Comparative Analysis of the Impact of Standard and Modified Laparoscopic Sleeve Gastrectomy on Life Quality Indicators of Patients with BMI>50 kg/m2

ABSTRACT

Background: Health-related quality of life (HRQoL) is often impaired in obese individuals undergoing bariatric surgery. Postoperative management of patients after bariatric surgery, as well as factors affecting patients’ quality of life, remain poorly comprehended and controversial.

Aim of the study: This study aimed to evaluate the dynamic changes in quality of life indicators (according to BAROS, GIQLI, MAQoLII and SF-36 questionnaires) in patients with a body mass index (BMI) >50 kg/m2 over 24 months after standard and modified laparoscopic sleeve gastrectomy (LSG).

Methods: A total of 176 patients after standard and modified LSG with appropriate postoperative management who met the inclusion criteria were selected for participation in the study. Participants were divided into 2 groups according to the LSG and postoperative management procedure. The first group (N=85) included patients who underwent modified LSG (MLSG) and appropriate postoperative management, the second group (N=91) consisted of patients who underwent LSG using the standard procedure (SLSG) with standard postoperative management. Each group was in turn divided into subgroups according to age criteria. Patients in subgroup A (IA n=42, IIA n=44) were aged 20 to 50 years, patients in subgroup B (IB n=43, IIB n=47) were aged 50-70 years. The average duration of follow-up was 2 years. BAROS, GIQLI, MAQoLII and SF-36 indicators were studied and their values at baseline and after 24 months were compared, as well as the two inter-subgroup differences in GIQLI, MAQoLII and SF-36 indicators were assessed 24 months after bariatric surgery.

Results: The study documented that 24 months after surgery, both the MLSG and SLSG led to positive changes in HRQoL indicators (according to GIQLI, MAQoLII and SF-36) compared to baseline data. Тhe changes in GIQLI and MAQoLII indicators were significant only in group I, while the SF-36 indicators recorded significant differences in both clinical groups. Moreover, the intergroup comparison revealed an essential difference in all observed HRQoL indicators (including BAROS).

Сonclusion: The results obtained allow to suggest that the MLSG, due to its stable positive effect, can act as an effective alternative to SLSG for patients with morbid obesity (BMI >50 kg/m2).