Bariatric Surgery in Patients With Inflammatory Bowel Disease: A Case-Control Study from the GETAID.


Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
01 08 2022
Historique:
received: 26 08 2021
pubmed: 13 10 2021
medline: 3 8 2022
entrez: 12 10 2021
Statut: ppublish

Résumé

The prevalence of obesity and the number of bariatric surgeries in both the general population and in patients with inflammatory bowel disease (IBD) have increased significantly in recent years. Due to small sample sizes and the lack of adequate controls, no definite conclusions can be drawn from the available studies on the safety and efficacy of bariatric surgery (BS) in patients with IBD. Our aim was to assess safety, weight loss, and deficiencies in patients with IBD and obesity who underwent BS and compare findings to a control group. Patients with IBD and a history of BS were retrospectively recruited to centers belonging to the Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID). Patients were matched 1:2 for age, sex, body mass index (BMI), hospital of surgery, and type of BS with non-IBD patients who underwent BS. Complications, rehospitalizations, weight, and deficiencies after BS were collected in cases and controls. We included 88 procedures in 85 patients (64 Crohn's disease, 20 ulcerative colitis, 1 unclassified IBD) with a mean BMI of 41.6 ± 5.9 kg/m2. Bariatric surgery included Roux-en-Y gastric bypass (n = 3), sleeve gastrectomy (n = 73), and gastric banding (n = 12). Eight (9%) complications were reported, including 4 (5%) requiring surgery. At a mean follow-up of 34 months, mean weight was 88.6 ± 22.4 kg. No difference was observed between cases and controls for postoperative complications (P = .31), proportion of weight loss (P = .27), or postoperative deficiencies (P = .99). Bariatric surgery is a safe and effective procedure in patients with IBD and obesity; outcomes in this patient group were similar to those observed in a control population.

Sections du résumé

BACKGROUND
The prevalence of obesity and the number of bariatric surgeries in both the general population and in patients with inflammatory bowel disease (IBD) have increased significantly in recent years. Due to small sample sizes and the lack of adequate controls, no definite conclusions can be drawn from the available studies on the safety and efficacy of bariatric surgery (BS) in patients with IBD. Our aim was to assess safety, weight loss, and deficiencies in patients with IBD and obesity who underwent BS and compare findings to a control group.
METHODS
Patients with IBD and a history of BS were retrospectively recruited to centers belonging to the Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID). Patients were matched 1:2 for age, sex, body mass index (BMI), hospital of surgery, and type of BS with non-IBD patients who underwent BS. Complications, rehospitalizations, weight, and deficiencies after BS were collected in cases and controls.
RESULTS
We included 88 procedures in 85 patients (64 Crohn's disease, 20 ulcerative colitis, 1 unclassified IBD) with a mean BMI of 41.6 ± 5.9 kg/m2. Bariatric surgery included Roux-en-Y gastric bypass (n = 3), sleeve gastrectomy (n = 73), and gastric banding (n = 12). Eight (9%) complications were reported, including 4 (5%) requiring surgery. At a mean follow-up of 34 months, mean weight was 88.6 ± 22.4 kg. No difference was observed between cases and controls for postoperative complications (P = .31), proportion of weight loss (P = .27), or postoperative deficiencies (P = .99).
CONCLUSIONS
Bariatric surgery is a safe and effective procedure in patients with IBD and obesity; outcomes in this patient group were similar to those observed in a control population.

Identifiants

pubmed: 34636895
pii: 6391132
doi: 10.1093/ibd/izab249
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1198-1206

Informations de copyright

© 2021 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Catherine Reenaers (C)

Hepato-gastroenterology Departement, CHU Sart Tilman, Liège University, Liège, Belgium.

Arnaud de Roover (A)

Abdominal surgery Departement, CHU Sart Tilman, Liège University, Liège, Belgium.

Laurent Kohnen (L)

Abdominal surgery Departement, CHU Sart Tilman, Liège University, Liège, Belgium.

Maria Nachury (M)

Univ. Lille, Inserm, CHU Lille, U1286 - Institute for Translational Research in Inflammation, F-59000 Lille, France.

Marion Simon (M)

Hepato-gastroenterology Departement, Insititut Mutualiste Montsouris, Paris, France.

Guillaume Pourcher (G)

Department of Digestive, Oncologic and Metabolic Surgery, Obesity Center, Institut Mutualiste Montsouris, Paris, France.
-Paris University.

Caroline Trang-Poisson (C)

Hepato-gastroenterology Departement, CHU Hôtel-Dieu, Nantes, France.

Sylvie Rajca (S)

AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Service de Gastroentérologie, Université de Paris, Colombes, France.

Simon Msika (S)

Abdominal surgery department, Louis Mourier Hospital, Colombes, France.

Stéphanie Viennot (S)

Hepato-gastroenterology Departement, CHU Caen, Caen, France.

Romain Alttwegg (R)

Hepato-gastroenterology Departement, CHU Montpellier, Montpellier, France.

Mélanie Serrero (M)

Hepato-gastroenterology Departement, APHM Hôpital Nord, Marseille, France.

Philippe Seksik (P)

Hepato-gastroenterology Departement, Saint-Antoine Hospital, APHP, Paris, France.

Laurent Peyrin-Biroulet (L)

Gastroenterology Departement, Nancy University Hospital, Université de Lorraine, Nancy, France.

Laurence Picon (L)

Hepato-gastroenterology Departement, CHRU Tours-TROUSSEAU Hospital, Tours, France.

Céline Bourbao Tournois (C)

Abdominal surgery department, CHRU Tours-TROUSSEAU Hospital, Tours, France.

Renaud Gontier (R)

Hepato-gastroenterology Departement, Centre Hospitalier de la Côte Basque, Bayonne, France.

Cyrielle Gilletta (C)

Hepato-gastroenterology Departement, ToulouseFrance.

Carmen Stefanescu (C)

Hepato-gastroenterology Departement, Beaujon hospital, APHP, France.

David Laharie (D)

Hepato-gastroenterology Departement, Haut-Lévêque Hospital, CHU, BordeauxFrance.

Xavier Roblin (X)

Hepato-gastroenterology Departement, CHU Saint-Etienne, Saint-Etienne, France.

Stéphane Nahon (S)

Hepato-gastroenterology Departement, Groupe Hospitalier Intercommunal Le Raincy Montfermeil, Montfermeil, France.

Guillaume Bouguen (G)

Hepato-gastroenterology Departement, CHU Pontchaillou 2, Rennes University, France.

Franck Carbonnel (F)

Hepato-gastroenterology Departement, CHU Bicêtre, Kremeli-Bicetre, France.

Alain Attar (A)

Hepato-gastroenterology Departement, Beaujon hospital, APHP, France.

Edouard Louis (E)

Hepato-gastroenterology Departement, CHU Sart Tilman, Liège University, Liège, Belgium.

Benoît Coffin (B)

AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Service de Gastroentérologie, Université de Paris, Colombes, France.

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