Marc-Cristian Cojocaru¹*, Anca Violeta Craitan², Victor Diaconu³ and Dan-Ioan Ulmeanu⁴

¹Department of General Surgery III, Bucharest Clinical Emergency Hospital, Romania
²Department of Anaesthesia and ICU, Bucharest Clinical Emergency Hospital, Romania
³Department of Obesity Surgery, Provita Medical Center Bucharest, Romania
⁴Chief Department of General and Thoracic Surgery, Regina Maria Hospital, Romania

*Corresponding Author: Marc-Cristian Cojocaru, Department of General Surgery III, Bucharest Clinical Emergency Hospital, Romania.

Received: December 09, 2024; Published: January 03, 2025

Abstract

Objective: The objective of this study is to demonstrate the major contribution of metabolic surgery in the treatment of obesity and the improvement or even complete remission of its associated comorbidities.

Patients and Methods: The study base of this thesis comprises a cohort of 272 patients diagnosed and treated at various stages of obesity at the Bariatric Surgery Center in Bucharest between January 2018, and June 2019.

Results: A higher prevalence of female patients (71%) and urban origin (88%) is a general characteristic of candidates for bariatric surgery. Patient compliance tends to favor laparoscopic vertical sleeve gastrectomy, with the decisive factor being the short hospital stay duration. Laparoscopic vertical sleeve gastrectomy requires thorough preoperative patient education regarding potential complications. A postoperative complication rate of 35.7% was observed, which aligns with rates reported in multicenter studies. All patients experienced significant weight loss 12 months after undergoing laparoscopic vertical sleeve gastrectomy, with an average excess weight loss percentage of 59.6%. The success of the surgical procedure showed higher values in diabetic patients compared to non-diabetic patients 12 months postoperatively, with marked weight loss during the first three months after surgery. More than half of the studied cohort (53.67%) presented with a BMI corresponding to grade II obesity, indicating a correlation between weight status awareness and the timing of seeking medical advice. Average plasma HbA1c levels demonstrated a consistent decline throughout the follow-up period. Dyslipidemia resolved in 48.8% of the patients. Both the short median hospitalization duration (2 days) and direct costs support the use of laparoscopic vertical sleeve gastrectomy.

Conclusion: The revision rate for vertical sleeve gastrectomy largely depends on the patient’s eating behavior. Skipping the preoperative psychiatric evaluation significantly reduces the success rate at 12 months postoperatively due to the adoption of harmful behaviors by patients.Recognizing that bariatric surgery is the only viable solution for sustained weight loss and improved quality of life in patients with morbid obesity underscores the need to incorporate these procedures into treatment guidelines and expand public access to this treatment option.

Keywords:Metabolic Surgery; Obesity; Postoperative Complications; Surgical Techn

References

1. Ministerul Sanatatii. “Copiii romani sunt normoponderali”. (2014).
2. Flegal KM., et al. “Overweight and obesity in the United States: prevalence and trends 1960-1964”. International Journal of Obesity (1998): 22-39.
3. CM Odgen CL. “Prevalence of Childhood and Adult Obesity in the United States 2011-2012”. JAMA 8 (2014): 806-814.
4. CV Mehta NK. “Mortality attributable to obesity among middle-agged adults in The United States”. (2009).
5. Odgen CL., et al. “Prevalence of high body mass index in US children and adolescents 2007-2008”. JAMA 3 (2010): 249-249.
6. European Union. “Health at a Glance: Europe OECD”. 3 (2014): 12.
7. E Comission. “A Pan-Eu Survey on Consumer Attitudes to Physical Activity”. Body Weight and Health (1999).
8. Mason JE., et al. “A prospective study of obesity and risk of coronary heart disease in women”. The New England Journal of Medicine (1991): 882-889.
9. Obesity-Cardiovascular Disease, Colwood House Medical Publications, (1996).
10. Mason JE., et al. “A prospective study of obesity and risk of coronary heart disease in women”. The New England Journal of Medicine (1991): 882-889.
11. Hubert H B., et al. “Obesity as an independent risk factor cardiovascular disease: A 26 year follow-up participants in the Farmingham Heart Study”. Circulation 67 (1983): 968-977.
12. W H Organisation. “Obesity: preventing and managing the global epidemic”. Geneva, 03.06.-05.06. (1997).
13. C C J and Frentzel Beyme. “Vegetarian diets and colon cancer: the German experience”. The American Journal of Clinical Nutrition (1994): 1143-1152.
14. W J., et al. “Williams Textbook of Endocrinology 9^th ed”. W.B. Saunders Co., (1998): 1061-1099.
15. Barbara L., et al. “A population study on the prevalence of gallstone disease”. Hepatology 7 (1987): 913-917.
16. D L C R Payne JH. “Metabolic observations in patients with jejunocolic shunts”. American Journal of Surgery 106 (1963): 273-289.
17. PJ DeWind LT. “Intestinal bypass surgery for morbid obesity: long-term results”. JAMA 294 (1976): 121-124.
18. S B A P Deitel M. “Long-termn out-come in a series of jejunoileal bypass patients”. Obesity Surgery 3 (1993): 247-252.
19. S B K Sylvan A. “Favorable long-termn results with end-to-side jejunoileal bypass”. Obesity Surgery 5 (1995): 357-363.
20. B B G H Kwong NK. “Electrical activity of the gastric antrum in man”. British Journal of Surgery 57 (1970): 913-916.
21. S H Monges H. “A method of recording the gastric electrical activity in man”. Digestive Disease 15 (1970): 271-276.
22. H E Miller K. “Orlistat treatment after failure of the adjustable gastric band system”. Obesity Surgery 4 (1990): 333.
23. N I o Health. “National Task Force on The Prevention and treatment of Obesity”. Weight cycling JAMA 272 (1994): 1196-202.
24. D C Popkin BM. “The obesity epidemic is a worldwide phenomen”. Nutrition Reviews (1998): 50-106-14.
25. C G and Wolf AM. “The cost of Obesity-The U.S. Perspective”. Pharmaco-Economics Supplement 5 (1994): 34-37.
26. Z P Hudge AM. “The cost of Obesity”. Medicographia 55 (1997): 13-17.
27. Hubert HB., et al. “Obesity as an independent risk factor cardiovascular disease: A 26-year follow-up of participants in the Framingham Heart Study”. Circulation 67 (1983): 968-977.
28. Egger G., et al. “An "ecological" approach to the obesity pandemic”. BMJ 315 (1997): 477-480.
29. Fried M., et al. “Literature review of comparative studies of complications with Swedish band and Lap-Band”. Obesity Surgery 14 (2004): 256-260.
30. BW S A C L K A D J S M O'Brian P. “The LAP-BAND provides effective control of morbid obesity - a prospective study of 350 patients followed for up to 4 years”. Obesity Surgery 8 (1998): 398.
31. “Influence of the initial volume of the gastric pouch on the rate of complication after adjustable silicone gastric banding”. Obesity Surgery 5 (1995): 247.
32. FL Choban PS. “The effect of Roux limb lenghts on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial”. Obesity Surgery 4 (2002): 540-545.
33. JM DeMaria EJ. “Surgical options for obesity”. Gastroenterology Clinics of North America 1 (2005): 127-142.
34. Nguyen NT., et al. “Laparoscopic versus open gastric bypass: a randomized study of out-comes, quality of life and costs”. Annals of Surgery 3 (2001): 279289.
35. Mokdad AH., et al. “Prevalence of obesity, diabetes and obesity-related health risk factors 2001”. JAMA 1 (2003): 76-79.

Citation

Citation: Marc-Cristian Cojocaru., et al. “Postoperative Complications in Metabolic Surgery". Acta Scientific Clinical Case Reports 6.2 (2025): 04-37.

Copyright

Copyright: © 2025 Marc-Cristian Cojocaru., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.