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Open vs laparoscopic Roux-en-Y gastric bypass: comparison of operative morbidity and mortality.
Obes Surg. 2004 Jan; 14(1):73-6.OS

Abstract

BACKGROUND

Open Roux-en-Y gastric bypass (RYGBP) has proven to be an effective method for weight control for the morbidly obese patient. With technologic and surgical skill advancement in the application of laparoscopic surgery, laparoscopic RYGBP has also been found to be of value in surgical control of obesity. Risk/benefit ratios in comparison of the 2 methods are undergoing definition by experience.

METHODS

779 patients who underwent RYGBP between March 1, 2000 and June 30, 2002 were evaluated retrospectively. 328 patients underwent laparoscopic RYGBP (Group A) and 451 underwent open RYGBP (Group B). All charts and hospital records of these patients were reviewed. Questionnaires were mailed to all patients who had undergone RYGBP. Follow-up was 5-29 months.

RESULTS

89 patients in Group A and 162 patients in Group B experienced significant morbidity. There were no surgical deaths in Group A and one surgical death in Group B. Weight loss profiles were the same. Significant differences in morbidity were noted with respect to gastrojejunal stenosis (Group A = 11.6%, Group B = 4.7%, P=.0012), occurrence of ventral incisonal hernia (A=0%, B=10%, P<.00013), and wound problems (abdominal wall hematoma A=1.5%%, B=0%, P=.013; wound infection A=1.2%, B=6.2%, P=.00037). Gastrojejunal perforation was not significantly different (A=1.5%, B=0.89%, P=.50), as was true of small bowel obstruction (A=2.7%, B=3.3%, P=.68).

CONCLUSIONS

Each operative approach has associated problems.Wound care problems and ventral hernias are more common in Group B (open) and anas tomotic stenoses are more common in Group A (laparoscopic). Anastomotic leaks and small bowel obstruction are troublesome but not statistically different in occurrence.

Authors+Show Affiliations

Rocky Mountain Associated Physicians, Salt Lake City, UT 84124, USA. scc@surgeons4weightloss.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14980037

Citation

Smith, Sherman C., et al. "Open Vs Laparoscopic Roux-en-Y Gastric Bypass: Comparison of Operative Morbidity and Mortality." Obesity Surgery, vol. 14, no. 1, 2004, pp. 73-6.
Smith SC, Edwards CB, Goodman GN, et al. Open vs laparoscopic Roux-en-Y gastric bypass: comparison of operative morbidity and mortality. Obes Surg. 2004;14(1):73-6.
Smith, S. C., Edwards, C. B., Goodman, G. N., Halversen, R. C., & Simper, S. C. (2004). Open vs laparoscopic Roux-en-Y gastric bypass: comparison of operative morbidity and mortality. Obesity Surgery, 14(1), 73-6.
Smith SC, et al. Open Vs Laparoscopic Roux-en-Y Gastric Bypass: Comparison of Operative Morbidity and Mortality. Obes Surg. 2004;14(1):73-6. PubMed PMID: 14980037.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Open vs laparoscopic Roux-en-Y gastric bypass: comparison of operative morbidity and mortality. AU - Smith,Sherman C, AU - Edwards,Charles B, AU - Goodman,Gerald N, AU - Halversen,R Chad, AU - Simper,Steven C, PY - 2004/2/26/pubmed PY - 2004/6/21/medline PY - 2004/2/26/entrez SP - 73 EP - 6 JF - Obesity surgery JO - Obes Surg VL - 14 IS - 1 N2 - BACKGROUND: Open Roux-en-Y gastric bypass (RYGBP) has proven to be an effective method for weight control for the morbidly obese patient. With technologic and surgical skill advancement in the application of laparoscopic surgery, laparoscopic RYGBP has also been found to be of value in surgical control of obesity. Risk/benefit ratios in comparison of the 2 methods are undergoing definition by experience. METHODS: 779 patients who underwent RYGBP between March 1, 2000 and June 30, 2002 were evaluated retrospectively. 328 patients underwent laparoscopic RYGBP (Group A) and 451 underwent open RYGBP (Group B). All charts and hospital records of these patients were reviewed. Questionnaires were mailed to all patients who had undergone RYGBP. Follow-up was 5-29 months. RESULTS: 89 patients in Group A and 162 patients in Group B experienced significant morbidity. There were no surgical deaths in Group A and one surgical death in Group B. Weight loss profiles were the same. Significant differences in morbidity were noted with respect to gastrojejunal stenosis (Group A = 11.6%, Group B = 4.7%, P=.0012), occurrence of ventral incisonal hernia (A=0%, B=10%, P<.00013), and wound problems (abdominal wall hematoma A=1.5%%, B=0%, P=.013; wound infection A=1.2%, B=6.2%, P=.00037). Gastrojejunal perforation was not significantly different (A=1.5%, B=0.89%, P=.50), as was true of small bowel obstruction (A=2.7%, B=3.3%, P=.68). CONCLUSIONS: Each operative approach has associated problems.Wound care problems and ventral hernias are more common in Group B (open) and anas tomotic stenoses are more common in Group A (laparoscopic). Anastomotic leaks and small bowel obstruction are troublesome but not statistically different in occurrence. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/14980037/Open_vs_laparoscopic_Roux_en_Y_gastric_bypass:_comparison_of_operative_morbidity_and_mortality_ DB - PRIME DP - Unbound Medicine ER -