Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey
Background The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data. Methods We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery thr...
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| Veröffentlicht in: | Obesity surgery 2017-03, Vol.27 (3), p.754-762 |
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| creator | Haruta, Hidenori Kasama, Kazunori Ohta, Masayuki Sasaki, Akira Yamamoto, Hiroshi Miyazaki, Yasuhiro Oshiro, Takashi Naitoh, Takeshi Hosoya, Yoshinori Togawa, Takeshi Seki, Yosuke Lefor, Alan Kawarai Tani, Toru |
| description | Background
The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data.
Methods
We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery throughout Japan and reviewed outcomes. Surveys were sent to ten institutions for number of procedures, preoperative patient weight and preoperative obesity-related comorbidities, and data at 1, 3, and 5 years postoperatively. Improvement of type 2 diabetes mellitus at 3 years after surgery was stratified by baseline ABCD score, based on age, body mass index, C-peptide level, and duration of diabetes.
Results
Replies were received from nine of the ten institutions. From August 2005 to June 2015, 831 patients, including 366 males and 465 females, underwent bariatric procedures. The mean age was 41 years, and mean BMI was 42 kg/m
2
. The most common procedure was laparoscopic sleeve gastrectomy (
n
= 501, 60 %) followed by laparoscopic sleeve gastrectomy with duodenojejunal bypass (
n
= 149, 18 %). Laparoscopic Roux-en-Y gastric bypass was performed in 100 patients (12 %), and laparoscopic adjustable gastric banding was performed in 81 (10 %). At 3 years postoperatively, the remission rate of obesity-related comorbidities was 78 % for diabetes, 60 % for hypertension, and 65 % for dyslipidemia. Patients with complete remission of diabetes at 3 years postoperatively had a higher ABCD score than those without (6.4 ± 1.6 vs 4.2 ± 2.0,
P
|
| doi_str_mv | 10.1007/s11695-016-2361-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859722767</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4313360271</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-490860cd70cddf7cd7689a4e4f5f1988d32bd5cc407b7f298212a09cf5ffb7d43</originalsourceid><addsrcrecordid>eNp1kUtLxDAUhYMoOj5-gBsJuHETzaOThzsVn4wIPtYhTdOh0jZjkgrz700dFRFchNxwv3OS3APAPsHHBGNxEgnhaoow4YgyThBbAxMisES4oHIdTLDiGElF2RbYjvEVY0o4pZtgiwrOCKNqAuYz38_RswsdfBiS9Z2L0Nfw3ITGpNBYaPoK3rtkSt_m09MQ5i4sYdPDO7Mw_Sl8dHFo06fIwPtcNui2j6lJQ2p8b9pR8u6Wu2CjNm10e1_7Dni5uny-uEGzh-vbi7MZsgWTCRUKS45tJfKqapELLpUpXFFPa6KkrBgtq6m1BRalqKmSlFCDlc3tuhRVwXbA0cp3Efzb4GLSXROta1vTOz9ETeRUCZr_LzJ6-Ad99UPITx4pLlSG1GhIVpQNPsbgar0ITWfCUhOsxxT0KgWdU9BjCpplzcGX81B2rvpRfI89A3QFxNzq80R_Xf2v6wcafpIF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1867927694</pqid></control><display><type>article</type><title>Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Haruta, Hidenori ; Kasama, Kazunori ; Ohta, Masayuki ; Sasaki, Akira ; Yamamoto, Hiroshi ; Miyazaki, Yasuhiro ; Oshiro, Takashi ; Naitoh, Takeshi ; Hosoya, Yoshinori ; Togawa, Takeshi ; Seki, Yosuke ; Lefor, Alan Kawarai ; Tani, Toru</creator><creatorcontrib>Haruta, Hidenori ; Kasama, Kazunori ; Ohta, Masayuki ; Sasaki, Akira ; Yamamoto, Hiroshi ; Miyazaki, Yasuhiro ; Oshiro, Takashi ; Naitoh, Takeshi ; Hosoya, Yoshinori ; Togawa, Takeshi ; Seki, Yosuke ; Lefor, Alan Kawarai ; Tani, Toru</creatorcontrib><description>Background
The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data.
Methods
We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery throughout Japan and reviewed outcomes. Surveys were sent to ten institutions for number of procedures, preoperative patient weight and preoperative obesity-related comorbidities, and data at 1, 3, and 5 years postoperatively. Improvement of type 2 diabetes mellitus at 3 years after surgery was stratified by baseline ABCD score, based on age, body mass index, C-peptide level, and duration of diabetes.
Results
Replies were received from nine of the ten institutions. From August 2005 to June 2015, 831 patients, including 366 males and 465 females, underwent bariatric procedures. The mean age was 41 years, and mean BMI was 42 kg/m
2
. The most common procedure was laparoscopic sleeve gastrectomy (
n
= 501, 60 %) followed by laparoscopic sleeve gastrectomy with duodenojejunal bypass (
n
= 149, 18 %). Laparoscopic Roux-en-Y gastric bypass was performed in 100 patients (12 %), and laparoscopic adjustable gastric banding was performed in 81 (10 %). At 3 years postoperatively, the remission rate of obesity-related comorbidities was 78 % for diabetes, 60 % for hypertension, and 65 % for dyslipidemia. Patients with complete remission of diabetes at 3 years postoperatively had a higher ABCD score than those without (6.4 ± 1.6 vs 4.2 ± 2.0,
P
< 0.05).
Conclusions
Bariatric and metabolic surgery for Japanese morbidly obese patients is safe and effective. These results are comparable with the results of previous studies.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-016-2361-3</identifier><identifier>PMID: 27631329</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Bariatric Surgery - adverse effects ; Bariatric Surgery - methods ; Body Mass Index ; Comorbidity ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes Mellitus, Type 2 - surgery ; Female ; Gastrectomy - adverse effects ; Gastrectomy - methods ; Gastric Bypass - adverse effects ; Gastric Bypass - methods ; Gastrointestinal surgery ; Health Care Surveys ; Humans ; Japan ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Long term ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Obesity, Morbid - physiopathology ; Obesity, Morbid - surgery ; Original Contributions ; Polls & surveys ; Postoperative Period ; Retrospective Studies ; Surgery ; Surgical outcomes ; Treatment Outcome ; Weight Loss</subject><ispartof>Obesity surgery, 2017-03, Vol.27 (3), p.754-762</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>Obesity Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-490860cd70cddf7cd7689a4e4f5f1988d32bd5cc407b7f298212a09cf5ffb7d43</citedby><cites>FETCH-LOGICAL-c438t-490860cd70cddf7cd7689a4e4f5f1988d32bd5cc407b7f298212a09cf5ffb7d43</cites><orcidid>0000-0002-1613-9723</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-016-2361-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-016-2361-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27631329$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haruta, Hidenori</creatorcontrib><creatorcontrib>Kasama, Kazunori</creatorcontrib><creatorcontrib>Ohta, Masayuki</creatorcontrib><creatorcontrib>Sasaki, Akira</creatorcontrib><creatorcontrib>Yamamoto, Hiroshi</creatorcontrib><creatorcontrib>Miyazaki, Yasuhiro</creatorcontrib><creatorcontrib>Oshiro, Takashi</creatorcontrib><creatorcontrib>Naitoh, Takeshi</creatorcontrib><creatorcontrib>Hosoya, Yoshinori</creatorcontrib><creatorcontrib>Togawa, Takeshi</creatorcontrib><creatorcontrib>Seki, Yosuke</creatorcontrib><creatorcontrib>Lefor, Alan Kawarai</creatorcontrib><creatorcontrib>Tani, Toru</creatorcontrib><title>Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data.
Methods
We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery throughout Japan and reviewed outcomes. Surveys were sent to ten institutions for number of procedures, preoperative patient weight and preoperative obesity-related comorbidities, and data at 1, 3, and 5 years postoperatively. Improvement of type 2 diabetes mellitus at 3 years after surgery was stratified by baseline ABCD score, based on age, body mass index, C-peptide level, and duration of diabetes.
Results
Replies were received from nine of the ten institutions. From August 2005 to June 2015, 831 patients, including 366 males and 465 females, underwent bariatric procedures. The mean age was 41 years, and mean BMI was 42 kg/m
2
. The most common procedure was laparoscopic sleeve gastrectomy (
n
= 501, 60 %) followed by laparoscopic sleeve gastrectomy with duodenojejunal bypass (
n
= 149, 18 %). Laparoscopic Roux-en-Y gastric bypass was performed in 100 patients (12 %), and laparoscopic adjustable gastric banding was performed in 81 (10 %). At 3 years postoperatively, the remission rate of obesity-related comorbidities was 78 % for diabetes, 60 % for hypertension, and 65 % for dyslipidemia. Patients with complete remission of diabetes at 3 years postoperatively had a higher ABCD score than those without (6.4 ± 1.6 vs 4.2 ± 2.0,
P
< 0.05).
Conclusions
Bariatric and metabolic surgery for Japanese morbidly obese patients is safe and effective. These results are comparable with the results of previous studies.</description><subject>Adult</subject><subject>Bariatric Surgery - adverse effects</subject><subject>Bariatric Surgery - methods</subject><subject>Body Mass Index</subject><subject>Comorbidity</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - surgery</subject><subject>Female</subject><subject>Gastrectomy - adverse effects</subject><subject>Gastrectomy - methods</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastric Bypass - methods</subject><subject>Gastrointestinal surgery</subject><subject>Health Care Surveys</subject><subject>Humans</subject><subject>Japan</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Long term</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - physiopathology</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Polls & surveys</subject><subject>Postoperative Period</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUtLxDAUhYMoOj5-gBsJuHETzaOThzsVn4wIPtYhTdOh0jZjkgrz700dFRFchNxwv3OS3APAPsHHBGNxEgnhaoow4YgyThBbAxMisES4oHIdTLDiGElF2RbYjvEVY0o4pZtgiwrOCKNqAuYz38_RswsdfBiS9Z2L0Nfw3ITGpNBYaPoK3rtkSt_m09MQ5i4sYdPDO7Mw_Sl8dHFo06fIwPtcNui2j6lJQ2p8b9pR8u6Wu2CjNm10e1_7Dni5uny-uEGzh-vbi7MZsgWTCRUKS45tJfKqapELLpUpXFFPa6KkrBgtq6m1BRalqKmSlFCDlc3tuhRVwXbA0cp3Efzb4GLSXROta1vTOz9ETeRUCZr_LzJ6-Ad99UPITx4pLlSG1GhIVpQNPsbgar0ITWfCUhOsxxT0KgWdU9BjCpplzcGX81B2rvpRfI89A3QFxNzq80R_Xf2v6wcafpIF</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Haruta, Hidenori</creator><creator>Kasama, Kazunori</creator><creator>Ohta, Masayuki</creator><creator>Sasaki, Akira</creator><creator>Yamamoto, Hiroshi</creator><creator>Miyazaki, Yasuhiro</creator><creator>Oshiro, Takashi</creator><creator>Naitoh, Takeshi</creator><creator>Hosoya, Yoshinori</creator><creator>Togawa, Takeshi</creator><creator>Seki, Yosuke</creator><creator>Lefor, Alan Kawarai</creator><creator>Tani, Toru</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1613-9723</orcidid></search><sort><creationdate>20170301</creationdate><title>Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey</title><author>Haruta, Hidenori ; Kasama, Kazunori ; Ohta, Masayuki ; Sasaki, Akira ; Yamamoto, Hiroshi ; Miyazaki, Yasuhiro ; Oshiro, Takashi ; Naitoh, Takeshi ; Hosoya, Yoshinori ; Togawa, Takeshi ; Seki, Yosuke ; Lefor, Alan Kawarai ; Tani, Toru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-490860cd70cddf7cd7689a4e4f5f1988d32bd5cc407b7f298212a09cf5ffb7d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Bariatric Surgery - adverse effects</topic><topic>Bariatric Surgery - methods</topic><topic>Body Mass Index</topic><topic>Comorbidity</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - surgery</topic><topic>Female</topic><topic>Gastrectomy - adverse effects</topic><topic>Gastrectomy - methods</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastric Bypass - methods</topic><topic>Gastrointestinal surgery</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Japan</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Long term</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - physiopathology</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Polls & surveys</topic><topic>Postoperative Period</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haruta, Hidenori</creatorcontrib><creatorcontrib>Kasama, Kazunori</creatorcontrib><creatorcontrib>Ohta, Masayuki</creatorcontrib><creatorcontrib>Sasaki, Akira</creatorcontrib><creatorcontrib>Yamamoto, Hiroshi</creatorcontrib><creatorcontrib>Miyazaki, Yasuhiro</creatorcontrib><creatorcontrib>Oshiro, Takashi</creatorcontrib><creatorcontrib>Naitoh, Takeshi</creatorcontrib><creatorcontrib>Hosoya, Yoshinori</creatorcontrib><creatorcontrib>Togawa, Takeshi</creatorcontrib><creatorcontrib>Seki, Yosuke</creatorcontrib><creatorcontrib>Lefor, Alan Kawarai</creatorcontrib><creatorcontrib>Tani, Toru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haruta, Hidenori</au><au>Kasama, Kazunori</au><au>Ohta, Masayuki</au><au>Sasaki, Akira</au><au>Yamamoto, Hiroshi</au><au>Miyazaki, Yasuhiro</au><au>Oshiro, Takashi</au><au>Naitoh, Takeshi</au><au>Hosoya, Yoshinori</au><au>Togawa, Takeshi</au><au>Seki, Yosuke</au><au>Lefor, Alan Kawarai</au><au>Tani, Toru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>27</volume><issue>3</issue><spage>754</spage><epage>762</epage><pages>754-762</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data.
Methods
We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery throughout Japan and reviewed outcomes. Surveys were sent to ten institutions for number of procedures, preoperative patient weight and preoperative obesity-related comorbidities, and data at 1, 3, and 5 years postoperatively. Improvement of type 2 diabetes mellitus at 3 years after surgery was stratified by baseline ABCD score, based on age, body mass index, C-peptide level, and duration of diabetes.
Results
Replies were received from nine of the ten institutions. From August 2005 to June 2015, 831 patients, including 366 males and 465 females, underwent bariatric procedures. The mean age was 41 years, and mean BMI was 42 kg/m
2
. The most common procedure was laparoscopic sleeve gastrectomy (
n
= 501, 60 %) followed by laparoscopic sleeve gastrectomy with duodenojejunal bypass (
n
= 149, 18 %). Laparoscopic Roux-en-Y gastric bypass was performed in 100 patients (12 %), and laparoscopic adjustable gastric banding was performed in 81 (10 %). At 3 years postoperatively, the remission rate of obesity-related comorbidities was 78 % for diabetes, 60 % for hypertension, and 65 % for dyslipidemia. Patients with complete remission of diabetes at 3 years postoperatively had a higher ABCD score than those without (6.4 ± 1.6 vs 4.2 ± 2.0,
P
< 0.05).
Conclusions
Bariatric and metabolic surgery for Japanese morbidly obese patients is safe and effective. These results are comparable with the results of previous studies.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27631329</pmid><doi>10.1007/s11695-016-2361-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1613-9723</orcidid></addata></record> |
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| ispartof | Obesity surgery, 2017-03, Vol.27 (3), p.754-762 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Bariatric Surgery - adverse effects Bariatric Surgery - methods Body Mass Index Comorbidity Diabetes Mellitus, Type 2 - physiopathology Diabetes Mellitus, Type 2 - surgery Female Gastrectomy - adverse effects Gastrectomy - methods Gastric Bypass - adverse effects Gastric Bypass - methods Gastrointestinal surgery Health Care Surveys Humans Japan Laparoscopy - adverse effects Laparoscopy - methods Long term Male Medicine Medicine & Public Health Middle Aged Obesity Obesity, Morbid - physiopathology Obesity, Morbid - surgery Original Contributions Polls & surveys Postoperative Period Retrospective Studies Surgery Surgical outcomes Treatment Outcome Weight Loss |
| title | Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey |
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