Yonsei Med J.  2016 Mar;57(2):430-440. 10.3349/ymj.2016.57.2.430.

Short-Term Analysis of Food Tolerance and Quality of Life after Laparoscopic Greater Curvature Plication

• Kim SB
• Kim SM

• KMID: 2374050
• DOI: http://doi.org/10.3349/ymj.2016.57.2.430

Abstract

PURPOSE
The aim of this study was to compare short-term outcomes [food tolerance scores (FTS) and quality of life] after three types of restrictive bariatric surgery: laparoscopic adjustable gastric banding (LAGB), laparoscopic greater curvature plication (LGCP), and laparoscopic sleeve gastrectomy (LSG).
MATERIALS AND METHODS
From January 2012 to December 2013, all patients that underwent primary surgery were included in one of the LAGB, LGCP, or LSG groups. These three groups were then compared with respect to FTS, gastrointestinal quality of life indices (GIQLI), and the Medical Outcomes Study Short-Form 36 (SF-36) questionnaire. Questionnaires were sent to all patients both pre- and post-operatively.
RESULTS
A total of 85 patients (LAGB=45, LGCP=22, and LSG=18) returned the questionnaires in full, and these patients constituted the study cohort. The cohort was predominately female (n=73, 85.9%). Mean percentage excess weight loss (%EWL) values after LAGB, LGCP, and LSG were 65.4+/-27.0%, 65.6+/-25.2%, and 82.7+/-21.7%, respectively (p=0.044). Mean postoperative FTSs and improvements in total GIQLIs after LAGB, LGCP, and LSG were 15.96, 20.95, and 21.33 and -3.40, 6.68, and 18.78, respectively (p<0.05). All procedures produced improvements in the three SF-36 domain scores. Subgroup analysis revealed significant differences between the three procedures in terms of improvements in general health and emotional well-being.
CONCLUSION
LGCP is safe and effective at achieving significant weight loss. In terms of food tolerance and GI quality of life, LGCP was found to be comparable to gastric banding and sleeve gastrectomy.

Keyword

Laparoscopic greater curvature plication; food tolerance score; GIQLI; SF-36

MeSH Terms

Adult
Cohort Studies
Female
Gastrectomy/*methods
Gastroplasty/adverse effects/*methods
Humans
Laparoscopy/*methods
Male
Middle Aged
Obesity, Morbid/psychology/*surgery
Postoperative Complications/epidemiology
Postoperative Period
*Quality of Life
Surveys and Questionnaires
Treatment Outcome
Weight Loss
Young Adult

Figure

• 

  Fig. 1 The mean tolerance scores for eight specific types of food. 2 points were awarded if a patient could eat the food type without any particular difficulty, 1 point if he/she could eat it with some difficulties/restrictions, and 0 points if he/she could not eat it at all. *p<0.05. LAGB, laparoscopic adjustable gastric banding; LGCP, laparoscopic greater curvature plication; LSG, laparoscopic sleeve gastrectomy.

• 

  Fig. 2 Improvements in GIQLI scores before and after operation in the three study groups (LAGB, LGCP, LSG) were significantly different for symptom (-8.84±7.76, -4.55±7.73, and 3.22±17.00), emotion (0.82±4.48, 4.50±5.23, and 5.56±7.05), and total GIQLI scores (-3.40±20.58, 6.68±22.29, and 18.78±29.28). *p<0.05. GIQLI, GI quality of life index; LAGB, laparoscopic adjustable gastric banding; LGCP, laparoscopic greater curvature plication; LSG, laparoscopic sleeve gastrectomy.

• 

  Fig. 3 The SF-36 measures the following eight subscales: PF, RP, RE, EF, EWB, SF, BP, GH. Of these eight subscales of the SF-36, preoperative PF and GH domain scores were significantly higher in the LAGB group that in the LGCP and LSG groups. Postoperatively, mean PF domain scores remained significantly lower in the LGCP and LSG groups than in the LAGB group. Postoperative mean EWB domain score was significantly higher in the LSG group than in the LAGB and LGCP groups. Improvements in EWB and GH domain scores were significantly greater in the LSG group [improvements in EWB domain scores in the LAGB, LGCP, and LSG groups were 7.8±19.0, 19.5±33.3, and 27.6±19.6, respectively (p<0.01), and corresponding improvements in GH domain scores were 13.8±24.5, 30.9±20.2, and 35.6±16.2, respectively (p<0.01)]. PF, physical functioning; RP, role limitations due to a physical problem; RE, role limitations due to an emotional problem; EF, energy/fatigue; EWB, emotional wellbeing; SF, social functioning; BP, bodily pain; GH, general health; LAGB, laparoscopic adjustable gastric banding; LGCP, laparoscopic greater curvature plication; LSG, laparoscopic sleeve gastrectomy.

• 

  Fig. 4 The eight subscales of the SF-36 comprise two higher order summary scales: the physical component summary scale (PCS), which is mainly based on PF, RP, BP, and GH, and the mental summary component scale (MCS), which is mainly based on RE, role limitations due to an emotional problem; EF, EWB, and SF. Preoperative PCS score was significantly lower in the LSG group than in the LGCP and LAGB groups. However, mean improvements in the PCS and MCS scales were significantly greater in the LSG group (121.1±97.8 and 110.2±114.8) than in the LAGB/LGCP groups (50.1±90.4 and 37.4±99.4/76.7±92.8 and 78.6±108.0) (p<0.05). LAGB, laparoscopic adjustable gastric banding; LGCP, laparoscopic greater curvature plication; LSG, laparoscopic sleeve gastrectomy; PF, physical functioning; RP, role limitations due to a physical problem; BP, bodily pain; GH, general health; EF, energy/fatigue; EWB, emotional wellbeing; SF, social functioning.

• 

  Fig. 5 The serial data obtained from questionnaires for each of the three patient groups. *p<0.05. LAGB, laparoscopic adjustable gastric banding; LGCP, laparoscopic greater curvature plication; LSG, laparoscopic sleeve gastrectomy; FTS, food tolerance scores; %EWL, percentage excess weight loss.

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