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Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility.
Am J Surg. 2004 Nov; 188(5):606-10.AJ

Abstract

BACKGROUND

Previous studies have shown that advanced age, diabetes, and male gender are associated with higher morbidity and mortality after bariatric surgery. Those risk factors are characteristic of patients in the Veterans Affairs (VA) health care system. Laparoscopic Roux-en-Y gastric bypass (RYGB) has become an established treatment modality for morbid obesity. Our objective was to review the initial experience with laparoscopic (RYGB) for morbid obesity at our VA facility.

METHODS

A retrospective review was used.

RESULTS

Between May of 2002 and April of 2004, 40 patients underwent laparoscopic RYGB. All patients met National Institutes of Health consensus statement guidelines for bariatric surgery. There were 30 (75%) male and 10 (25%) female patients, with an average age of 49.9 +/- 8.7 years and an average body mass index (BMI) of 48.1 +/- 8.5 kg/m(2). Preoperative comorbidities included diabetes mellitus (DM) in 59%, hypertension in 79%, and obstructive sleep apnea in 74.4%. The procedure was converted to an open procedure in 3 patients (7.5%). There were no mortalities. Immediate (within 30 days) complications developed in 9 (22.5%) patients, necessitating abdominal re-operation in 3 patients (7.5%). The median length of hospital stay was 3 days. Late complications (>30 days) developed in 8 (20%) patients. Percent excess weight loss at 3, 6, and 12 months was 44% (n = 34), 59% (n = 29), and 70.0% (n = 22), respectively. In 23 patients who were followed-up for more than 3 months, DM resolved in 79% and improved in 21% at a mean follow-up evaluation of 13 months.

CONCLUSIONS

Laparoscopic RYGB can be performed with acceptable morbidity and with good short-term results in a VA hospital setting. Morbid obesity is prevalent in the VA patient population and access to bariatric surgery should be an available alternative.

Authors+Show Affiliations

Stanford University School of Medicine, Palo Alto, CA, USA; VA Palo Alto Health Care System, 3801 Miranda Ave., 112G, Palo Alto, CA 94304, USA. bsafadi@stanford.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15546580

Citation

Safadi, Bassem Y., et al. "Introducing Laparoscopic Roux-en-Y Gastric Bypass at a Veterans Affairs Medical Facility." American Journal of Surgery, vol. 188, no. 5, 2004, pp. 606-10.
Safadi BY, Kieran JA, Hall RG, et al. Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility. Am J Surg. 2004;188(5):606-10.
Safadi, B. Y., Kieran, J. A., Hall, R. G., Morton, J. M., Bellatorre, N., Shinoda, E., Johnson, P. J., Curet, M. J., & Wren, S. M. (2004). Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility. American Journal of Surgery, 188(5), 606-10.
Safadi BY, et al. Introducing Laparoscopic Roux-en-Y Gastric Bypass at a Veterans Affairs Medical Facility. Am J Surg. 2004;188(5):606-10. PubMed PMID: 15546580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility. AU - Safadi,Bassem Y, AU - Kieran,Jennefer A, AU - Hall,Robert G, AU - Morton,John M, AU - Bellatorre,Nina, AU - Shinoda,Evelyn, AU - Johnson,Paul J, AU - Curet,Myriam J, AU - Wren,Sherry M, PY - 2004/06/10/received PY - 2004/11/18/pubmed PY - 2004/12/22/medline PY - 2004/11/18/entrez SP - 606 EP - 10 JF - American journal of surgery JO - Am. J. Surg. VL - 188 IS - 5 N2 - BACKGROUND: Previous studies have shown that advanced age, diabetes, and male gender are associated with higher morbidity and mortality after bariatric surgery. Those risk factors are characteristic of patients in the Veterans Affairs (VA) health care system. Laparoscopic Roux-en-Y gastric bypass (RYGB) has become an established treatment modality for morbid obesity. Our objective was to review the initial experience with laparoscopic (RYGB) for morbid obesity at our VA facility. METHODS: A retrospective review was used. RESULTS: Between May of 2002 and April of 2004, 40 patients underwent laparoscopic RYGB. All patients met National Institutes of Health consensus statement guidelines for bariatric surgery. There were 30 (75%) male and 10 (25%) female patients, with an average age of 49.9 +/- 8.7 years and an average body mass index (BMI) of 48.1 +/- 8.5 kg/m(2). Preoperative comorbidities included diabetes mellitus (DM) in 59%, hypertension in 79%, and obstructive sleep apnea in 74.4%. The procedure was converted to an open procedure in 3 patients (7.5%). There were no mortalities. Immediate (within 30 days) complications developed in 9 (22.5%) patients, necessitating abdominal re-operation in 3 patients (7.5%). The median length of hospital stay was 3 days. Late complications (>30 days) developed in 8 (20%) patients. Percent excess weight loss at 3, 6, and 12 months was 44% (n = 34), 59% (n = 29), and 70.0% (n = 22), respectively. In 23 patients who were followed-up for more than 3 months, DM resolved in 79% and improved in 21% at a mean follow-up evaluation of 13 months. CONCLUSIONS: Laparoscopic RYGB can be performed with acceptable morbidity and with good short-term results in a VA hospital setting. Morbid obesity is prevalent in the VA patient population and access to bariatric surgery should be an available alternative. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/15546580/Introducing_laparoscopic_Roux_en_Y_gastric_bypass_at_a_Veterans_Affairs_medical_facility_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(04)00354-X DB - PRIME DP - Unbound Medicine ER -