Roux-en-Y gastric bypass: Pilot study results from a resource constrained setting

Obesity is a growing global health issue, with significant implications for comorbid conditions and overall mortality. Metabolic and bariatric surgery (MBS), particularly Roux-en-Y gastric bypass (RYGB), has proven effective in achieving sustained weight loss and improving comorbidity resolution. MBS is limited in the public sector within South Africa due to cost. This pilot study, taking into consideration the resource constrained setting in South Africa, aims to assess the outcomes of RYGB surgery in a low resource setting, focusing on weight loss, comorbidity resolution, and complications over a 3-year period.

A retrospective analysis was conducted on 17 patients who underwent RYGB at New Somerset Hospital, South Africa, between August 2017 and February 2020. The primary outcomes included percentage total weight loss (%TWL), excess weight loss (%EWL), and excess body mass index (BMI) loss (%EBMIL), while secondary outcomes involved the resolution of type 2 diabetes, hypertension, gastro‑oesophageal reflux disease (GERD), and dyslipidaemia.

At 3 years, the mean BMI decreased from 48.3 kg/m² to 38.35 kg/m², with a mean %TWL of 20.3%, %EWL of 42.5%, and %EBMIL of 43.2%. Notably, there were significant improvements in comorbidities, with a 50% resolution of type 2 diabetes, 71.4% resolution of GERD, and 66.7% resolution of dyslipidaemia. The complication rate was low, with one reported port site hernia.

This study highlights the feasibility and effectiveness of MBS in a resource-constrained setting and demonstrates its potential for improving patient outcomes in the context of the obesity epidemic in South Africa. Further studies with larger cohorts and longer follow-up are needed to validate these findings and explore the long-term impact of MBS on public health.