Outcomes in Bariatric and Metabolic Surgery: an Updated 5-Year Review

Area of Science:

• Bariatric and Metabolic Surgery
• Surgical Outcomes Research
• Obesity Medicine

Background:

• Postoperative outcomes in bariatric and metabolic surgery are continually advancing.
• Understanding evolving trends in weight loss, disease remission, and surgical complications is crucial.

Purpose of the Study:

• To review key findings in bariatric and metabolic surgery outcomes research from the past five years.
• To highlight advancements in weight loss, obesity-related disease remission, reflux, revisional surgery, robotic platforms, and adolescent populations.

Main Methods:

• Systematic review of recent literature (last 5 years) on bariatric and metabolic surgery outcomes.
• Analysis of data concerning weight loss, comorbidity remission, specific surgical techniques, and patient demographics.

Main Results:

• Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) show comparable 5-year weight loss; duodenal switch (BPD/DS) yields maximal weight loss and comorbidity resolution.
• Type 2 diabetes mellitus (T2DM) remission is higher in non-insulin-dependent patients. Surgery offers protection against coronary artery disease (CAD) and heart failure (HF).
• Gastroesophageal reflux disease (GERD) and dysphagia are common after SG. Robotic surgery shows similar outcomes to laparoscopy, potentially benefiting high BMI patients. Adolescent surgery mirrors adult outcomes with improved T2DM remission.

Conclusions:

• Bariatric surgery is effective for weight loss and obesity-related comorbidity management.
• While SG is effective, it is associated with high rates of postoperative GERD. Duodenal switch provides superior weight loss and comorbidity resolution.
• Revisional surgery has higher complication rates. Robotic platforms offer comparable outcomes, especially for high BMI patients. Adolescent bariatric surgery demonstrates favorable results.