Endocrine Abstracts

Aim: Describing bariatric surgery (BS) interventions in our center in the last five years, complications and effectiviness in weight loss and resolution of comorbities.

Methodology: Prospective descriptive study on a cohort of people who underwent BS surgery at Virgen Macarena University Hospital, a tertiary hospital of the Public Health System of Andalusia, between January 2018 and May 2023. Patients who underwent revision surgery with a first previous surgery were excluded. Description of demographic characteristics, complications, weight evolution, comorbidities associated with obesity (diabetes, arterial hypertension and OSA) and their remission after BS up to two years later. Quality criteria based on AEC and SECO recommendations.

Results: 217 patients, average age 46.55 years, 156 women (71.9%) Median follow-up time between surgery and last check-up 19.8 months. Most common surgery: vertical sleeve gastrectomy (77.88%), 21.66% gastric bypass. Surgery complications: early complications 23 cases (10.6%), 1 death (0.46%). Reintervention before 30 days 5.06%. Revision surgery: 5.52%, GERD most common cause. Initial average weight 140.7 kg (SDS 23.42). Initial BMI 51.36 kg/m², 14.5% weight loss in preparation for surgery. Average weight after one year 83.97 kg (SDS 14.10). Average weight after 2 years 83.29 (SDS 14.77), loss of 40.8% of weight and 79.2% of excess overweight. Average weight after 5 years 87.5 kg (SDS 14.5), weight loss of 37.8%. Comorbidities before BS: Diabetes mellitus (DM) 64 (29.5%), prediabetes 28 (12.9%). Average oral drugs for + GLP1a 2.01 (70.3% of patients with GLP1 analogues). 13 patients with insulin (20.6%, 64 IU/day on average, SDS 40.55). Arterial hypertension (AHT) 113 cases (52.1%), average number of drugs for control 2.03. OSA with CPAP 126 patients (58.1%). After BS: DM remission 69.8%. Insulinization 3 patients (1.38%), 12.55 IU/day on average (SDS 12.14). Cessation of aGLP1 in 97.77%. AHT remission 68.1%. Withdrawal of CPAP in patients with OSA 49.2%.

Conclusions: We observed good initial weight loss data, highlighting a high percentage of loss in the preoperative period and maintenance of the percentage obtained after the intervention. Sleeve vertical gastrectomy was the most used technique. The percentage of remission of comorbidities after BS is high two years after surgery. Greater follow-up is needed to evaluate definitive data on weight loss, medium-long term complications, evolution of comorbidities, need to reintroduce drugs due to comorbidities and revision surgery.