Bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m 2 : a systematic review and meta-analysis
Bariatric surgery on patients with body mass index (BMI) ≥ 50 kg/m , historically known as superobesity, is technically challenging and carries a higher risk of complications. Bridging interventions have been introduced for weight loss before bariatric surgery in this population. This systematic rev...
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| Veröffentlicht in: | Surgical endoscopy 2019-11, Vol.33 (11), p.3578 |
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| creator | Lee, Yung Dang, Jerry T Switzer, Noah Malhan, Roshan Birch, Daniel W Karmali, Shahzeer |
| description | Bariatric surgery on patients with body mass index (BMI) ≥ 50 kg/m
, historically known as superobesity, is technically challenging and carries a higher risk of complications. Bridging interventions have been introduced for weight loss before bariatric surgery in this population. This systematic review and meta-analysis aims to assess the efficacy and safety of bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m
.
MEDLINE, EMBASE, Web of Science, and Scopus were searched from database inception to September 2018. Studies were eligible for inclusion if they conducted any bridging intervention for weight loss in patients with BMI greater than 50 kg/m
prior to bariatric surgery. Primary outcome was the change in BMI before and after bridging intervention. Secondary outcomes included comorbidity status after bridging interventions and resulting complications. Pooled mean differences (MD) were calculated using random effects meta-analysis.
13 studies including 550 patients met inclusion criteria (mean baseline BMI of 61.26 kg/m
). Bridging interventions included first-step laparoscopic sleeve gastrectomy (LSG), intragastric balloon (IGB), and liquid low-calorie diet program (LLCD). There was a reduction of BMI by 12.8 kg/m
after a bridging intervention (MD 12.8, 95% CI 9.49-16.1, P |
| format | Article |
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, historically known as superobesity, is technically challenging and carries a higher risk of complications. Bridging interventions have been introduced for weight loss before bariatric surgery in this population. This systematic review and meta-analysis aims to assess the efficacy and safety of bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m
.
MEDLINE, EMBASE, Web of Science, and Scopus were searched from database inception to September 2018. Studies were eligible for inclusion if they conducted any bridging intervention for weight loss in patients with BMI greater than 50 kg/m
prior to bariatric surgery. Primary outcome was the change in BMI before and after bridging intervention. Secondary outcomes included comorbidity status after bridging interventions and resulting complications. Pooled mean differences (MD) were calculated using random effects meta-analysis.
13 studies including 550 patients met inclusion criteria (mean baseline BMI of 61.26 kg/m
). Bridging interventions included first-step laparoscopic sleeve gastrectomy (LSG), intragastric balloon (IGB), and liquid low-calorie diet program (LLCD). There was a reduction of BMI by 12.8 kg/m
after a bridging intervention (MD 12.8, 95% CI 9.49-16.1, P < 0.0001). Specifically, LSG demonstrated a BMI reduction of 15.2 kg/m
(95% CI 12.9-17.5, P < 0.0001) and preoperative LLCD by 9.8 kg/m
(95% CI 9.82-15.4, P = 0.0006). IGB did not demonstrate significant weight loss prior to bariatric surgery. There was remission or improvement of type 2 diabetes, hypertension, and sleep apnea in 62.8%, 74.6%, and 74.6% of patients, respectively.
First-step LSG and LLCD are both safe and appropriate bridging interventions which can allow for effective weight loss prior to bariatric surgery in patients with BMI greater than 50 kg/m
.</description><identifier>EISSN: 1432-2218</identifier><identifier>PMID: 31399947</identifier><language>eng</language><publisher>Germany</publisher><subject>Bariatric Surgery - methods ; Comorbidity ; Diabetes Mellitus, Type 2 - complications ; Gastrectomy - methods ; Humans ; Hypertension - complications ; Laparoscopy - methods ; Obesity, Morbid - complications ; Obesity, Morbid - surgery ; Preoperative Care - standards ; Treatment Outcome ; Weight Loss</subject><ispartof>Surgical endoscopy, 2019-11, Vol.33 (11), p.3578</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-8659-0934</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31399947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Yung</creatorcontrib><creatorcontrib>Dang, Jerry T</creatorcontrib><creatorcontrib>Switzer, Noah</creatorcontrib><creatorcontrib>Malhan, Roshan</creatorcontrib><creatorcontrib>Birch, Daniel W</creatorcontrib><creatorcontrib>Karmali, Shahzeer</creatorcontrib><title>Bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m 2 : a systematic review and meta-analysis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><description>Bariatric surgery on patients with body mass index (BMI) ≥ 50 kg/m
, historically known as superobesity, is technically challenging and carries a higher risk of complications. Bridging interventions have been introduced for weight loss before bariatric surgery in this population. This systematic review and meta-analysis aims to assess the efficacy and safety of bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m
.
MEDLINE, EMBASE, Web of Science, and Scopus were searched from database inception to September 2018. Studies were eligible for inclusion if they conducted any bridging intervention for weight loss in patients with BMI greater than 50 kg/m
prior to bariatric surgery. Primary outcome was the change in BMI before and after bridging intervention. Secondary outcomes included comorbidity status after bridging interventions and resulting complications. Pooled mean differences (MD) were calculated using random effects meta-analysis.
13 studies including 550 patients met inclusion criteria (mean baseline BMI of 61.26 kg/m
). Bridging interventions included first-step laparoscopic sleeve gastrectomy (LSG), intragastric balloon (IGB), and liquid low-calorie diet program (LLCD). There was a reduction of BMI by 12.8 kg/m
after a bridging intervention (MD 12.8, 95% CI 9.49-16.1, P < 0.0001). Specifically, LSG demonstrated a BMI reduction of 15.2 kg/m
(95% CI 12.9-17.5, P < 0.0001) and preoperative LLCD by 9.8 kg/m
(95% CI 9.82-15.4, P = 0.0006). IGB did not demonstrate significant weight loss prior to bariatric surgery. There was remission or improvement of type 2 diabetes, hypertension, and sleep apnea in 62.8%, 74.6%, and 74.6% of patients, respectively.
First-step LSG and LLCD are both safe and appropriate bridging interventions which can allow for effective weight loss prior to bariatric surgery in patients with BMI greater than 50 kg/m
.</description><subject>Bariatric Surgery - methods</subject><subject>Comorbidity</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Gastrectomy - methods</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Laparoscopy - methods</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - surgery</subject><subject>Preoperative Care - standards</subject><subject>Treatment Outcome</subject><subject>Weight Loss</subject><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFzj1uwkAQhuFVpAhIyBWiuYCF_1BiShBRKOjo0dgezBB2sWYWkCvScgsaLsJROElcJHWa722e4nswvShN4iCOo_eueVLdhGGYZtGwY7pJlGRZlr71zGksXFbsKmDnSQ7kPO-cQk6rnRDkKIxeuADdS0XStAxq9Nw6hSP7NYzns_v3-X6-tjsMb5evamAhhhEgaKOebKsLEDowHQFdCZY8Buhw2yhr3zyucKv08ttn8_oxXUw-g3qfWyqXtbBFaZZ_j5N_wQ9UdlCh</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Lee, Yung</creator><creator>Dang, Jerry T</creator><creator>Switzer, Noah</creator><creator>Malhan, Roshan</creator><creator>Birch, Daniel W</creator><creator>Karmali, Shahzeer</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><orcidid>https://orcid.org/0000-0001-8659-0934</orcidid></search><sort><creationdate>201911</creationdate><title>Bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m 2 : a systematic review and meta-analysis</title><author>Lee, Yung ; Dang, Jerry T ; Switzer, Noah ; Malhan, Roshan ; Birch, Daniel W ; Karmali, Shahzeer</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-pubmed_primary_313999473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Bariatric Surgery - methods</topic><topic>Comorbidity</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Gastrectomy - methods</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Laparoscopy - methods</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - surgery</topic><topic>Preoperative Care - standards</topic><topic>Treatment Outcome</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Yung</creatorcontrib><creatorcontrib>Dang, Jerry T</creatorcontrib><creatorcontrib>Switzer, Noah</creatorcontrib><creatorcontrib>Malhan, Roshan</creatorcontrib><creatorcontrib>Birch, Daniel W</creatorcontrib><creatorcontrib>Karmali, Shahzeer</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Yung</au><au>Dang, Jerry T</au><au>Switzer, Noah</au><au>Malhan, Roshan</au><au>Birch, Daniel W</au><au>Karmali, Shahzeer</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m 2 : a systematic review and meta-analysis</atitle><jtitle>Surgical endoscopy</jtitle><addtitle>Surg Endosc</addtitle><date>2019-11</date><risdate>2019</risdate><volume>33</volume><issue>11</issue><spage>3578</spage><pages>3578-</pages><eissn>1432-2218</eissn><abstract>Bariatric surgery on patients with body mass index (BMI) ≥ 50 kg/m
, historically known as superobesity, is technically challenging and carries a higher risk of complications. Bridging interventions have been introduced for weight loss before bariatric surgery in this population. This systematic review and meta-analysis aims to assess the efficacy and safety of bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m
.
MEDLINE, EMBASE, Web of Science, and Scopus were searched from database inception to September 2018. Studies were eligible for inclusion if they conducted any bridging intervention for weight loss in patients with BMI greater than 50 kg/m
prior to bariatric surgery. Primary outcome was the change in BMI before and after bridging intervention. Secondary outcomes included comorbidity status after bridging interventions and resulting complications. Pooled mean differences (MD) were calculated using random effects meta-analysis.
13 studies including 550 patients met inclusion criteria (mean baseline BMI of 61.26 kg/m
). Bridging interventions included first-step laparoscopic sleeve gastrectomy (LSG), intragastric balloon (IGB), and liquid low-calorie diet program (LLCD). There was a reduction of BMI by 12.8 kg/m
after a bridging intervention (MD 12.8, 95% CI 9.49-16.1, P < 0.0001). Specifically, LSG demonstrated a BMI reduction of 15.2 kg/m
(95% CI 12.9-17.5, P < 0.0001) and preoperative LLCD by 9.8 kg/m
(95% CI 9.82-15.4, P = 0.0006). IGB did not demonstrate significant weight loss prior to bariatric surgery. There was remission or improvement of type 2 diabetes, hypertension, and sleep apnea in 62.8%, 74.6%, and 74.6% of patients, respectively.
First-step LSG and LLCD are both safe and appropriate bridging interventions which can allow for effective weight loss prior to bariatric surgery in patients with BMI greater than 50 kg/m
.</abstract><cop>Germany</cop><pmid>31399947</pmid><orcidid>https://orcid.org/0000-0001-8659-0934</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Surgical endoscopy, 2019-11, Vol.33 (11), p.3578 |
| issn | 1432-2218 |
| language | eng |
| recordid | cdi_pubmed_primary_31399947 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Bariatric Surgery - methods Comorbidity Diabetes Mellitus, Type 2 - complications Gastrectomy - methods Humans Hypertension - complications Laparoscopy - methods Obesity, Morbid - complications Obesity, Morbid - surgery Preoperative Care - standards Treatment Outcome Weight Loss |
| title | Bridging interventions before bariatric surgery in patients with BMI ≥ 50 kg/m 2 : a systematic review and meta-analysis |
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