Five-year outcomes of gastric bypass for super-super-obesity (BMI ≥60 kg/m2): A case matched study

Background: Laparoscopic gastric bypass (LRYGB) is feasible for patients with body mass index (BMI) >= 60 kg/m(2) (super-super-obesity [SSO]) but long-term data are lacking. The objective of this study was to compare the 5-year weight loss and changes in obesity-related co-morbidities after LRYGB for SSO and non-SSO patients. Methods: From January 2004 to November 2008, 32 SSO and 320 non-SSO patients underwent LRYGB. We matched 30 SSO patients undergoing LRYGB (case group) with 60 non-SSO patients (control group) for age, sex, and presence of type 2 diabetes. Results: Baseline data indicate that case and control groups did not differ for age (42 12.4 versus 41.8 11.5 yr; P =.92) or sex ratio (80% female, P =.99). Preoperative BMI were 64.1 4.1 and 46.3 5.6 kg/m2 in SSO and non-SSO groups, respectively (P <.0001). The rates of coexisting conditions in the 2 groups were comparable except for hypertension (76.7% versus 53.3%; P =.03). At 5 years after surgery, the percentage of initial weight loss (%IWL) (27.4 11.8 versus 29.7 9.2; P =.35) for the groups were comparable whereas percentage of excess weight loss (%EWL) (44.9 19.9 versus 66.5 21.2; P <.0001) was higher for non-SSO patients. Rates of remission or improvement of coexisting conditions, including diabetes and hypertension, did not differ significantly different between groups. Conclusion: According to %IWL and rate of partial or complete remission of diabetes and hypertension, our study shows similar outcomes for LRYGB in SSO and non-SSO patients 5 years after surgery. The %EWL does not seem to be an adequate indicator for evaluation of LRYGB outcomes in patients with extreme obesity, such as SSO. (Surg Obes Relat Dis 2015;11:32-37.) C 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.