br> </br> Due to the noticeable lifestyle changes during the pandemic such as greater food intake and decrease in physical activity among the bariatric patients, the process of qualification to the bariatric procedure should be conducted very meticulously and the recommended values for weight loss should be implemented to increase patients' motivation before and after the procedure. As the research shows, bariatric patients tend to neglect their strive for healthy lifestyle, even in the presence of the pandemic. Therefore, weight gain prior to the bariatric procedure can lead to more frequent complications during surgery and deterioration of the expected results of bariatric surgery. In conclusion, the group of bariatric patients is a high-risk group not only because of greater mortality due to COVID-19 infection, but also because they do not attach much importance to the external factors such as global pandemic.

The influence of patient's age on metabolic and bariatric results of laparoscopic sleeve gastrectomy in 2-year observation.

BACKGROUND: The incidence of obesity has been constantly growing and bariatric procedures are considered to be the most effective treatment solution for morbidly obese patients. The results of laparoscopic sleeve gastrectomy (LSG) may differ depending on patient's age, gender, preoperative body mass index (BMI) and physical activity. METHODS: The aim of this study was to evaluate age-related differences in the outcome of LSG in terms of weight loss parameters, lipid and carbohydrate profile. The retrospective analysis of 555 patients who had undergone LSG was performed to compare the metabolic outcomes of surgery in individuals < 45 and ≥ 45 years old. Evaluation of weight loss parameters along with selected laboratory data was performed to demonstrate the results of LSG in 2 years follow-up. RESULTS: Overall, 238 males and 317 females (43%/57%) with median age of 43 years and median preoperative BMI of 46.41 (42.06-51.02) kg/m2 were analyzed. Patients in both groups presented significant weight loss at 24 months after the surgery with comparable percentage of total weight loss (40.95% in < 45 years old group and 40.44% in ≥ 45 years old group). The percentage of excess weight loss (78.52% vs. 74.53%) and percentage of excess BMI loss (91.95% vs. 88.01%) were higher in patients < 45 years old. However, the differences were not statistically significant (p = 0.662, p = 0.788 respectively). Patients under 45 years old experienced faster decrease in fasting glucose level that was observed after only 3 months (109 mg/dl to 95 mg/dl in < 45 years old group vs. 103.5 mg/dl to 99.5 mg/dl in ≥ 45 years old group, p < 0.001). Both groups presented improvement of lipid parameters during the observation. However, patients < 45 years old achieved lower values of LDL at 3 and 12 months follow-up (115 mg/dl vs. 126 mg/dl, p = 0.010; 114.8 mg/dl vs. 122 mg/dl, p = 0.002). Younger group of patients also showed superior improvement of triglycerides level. CONCLUSIONS: LSG results in significant weight loss in all patients regardless age. In turn, superior and faster improvement in lipid and carbohydrate profile is achieved in patients under 45 years old.

Gender-related metabolic outcomes of laparoscopic sleeve gastrectomy in 6-month follow-up.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is recently a leading method in surgical treatment of morbid obesity. The metabolic outcome of intervention may be a result of many factors such as age, gender, preoperative weight loss and dietary restrictions. AIM: To evaluate gender-related differences in the results of LSG in 6-month follow-up. MATERIAL AND METHODS: The study included 101 patients who underwent LSG at the University Clinical Hospital of Bialystok. Patients were divided and analyzed in 2 groups: males (n = 48) and females (n = 53). The primary analysis included the influence of gender on postoperative weight loss calculated using the percentage of excess weight loss (%EWL) and excess BMI loss (%EBMIL). For secondary outcomes the levels of glucose, insulin, glycated hemoglobin, aspartate transaminase, alanine transaminase, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides and C-reactive protein were analyzed. RESULTS: A significant influence of patients' gender was proved for both %EWL (p = 0.026) and %EBMIL (p = 0.001). Females had significantly higher %EWL in 6-month follow-up than males (p = 0.0034). The analysis also showed significantly higher %EBMIL for women at 3 and 6 months observation (p = 0.022 and p < 0.001 respectively). CONCLUSIONS: Laparoscopic sleeve gastrectomy is an effective method of obesity treatment especially in terms of postoperative weight loss. Females seem to benefit more from the procedure when analyzing the parameters of body mass reduction. However, further research is needed to provide strong evidence of an association between gender and the results of LSG.