| Title | Laparoscopic gastric bypass: risks vs. benefits up to two years following surgery in super-super obese patients. | | Author(s) | Gould JC, Garren MJ, Boll V, Starling JR | | Institution | Department of Surgery, University of Wisconsin Medical School, Madison, Wis, USA. | | Source | Surgery 2006 Oct; 140(4):524-9; discussion 529-31. | | MeSH | Adult
Body Mass Index
Comorbidity
Female
Gastric Bypass
Humans
Laparoscopy
Male
Middle Aged
Obesity, Morbid
Postoperative Complications
Prevalence
Quality of Life
Retrospective Studies
Risk Factors
Treatment Outcome
Weight Loss
| | Abstract | BACKGROUND: Super-super obesity (body mass index [BMI] >/= 60 kg/m(2)) is thought to be a risk factor for complications and mortality in laparoscopic Roux-en-Y gastric bypass. Excess weight loss has been demonstrated to be diminished compared with less obese patients following surgery. However, we hypothesize that super-super obese patients who undergo laparoscopic gastric bypass can realize major improvements in their health and a good quality of life without a significantly increased risk of complications when compared with less obese patients.
METHODS: From July 2002 to July 2005, University of Wisconsin Health bariatric surgeons performed 288 consecutive laparoscopic Roux-en-Y gastric bypass procedures. Patients were divided into 2 groups: BMI >/= 60 kg/m(2) (n = 28) and BMI < 60 kg/m(2) (n = 260). The groups were compared at defined time intervals during a 2-year period following surgery. Comparison criteria included complications, weight loss, comorbidities, and quality of life.
RESULTS: Both groups had similar morbidity and mortality rates. Excess weight loss was shown to be less, but total pounds lost were greater, for the super-super obese patients at all postoperative time intervals specified for postoperative analysis.Despite this fact, overall health improved to a similar degree in each group of patients following surgery; both groups also had similar Moorehead-Ardelt quality of life scores. Using the Bariatric Analysis and Reporting Outcome System (BAROS) to categorize outcomes, the average result for a patient in either group of patients would be considered "very good" at 1 year following surgery.
CONCLUSIONS: Laparoscopic Roux-en-Y gastric bypass can be accomplished safely even in extremely obese patients. Although excess weight loss in the super-super obese is diminished postoperatively when compared with less obese patients, health is improved and quality of life is good regardless of a patient's preoperative BMI. Therefore, laparoscopic gastric bypass is a good option even in the extremely obese. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 17011899 |
|
