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

Area of Science:

• Bariatric Surgery
• Public Health
• Metabolic Disorders

Background:

• Obesity is a global health crisis with severe consequences.
• Metabolic and bariatric surgery (MBS) offers sustained weight loss and improved comorbidities.
• MBS accessibility is limited in South Africa's public sector due to high costs.

Purpose of the Study:

• To assess the outcomes of Roux-en-Y gastric bypass (RYGB) in a resource-constrained South African setting.
• To evaluate weight loss, comorbidity resolution, and complication rates over a 3-year period.
• To determine the feasibility of MBS in a low-resource public healthcare environment.

Main Methods:

• Retrospective analysis of 17 patients undergoing RYGB.
• Data collected from August 2017 to February 2020 at New Somerset Hospital, South Africa.
• Primary outcomes: percentage total weight loss (%TWL), excess weight loss (%EWL), excess BMI loss (%EBMIL). Secondary outcomes: comorbidity resolution (T2D, hypertension, GERD, dyslipidemia).

Main Results:

• Mean BMI reduced from 48.3 to 38.35 kg/m² at 3 years.
• Significant weight loss achieved: %TWL 20.3%, %EWL 42.5%, %EBMIL 43.2%.
• Comorbidity resolution rates: 50% for type 2 diabetes, 71.4% for GERD, 66.7% for dyslipidemia. Low complication rate (one port site hernia).

Conclusions:

• MBS is feasible and effective in resource-constrained settings like South Africa.
• RYGB shows significant potential for managing the obesity epidemic and its comorbidities.
• Further research with larger cohorts and longer follow-up is recommended to validate findings.