Additional preconditioning program for bariatric surgery: Any benefits? A large cohort study.

Area of Science:

• Bariatric Surgery
• Clinical Outcomes
• Health Resource Management

Background:

• Additional preconditioning programs (APP) are resource-intensive for bariatric surgery patients.
• Evidence supporting the effectiveness of APPs is limited and inconsistent.
• This study evaluates APP's impact on outcomes for vulnerable patients undergoing bariatric surgery.

Purpose of the Study:

• To determine the effectiveness of an additional preconditioning program (APP) in bariatric surgery.
• To compare outcomes between vulnerable patients with and without an APP.
• To assess the impact of APP on weight loss, comorbidities, and adherence.

Main Methods:

• Retrospective, single-centre cohort study with a before-and-after design.
• Compared vulnerable patients who received an APP (Sept 2017-Mar 2018) with those who did not (Sept 2018-Mar 2019).
• Key endpoints included % total weight loss (%TWL), bodyweight, comorbidity evolution, protein intake, and no-show rates.

Main Results:

• The group without APP showed statistically significant better %TWL at 7 and 12 months postoperatively.
• The comparator group (no APP) also had significantly lower bodyweight at 12 months.
• Differences in comorbidity evolution, protein intake, and no-shows favored the group without APP.

Conclusions:

• An additional preconditioning program (APP) was not superior to standard care in this cohort.
• Statistically significant differences observed were small, questioning clinical relevance.
• A bariatric surgery care pathway without an APP appears to be at least as effective as one with it.