Since 2014, sleeve gastrectomy (SG) has been the most frequently performed bariatric-metabolic operation worldwide (2018: 386,096). There are only a few studies reporting a long-term follow-up (up to 11 years) available today. The aim of this study was to evaluate the long-term outcome of SG with a follow-up of at least 15 years regarding weight loss, remission of associated medical problems (AMP), conversions, and quality of life (QOL).Multicenter cross-sectional study; university hospital.This study includes all patients who had SG before 2005 at the participating bariatric centers. History of weight, AMP, conversions, and QOL were evaluated by interview at our bariatric center.Fifty-three patients met the inclusion criteria of a minimal follow-up of 15 years. Weight and body mass index at the time of the SG were 136.8kg and 48.7kg/m2. Twenty-six patients (49.1%) were converted to Roux-en-Y gastric bypass (RYGB) for weight regain and gastroesophageal reflux within the follow-up period. Total weight loss after 15 years was 31.5% in the non-converted group and 32.9% in the converted group. Remission rates of AMP and QOL were stable over the follow-up period.Fifteen years after SG, a stable postoperative weight was observed at the cost of a high conversion rate. Patients converted to RYGB were able to achieve further weight loss and preserve good remission rates of AMP. SG in patients without the need of a conversion to another bariatric-metabolic procedure may be considered effective. Careful preoperative patient selection is mandatory when performing SG.
The prevalence of overweight and obesity is steadily increasing in Austria as well as internationally. Obesity in particular is associated with multiple health risks, comorbidities, functional disability, and social stigma. Obesity is an independent, complex, chronic disease and should be treated as such by a multidisciplinary team of appropriately qualified personnel. In addition to recent international guidelines, this consensus paper outlines the overall principles of the management of overweight and obesity and provides guidance for the diagnosis and conservative treatment, focusing on lifestyle modifications and pharmacotherapy. Using the "5A" framework of behavioral health intervention, guidelines for a structured, pragmatic, and patient-centered medical care of adults with overweight or obesity are presented.Die Prävalenz von Übergewicht und Adipositas nimmt in Österreich – wie auch international – kontinuierlich zu. Insbesondere Adipositas ist mit multiplen Gesundheitsrisiken, Begleiterkrankungen, funktionellen Einschränkungen und sozialer Stigmatisierung assoziiert. Adipositas ist eine eigenständige und komplexe chronische Erkrankung und entsprechend multidisziplinär durch qualifizierte Fachkräfte zu behandeln. In Ergänzung rezenter internationaler Leitlinien skizziert das vorliegende Konsensuspapier allgemeine Grundsätze des Managements von Übergewicht und Adipositas und gibt Handlungsanleitungen für die Diagnose und für die konservative Therapie, wobei der Schwerpunkt auf die Lebensstilmodifikation und die medikamentöse Gewichtskontrolle gelegt wird. Anhand des „5A“-Modells der Verhaltensintervention wird ein Handlungsleitfaden für eine strukturierte, praxisorientierte und PatientInnen-zentrierte Betreuung von Menschen mit Übergewicht und Adipositas in Österreich präsentiert.
<b>Background:</b> While patients’ needs for adequate preoperative information are generally recognized, data evaluating the effectiveness of the consultation before laparoscopic cholecystectomy have not been published until today. This prospective study was performed to investigate the success of preoperative information. <b>Methods:</b> A combination of oral and written information was given to all patients in two interviews. Information concentrated on indications for surgery, operative procedures, and risks. Patients were asked to answer questionnaires 5 days after the operation. <b>Results:</b> From January 1996 to January 1997, 200 patients were interviewed. Ninety-seven percent indicated to wish detailed information. Eighty-four percent indicated a high level of satisfaction with the presented information. While the levels of knowledge concerning indications for surgery and procedures were satisfactory in 85 and 51% respectively, only 30% were able to name at least one risk factor of laparoscopic cholecystectomy. <b>Conclusion:</b> This study demonstrated that patients’ evaluation of their surgical knowledge and the process by which it was communicated to them did not correspond to their ability to recall this information after surgery.
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