Short-Term Outcomes of Inflammatory Bowel Disease after Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy.
Journal
Journal of the American College of Surgeons
ISSN: 1879-1190
Titre abrégé: J Am Coll Surg
Pays: United States
ID NLM: 9431305
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
02
11
2018
revised:
16
01
2019
accepted:
16
01
2019
pubmed:
24
2
2019
medline:
10
7
2020
entrez:
24
2
2019
Statut:
ppublish
Résumé
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most effective therapies for obesity and may have beneficial effects on the immune system. Therefore, we compared RYGB vs SG outcomes in patients with inflammatory bowel disease (IBD). In this retrospective cohort study, we identified 54 patients with either Crohn's disease (CD; n = 31) or ulcerative colitis (UC; n = 23), diagnosed before bariatric surgery, between 2000 and 2017. Nineteen patients underwent RYGB and 35 patients underwent SG. Patients presenting for RYGB and SG were of similar age (46.2 ± 9.5 years vs 47.2 ± 12.3 years), preoperative BMI (48.5 ± 7.7 kg/m A sizable proportion of patients experienced improvements in IBD post-bariatric surgery. However, in CD patients, RYGB was associated with a significantly greater number of patients with increased IBD-medication requirements. Sleeve gastrectomy led to less weight loss, but had a lower rate of severe complications compared with RYGB. In patients with IBD, and particularly CD, SG may be the safer surgery.
Sections du résumé
BACKGROUND
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most effective therapies for obesity and may have beneficial effects on the immune system. Therefore, we compared RYGB vs SG outcomes in patients with inflammatory bowel disease (IBD).
STUDY DESIGN
In this retrospective cohort study, we identified 54 patients with either Crohn's disease (CD; n = 31) or ulcerative colitis (UC; n = 23), diagnosed before bariatric surgery, between 2000 and 2017. Nineteen patients underwent RYGB and 35 patients underwent SG.
RESULTS
Patients presenting for RYGB and SG were of similar age (46.2 ± 9.5 years vs 47.2 ± 12.3 years), preoperative BMI (48.5 ± 7.7 kg/m
CONCLUSIONS
A sizable proportion of patients experienced improvements in IBD post-bariatric surgery. However, in CD patients, RYGB was associated with a significantly greater number of patients with increased IBD-medication requirements. Sleeve gastrectomy led to less weight loss, but had a lower rate of severe complications compared with RYGB. In patients with IBD, and particularly CD, SG may be the safer surgery.
Identifiants
pubmed: 30797083
pii: S1072-7515(19)30153-X
doi: 10.1016/j.jamcollsurg.2019.01.021
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
893-901.e1Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 American College of Surgeons. Published by Elsevier Inc. All rights reserved.