M. Lauti1, M. Kularatna2, A. G. Hill1, A. D. MacCormick1 1University Of Auckland,Auckland, -, New Zealand 2Middlemore Hospital, University Of Auckland,Department Of Surgery,Auckland, Auckland, New Zealand
Introduction:
Weight regain is a recognised problem after bariatric surgery and is associated with recurrence of obesity-related co-morbidities. Sleeve gastrectomy is one of the most commonly performed bariatric procedures but the definition, incidence and cause of this problem is poorly reported and poorly understood. We performed a systematic review to clarify these issues in patients following sleeve gastrectomy.
Methods:
A systematic review was performed using four electronic databases to locate articles reporting the definition, rate or cause of weight regain in patients at least two years from sleeve gastrectomy. Papers were excluded if the series was of non-primary sleeves, had follow-up outcomes of less than two years or were not reporting primary research.
Results:
After abstract screening, 66 full text papers were reviewed of which thirteen met the inclusion criteria. Five papers reported a definition, five papers reported a rate and nine papers proposed a cause for weight regain following sleeve gastrectomy.
Definitions for weight regain reported in the literature included a gain of 10kg from nadir weight or an increase in BMI of 5kg/m2. Rates of regain following sleeve gastrectomy ranged from 10.2% at two years to 75.6% at six years. Proposed causes for the regain included initial sleeve size, sleeve dilation, increased ghrelin levels, inadequate follow-up support and maladaptive lifestyle behaviours.
Conclusion:
Weight regain appears to be a common complication following sleeve gastrectomy that is variably defined, described and reported in the literature. We make a number of recommendations to improve the reporting of clinical series so this problem can be better understood.