BEST WEIGHT LOSS MODEL AFTER STANDARD BARIATRIC SURGERY FOR MORBIDLY OBESE PATIENTS IN KOREA

초록

Background Since national insurance coverage started for bariatric surgery in Korea, laparoscopic sleeve gastrectomy (LSG) and Roux-en Y gastric bypass (LRYGB) are main bariatric procedures now. There is increasing demand on which assesses the effect of bariatric surgery, such as excess body weight loss (EWL) and total weight loss (TWL), and even on which predicts the effect of bariatric surgery. Objectives This study aimed to evaluate feasibility and 1-year weight loss outcomes of these two procedures in Korean morbid obese patients after national insurance coverage and find out which of these two criteria is better by validating previous weight loss predicting models . Methods Between 2019. Jan. and 2022. Jun., a retrospective data of morbid obesity patients who underwent either LSG or LRYGB from 4 hospitals was analyzed. Primary endpoint was 1-year follow up data of weight loss. Secondary endpoints included to find any risk factors affecting whether either 50% or more EWL or 25% or more TWL was achieved and to validate two different weight loss models using our data. Results A total of 137 patients were collected in the period. 76 patients underwent LSG and 62 patients underwent LRYGB. Mean age was significantly higher in patients who underwent LRYGB than LSG (47.3 ± 10.9 vs. 40.7 ± 12.0, P<0.001). Preoperative BMI was higher in patients who underwent LSG (39.8 ± 6.9 vs. 36.4 ± 5.1, P<0.001). significantly more patient underwent LRYGB. BMI was the only independent risk factor of hindering from achievement of 50% or more EWL (OR = 0.830, 95% confidence interval(CI) 0.764-0.902), whereas TWL was not affected by BMI (OR =1.010, 95% CI 0.957-1.065). External validation using Baltasar’s model using BMI showed highest accuracy (adjusted R2 , 71.3%), whereas lesser BMI difference was predicted in Seyssel’s model using TWL. Conclusion Both laparoscopic LSG and LRYGB were feasible and effective bariatric procedures for successful weight loss morbid obese patients in Korea. EWL and TWL proved to be similar trends for the success of 1-year weight loss. TWL model appeared to be a criterion that could more accurately predict weight loss without being affected by preoperative weight.