Laparoscopic longitudinal gastrectomy: long-term results and predictors of relapsing obesity

Background: morbid obesity is currently a serious medical and social problem. Bariatric surgery remains the most effective method of treating this disease. To ensure a more precise selection of patients for such interventions, it is necessary to determine the predictor factors of various treatment outcomes. Aim: to evaluate the long-term results of laparoscopic longitudinal gastrectomy (LLG) and to determine the list of genes associated with the relapsing obesity in the long-term postoperative period. Materials and Methods: the study included patients with obesity (n=81) (mean age 44.80±1.26 years, male patients — 27.16% (n=22)) hospitalized in the surgical department of St. Petersburg City Hospital No. 40. All patients underwent LLG. After hospital discharge, patients were monitored on an outpatient basis for 5 years. Then the patients were divided into two groups: 64 (79.0%) patients were included in the group of persistent weight loss, 17 (21.0%) — in the group of relapsing obesity. Besides, all patients included in the study underwent whole exome sequencing. Results: based on the T-test results, 22 genes were identified (CARD8, FMC1, MUC16, MUC21, HTR3D, MAMDC4, IFNK, HLA-DQB1, LUC7L2, KIR3DL1, LILRB4, RBBP6, ANKRD30A, ABCC12, LRRIQ3, PDE6B, OR5H15, CCDC187, PMIS2, SAMD11, PTCHD3, AKR7L), mutations in which were presumably associated with the relapsing obesity after LLG (p<0.01). Conclusion: the study results demonstrated the presence of variations in the genetic profiles of patients with different long-term LLG results. Further detailed study of the obtained data, in particular, the analysis of the allele frequency between the two groups of patients, the ratio with clinical data and genetic risk score development, will potentially allow to create a model predicting the relapsing obesity after bariatric surgery. KEYWORDS: obesity, bariatrics, genes associated with obesity, surgery, laparoscopic longitudinal gastrectomy; body mass index. FOR CITATION: Vetoshkin V.A., Gladyshev D.V., Sushentseva N.N., Apalko S.V., Shimansky V.S., Moiseev M.E., Gladyshev A.D., Kovalenko S.A., Askerkhanov R.G., Shcherbak S.G., Kotiv B.N. Laparoscopic longitudinal gastrectomy: long-term results and predictors of relapsing obesity. Russian Medical Inquiry. 2024;8(4):186–194 (in Russ.). DOI: 10.32364/2587-6821-2024-8-4-1.