Laparoscopic sleeve gastrectomy and one anastomosis gastric bypass showed similar weight loss patterns, while Roux-en-Y gastric bypass resulted in further weight reduction starting in the third year.
Patients who revised from laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass experienced greater weight loss (102.1%) compared to those revised to mini-gastric bypass (84.6%).
Nutritional deficiencies were common, with 41.2% of revised laparoscopic sleeve gastrectomy patients experiencing iron deficiency and 14.3% developing new vitamin D deficiencies.
Eighty-five percent of patients reported improvements in quality of life and expressed a willingness to undergo surgery again.
There is a need for individualized supplementation and long-term monitoring due to the prevalence of deficiencies.
Simplified
BACKGROUND: This study analyzes the long-term outcomes of (MBS), focusing on weight loss, nutritional deficiencies, and patient satisfaction. We evaluate different surgical techniques to identify their impact on these outcomes.
METHODS: A five-year retrospective analysis was conducted on 249 patients who underwent MBS at a specialized center. Baseline characteristics included an average age of 38.5 years, weight of 118.5 kg, and BMI of 43.2 kg/m². Weight loss outcomes were assessed using mean (%EWL) at 60 months. Surgical techniques included laparoscopic sleeve gastrectomy (LSG), one anastomosis gastric bypass (OAGB), and Roux-en-Y gastric bypass (RYGB). Nutritional deficiencies and patient-reported quality of life were also evaluated.
RESULTS: The mean %EWL at 60 months was 92.1% ± 25.8% (p = 0.013). While LSG and OAGB showed similar weight loss patterns, RYGB resulted in further weight reduction from the third year onwards. Patients revised from LSG to RYGB had significantly greater weight loss (102.1%) compared to those revised to mini-gastric bypass (MGB) (84.6%, p < 0.05). Nutritional deficiencies were prevalent, with 41.2% of revised LSG patients experiencing iron deficiency and 14.3% developing new vitamin D deficiencies (p < 0.05). Most patients (85%) reported improvements in quality of life, and 85% expressed a willingness to undergo surgery again (p = 0.0028).
CONCLUSIONS: MBS resulted in substantial and sustained weight loss, particularly in RYGB patients. Surgical revisions, especially from LSG to RYGB, were associated with greater weight loss but also increased nutritional risks. Persistent iron and vitamin D deficiencies highlight the necessity of individualized supplementation and long-term monitoring. Type-targeted supplementation represents an innovative approach to optimizing long-term nutritional support in bariatric patients. Future studies with larger cohorts and validated tools are needed to confirm these findings and strengthen clinical guidelines.
TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov (NCT06664580).
Key numbers
92.1%
Mean %EWL at 60 months
Average percentage of across all patients at 60 months.
41.2%
Iron deficiency in revised patients
Percentage of revised sleeve gastrectomy patients experiencing iron deficiency.
85%
Patient satisfaction
Percentage of patients reporting improved quality of life and willingness to repeat surgery.
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Declarations. Ethics approval and consent to participate: The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Lazio Area 5 Territorial Ethics Committee (100/SR/24). All participants provided written informed consent before being included in the study. Consent for publication: All authors and participants have provided consent for the publication of this manuscript and its findings. Competing interests: The authors declare that they have no competing interests.
