Bariatric surgery vs medical treatment leads to lower long-term mortality
Long-term all-cause, cardiovascular-caused and cancer-caused mortality are lower in obese patients who have received biliopancreatic diversion (BPD) and biliointestinal bypass (BIBP) compared to those who have received nonsurgical medical weight-loss treatment, a recent study has shown.
“Malabsorptive bariatric surgery (BS) significantly reduces long-term mortality in severely obese patients,” the investigators said.
Observation period lasted for a mean 12.1±3.41 years. BS vs nonsurgical patients had reduced all-cause mortality (7.2 percent vs 12.9 percent; χ2, 11.25; p=0.001; hazard ratio [HR], 0.64; 95 percent CI, 0.43–0.93; p=0.019).
Surgery patients also had significantly less frequent cardiovascular (HR, 0.26; 0.09–0.72; p=0.003) and cancer (HR, 0.21; 0.09–0.45) causes of death compared to those on nonsurgical treatment (p<0.001).
Another aspect of the study showed that patients who underwent malabsorptive BS showed less incident cases of diabetes, cardiovascular diseases, hyperlipidaemia, oculopathy and cancer compared with controls receiving medical treatment. [Obes Surg 2018;doi:10.1007/s11695-018-3601-5]
The present study sought to analyse long-term mortality in obese patients receiving malabsorptive BS (BPD and BIBP) compared to medical treatment of obesity.
The investigators collected medical records of 1,877 obese patients (body mass index [BMI], >35 kg/m2) aged 18–65 years undergoing BS (n=472,111 with diabetes) or nonsurgical medical treatment (n=1,405,385 with diabetes), during the period 1999–2008. Nonsurgical patients were matched for age, sex, BMI and blood pressure. Life status and causes of death were determined through December 2016.
Kaplan-Meier plots and Cox regression analyses were used to compare survival across surgery and nonsurgical patients.