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World J Clin Cases. Jul 6, 2023; 11(19): 4504-4512
Published online Jul 6, 2023. doi: 10.12998/wjcc.v11.i19.4504
Long-term effectiveness, outcomes and complications of bariatric surgery
Milena Gulinac, Dimitrina Georgieva Miteva, Monika Peshevska-Sekulovska, Ivan P Novakov, Svetozar Antovic, Milena Peruhova, Violeta Snegarova, Plamena Kabakchieva, Yavor Assyov, Georgi Vasilev, Metodija Sekulovski, Snezhina Lazova, Latchezar Tomov, Tsvetelina Velikova
Milena Gulinac, Department of General and Clinical Pathology, Medical University of Plovdiv, Plovdiv 4000, Bulgaria
Dimitrina Georgieva Miteva, Department of Genetics, Sofia University "St. Kliment Ohridski", Faculty of Biology, Sofia 1164, Bulgaria
Monika Peshevska-Sekulovska, Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Ivan P Novakov, Department of Thoraco-abdominal Surgery, Medical University Plovdiv, Plovdiv 6000, Bulgaria
Svetozar Antovic, University Clinic for Digestive Surgery, Medical Faculty, Skopje, Skopje 1000, North Macedonia
Milena Peruhova, Department of Gastroenterology, Heart and Brain Hospital, Burgas, Burgas 1000, Bulgaria
Violeta Snegarova, Clinic of Internal Diseases, Naval Hospital - Varna, Military Medical Academy, Medical Faculty, Medical University, Varna 9000, Bulgaria
Plamena Kabakchieva, Clinic of Internal Diseases, Naval Hospital - Varna, Military Medical Academy, Varna 9010, Bulgaria
Yavor Assyov, Clinic of Endocrinology, University Hospital "Alexandrovska, Sofia 1431, Bulgaria
Yavor Assyov, Department of Internal Diseases, Medical University – Sofia, Sofia 1431, Bulgaria
Georgi Vasilev, Clinic of Endocrinology and Metabolic Disorders, UMHAT "Sv. Georgi", Plovdiv 4000, Bulgaria
Metodija Sekulovski, Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, Sofia 1407, Bulgaria
Metodija Sekulovski, Medical Faculty, Sofia University, St. Kliment Ohridski, Sofia 1407, Bulgaria
Snezhina Lazova, Department of Pediatric, University Hospital "N. I. Pirogov", Sofia 1606, Bulgaria
Snezhina Lazova, Department of Healthcare, Faculty of Public Health "Prof. Tsekomir Vodenicharov, MD, DSc", Sofia 1527, Bulgaria
Latchezar Tomov, Department of Informatics, New Bulgarian University, Sofia 1618, Bulgaria
Tsvetelina Velikova, Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
Author contributions: Milena G, Peshevska-Sekulovska, Novakov I, Antovic S, and Velikova T contributed to conceptualization; Peruhova M, Peshevska-Sekulovska M, Snegarova V, Sekulovski M and Velikova T contributed to resources; Lazova S, Miteva D, Gulinac M, Tomov L, Assyov Y, Kabakchieva P, Georgiev T, Visualization, Miteva D, Peshevska-Sekulovska M contributed to data curation; Gulinac M, and Velikova T contributed to writing – original draft preparation; Miteva D, Peshevska-Sekulovska M, Snegarova V, Peruhova M, Sekulovski M and Velikova T contributed to writing – review & editing; Velikova T contributed to supervision; All authors revised and approved the final version of the manuscript; All of the authors approved the final version of the paper prior to submission.
Supported by the European Union-NextGenerationEU, through the National Recovery and Resilience Plan of the Republic of Bulgaria, No. BG-RRP-2.004-0008-C01.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Milena Gulinac, MD, PhD, Academic Research, Assistant Professor, Department of General and Clinical Pathology, Medical University of Plovdiv, Bul. Vasil Aprilov 15A, Plovdiv 4000, Bulgaria. mgulinac@hotmail.com
Received: April 1, 2023
Peer-review started: April 1, 2023
First decision: April 13, 2023
Revised: May 17, 2023
Accepted: June 6, 2023
Article in press: June 6, 2023
Published online: July 6, 2023
Processing time: 90 Days and 7.4 Hours
Abstract

Dietary imbalance and overeating can lead to an increasingly widespread disease - obesity. Aesthetic considerations aside, obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases, including diabetes; hypertension; atherosclerosis; coronary artery disease and stroke; obstructive sleep apnea; depression; weight-related arthropathies and endometrial and breast cancer. A body weight 20% above ideal for age, gender and height is a severe health risk. Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet, increased physical activity, behavioral changes and drugs have failed. The two most common procedures currently used are sleeve gastrectomy and gastric bypass. This procedure has gained popularity recently and is generally considered safe and effective. Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved, more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures. This review aims to synthesize and summarize the growing evidence on the long-term effectiveness, outcomes and complications of bariatric surgery.

Keywords: Bariatric surgery; Long-term outcomes; Obesity; Roux-en-Y gastric bypass; sleeve gastrectomy; Effectiveness; Safety; Quality of life

Core Tip: The method of bariatric surgery is associated with dramatic weight loss, overall health improvement and, in many cases curing obesity-related comorbidities (i.e., diabetes, high blood pressure, sleep apnea, asthma and other breathing disorders, arthritis, cholesterol problems, gastroesophageal reflux disease, fatty liver, urinary stress incontinence, brain pseudotumor, and more). Furthermore, in cases with a high degree of obesity, undergoing this type of surgical intervention also decreases overall mortality. Simultaneously, physical quality of life improved faster than mental quality of life.