Multifactorial assessment of the effectiveness of surgical treatment for obesity

Abstract

OBJECTIVE – to create a model for choosing the most effective method of surgical treatment of obesity. MATERIALS AND METHODS. The study was conducted at the Department of General Surgery No 2, Bogomolets National Medical University. The study group included 53 patients who consented to the bariatric procedure. The control group consisted of 59 patients. The study group underwent bariatric interventions: laparoscopic gastric bypass (37.7 %), laparoscopic sleeve gastrectomy (32.2 %), and 30.1 % underwent the installation of an intragastric balloon, followed by gastric bypass and outcome assessment after 12 months. The control group received conservative treatment for obesity. All patients underwent routine general clinical examinations, genotyping via the Fast Real-Time PCR System in TaqMan medium, and stool analysis using polymerase chain reaction to determine the parameters of the intestinal microbiome. RESULTS. Statistical data processing showed that the chance of achieving an optimal outcome is highest in patients with a detected SNP MC4R, an unsatisfactory initial intestinal microbiota pattern, and an extensive family history of obesity, as well as those who underwent laparoscopic gastric bypass. CONCLUSIONS. Laparoscopic gastric bypass is the preferred surgical technique for obesity treatment, yielding an optimal outcome. The presence of an unsatisfactory initial intestinal microbiota pattern, the detection of SNP MC4R polymorphism, and a family history of obesity influence the effectiveness of surgical treatment. The chance of achieving an optimal outcome is 3.6 times higher in patients with a detected SNP MC4R polymorphism.