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The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them

INTRODUCTION: Superobesity (SO) is defined as a BMI > 50 Kg/m(2), and represents the extreme severity of the disease, resulting in a challenge for the surgeons. METHODS: In this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients. RESULTS:...

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Autores principales: Medas, Fabio, Moroni, Enrico, Deidda, Simona, Zorcolo, Luigi, Restivo, Angelo, Canu, Gian Luigi, Cappellacci, Federico, Calò, Pietro Giorgio, Pintus, Stefano, Fantola, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932266/
https://www.ncbi.nlm.nih.gov/pubmed/36816006
http://dx.doi.org/10.3389/fsurg.2023.1100483
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author Medas, Fabio
Moroni, Enrico
Deidda, Simona
Zorcolo, Luigi
Restivo, Angelo
Canu, Gian Luigi
Cappellacci, Federico
Calò, Pietro Giorgio
Pintus, Stefano
Fantola, Giovanni
author_facet Medas, Fabio
Moroni, Enrico
Deidda, Simona
Zorcolo, Luigi
Restivo, Angelo
Canu, Gian Luigi
Cappellacci, Federico
Calò, Pietro Giorgio
Pintus, Stefano
Fantola, Giovanni
author_sort Medas, Fabio
collection PubMed
description INTRODUCTION: Superobesity (SO) is defined as a BMI > 50 Kg/m(2), and represents the extreme severity of the disease, resulting in a challenge for the surgeons. METHODS: In this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients. RESULTS: We included in this study 154 MO patients, with a median preoperative BMI of 40.8 kg/m(2), and 19 SO patients with median preoperative BMI of 54.9 kg/m(2). The MO patients underwent sleeve gastrectomy (SG) in 62 (40.3%) cases, laparoscopic Roux-and-Y gastric bypass (LRYGBP) in 85 (55.2%) cases and One-Anastomosis Gastric Bypass (OAGB) in 7 (4.5%) cases. underwent OAGB. The patients in the SO group were submitted to SG in 11 (57.9%) cases, LRYGBP in 5 (26.3%) cases, and OAGB in 3 (15.8%). At 24-month follow-up, an excess weight loss (EWL) >50% was achieved in 129 (83.8%) patients in the MO group and in 15 (78.9%) in the SO group (p = 0.53). A BMI < 35 kg/m(2) was achieved in 137 (89%) patients in the MO group and from 8 (42.2%) patients in the SO group (p < 0.001). The total weight loss was significantly directly related to the initial BMI. Superobesity was identified as independent risk factor for surgical failure when considering the outcome of BMI < 35 kg/m(2). DISCUSSION: Our study confirms that, although SO patients tend to gain a greater weight loss than MO patients, they less frequently achieve the desired BMI target. In this setting, it should be necessary to re-consider malabsorptive procedures as first choice.
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spelling pubmed-99322662023-02-17 The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them Medas, Fabio Moroni, Enrico Deidda, Simona Zorcolo, Luigi Restivo, Angelo Canu, Gian Luigi Cappellacci, Federico Calò, Pietro Giorgio Pintus, Stefano Fantola, Giovanni Front Surg Surgery INTRODUCTION: Superobesity (SO) is defined as a BMI > 50 Kg/m(2), and represents the extreme severity of the disease, resulting in a challenge for the surgeons. METHODS: In this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients. RESULTS: We included in this study 154 MO patients, with a median preoperative BMI of 40.8 kg/m(2), and 19 SO patients with median preoperative BMI of 54.9 kg/m(2). The MO patients underwent sleeve gastrectomy (SG) in 62 (40.3%) cases, laparoscopic Roux-and-Y gastric bypass (LRYGBP) in 85 (55.2%) cases and One-Anastomosis Gastric Bypass (OAGB) in 7 (4.5%) cases. underwent OAGB. The patients in the SO group were submitted to SG in 11 (57.9%) cases, LRYGBP in 5 (26.3%) cases, and OAGB in 3 (15.8%). At 24-month follow-up, an excess weight loss (EWL) >50% was achieved in 129 (83.8%) patients in the MO group and in 15 (78.9%) in the SO group (p = 0.53). A BMI < 35 kg/m(2) was achieved in 137 (89%) patients in the MO group and from 8 (42.2%) patients in the SO group (p < 0.001). The total weight loss was significantly directly related to the initial BMI. Superobesity was identified as independent risk factor for surgical failure when considering the outcome of BMI < 35 kg/m(2). DISCUSSION: Our study confirms that, although SO patients tend to gain a greater weight loss than MO patients, they less frequently achieve the desired BMI target. In this setting, it should be necessary to re-consider malabsorptive procedures as first choice. Frontiers Media S.A. 2023-02-02 /pmc/articles/PMC9932266/ /pubmed/36816006 http://dx.doi.org/10.3389/fsurg.2023.1100483 Text en © 2023 Medas, Moroni, Deidda, Zorcolo, Restivo, Canu, Cappellacci, Calò, Pintus and Fantola. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Medas, Fabio
Moroni, Enrico
Deidda, Simona
Zorcolo, Luigi
Restivo, Angelo
Canu, Gian Luigi
Cappellacci, Federico
Calò, Pietro Giorgio
Pintus, Stefano
Fantola, Giovanni
The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
title The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
title_full The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
title_fullStr The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
title_full_unstemmed The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
title_short The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
title_sort paradox of zeno in bariatric surgery weight loss: superobese patients run faster than morbidly obese patients, but can't overtake them
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932266/
https://www.ncbi.nlm.nih.gov/pubmed/36816006
http://dx.doi.org/10.3389/fsurg.2023.1100483
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