A Shared Decision-making Process may Affect Bariatric Procedure Selection and Alter Surgical Outcomes: a Single-unit...

Area of Science:

• Bariatric and Metabolic Surgery
• Patient-Centered Care
• Surgical Decision-Making

Background:

• Shared decision-making (SDM) enhances patient understanding and satisfaction.
• Implementing SDM in bariatric/metabolic surgery consultations is a growing area of focus.
• Patient perspective is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To evaluate the impact of SDM on the acceptance of bariatric/metabolic surgeries.
• To determine if SDM influences the choice between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).
• To assess the effect of SDM on 1-year post-operative results, including weight loss and comorbidity remission.

Main Methods:

• Retrospective analysis of 315 patients (BMI 32.5-50 kg/m²; age 20-65 years) undergoing bariatric/metabolic surgery consultation.
• Comparison of patient cohorts before (pre-SDM) and after (post-SDM) SDM program implementation.
• Analysis of consent rates, procedure choice (RYGB vs. SG), weight loss, and diabetes remission.

Main Results:

• Higher procedure acceptance was observed post-SDM (72% vs. 68%), though not statistically significant.
• A stronger preference for RYGB emerged post-SDM (71% vs. 62%).
• Significantly more diabetic patients chose RYGB post-SDM (34.1% vs. 15.2%; p=0.041), with RYGB achieving higher diabetes remission rates (76.2% vs. 66.7%).

Conclusions:

• SDM positively influenced bariatric/metabolic surgery selection, particularly favoring RYGB among diabetic patients.
• RYGB demonstrated superior diabetes remission rates compared to SG.
• Further research is needed to explore the broader effects of SDM on other surgical outcomes and patient adherence.