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Outcomes of Roux-en-Y gastric bypass stratified by a body mass index of 70 kg/m2: a comparative analysis of 825 procedures.

Abstract

We compared the safety, excess weight loss (EWL), and improvement in comorbidities after Roux-en-Y gastric bypass (RYGB) in morbidly obese and superobese patients (body mass index, <70 kg/m2 or >or=70 kg/m2). Of 825 patients who underwent RYGB by our group between 1995 and 2003, 79 (9.6%) were superobese (group A) and 746 were morbidly obese (group B). There were significant differences in age (A, 40.8 years; B, 43.2 years; P=0.01), gender (males: A, 40.5%; B, 17.6%; P<0.0001), and type of access (laparoscopic RYGB: A, 4.1%; B, 34.2%; P<0.0001). Sleep apnea (A, 57%; B, 31.4%; P<0.0001) and venous insufficiency (A, 16.5%; B, 2.4%; P<0.0001) were more common in superobese patients. Hospital stay was similar (A, 6.3 days; B, 5.3 days) with adjustment for differences in type of access. Although morbidity was comparable, mortality was higher in the superobese group (A, 2.5%; B, 0.5%; P<0.05). At a comparable follow-up (A, 17.7 months; B, 18.25 months), percent EWL at 1 year was lower in the superobese group (A, 54.6%; B, 64.3%; P<0.0001), but it became similar at 3 years (A, 66.5%; B, 60.7%). Postoperative improvement of comorbidities was equally dramatic in both groups with the exception of venous insufficiency. In conclusion, complications are not increased in the superobese, but they are more often fatal. Superobese patients achieve their maximum weight loss in a longer period of time and reach their nadir at year 3.

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  • Authors+Show Affiliations

    ,

    Division of Thoracic and Foregut Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15232, USA.

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    Source

    MeSH

    Adult
    Body Mass Index
    Comorbidity
    Female
    Gastric Bypass
    Humans
    Hypertension
    Length of Stay
    Male
    Middle Aged
    Obesity, Morbid
    Retrospective Studies
    Sleep Apnea Syndromes
    Treatment Outcome
    Venous Insufficiency

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    15623444

    Citation

    Raftopoulos, Ioannis, et al. "Outcomes of Roux-en-Y Gastric Bypass Stratified By a Body Mass Index of 70 Kg/m2: a Comparative Analysis of 825 Procedures." Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 9, no. 1, 2005, pp. 44-52; discussion 52-3.
    Raftopoulos I, Ercole J, Udekwu AO, et al. Outcomes of Roux-en-Y gastric bypass stratified by a body mass index of 70 kg/m2: a comparative analysis of 825 procedures. J Gastrointest Surg. 2005;9(1):44-52; discussion 52-3.
    Raftopoulos, I., Ercole, J., Udekwu, A. O., Luketich, J. D., & Courcoulas, A. P. (2005). Outcomes of Roux-en-Y gastric bypass stratified by a body mass index of 70 kg/m2: a comparative analysis of 825 procedures. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 9(1), pp. 44-52; discussion 52-3.
    Raftopoulos I, et al. Outcomes of Roux-en-Y Gastric Bypass Stratified By a Body Mass Index of 70 Kg/m2: a Comparative Analysis of 825 Procedures. J Gastrointest Surg. 2005;9(1):44-52; discussion 52-3. PubMed PMID: 15623444.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Outcomes of Roux-en-Y gastric bypass stratified by a body mass index of 70 kg/m2: a comparative analysis of 825 procedures. AU - Raftopoulos,Ioannis, AU - Ercole,Julie, AU - Udekwu,Anthony O, AU - Luketich,James D, AU - Courcoulas,Anita P, PY - 2004/12/30/pubmed PY - 2005/6/16/medline PY - 2004/12/30/entrez SP - 44-52; discussion 52-3 JF - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract JO - J. Gastrointest. Surg. VL - 9 IS - 1 N2 - We compared the safety, excess weight loss (EWL), and improvement in comorbidities after Roux-en-Y gastric bypass (RYGB) in morbidly obese and superobese patients (body mass index, <70 kg/m2 or >or=70 kg/m2). Of 825 patients who underwent RYGB by our group between 1995 and 2003, 79 (9.6%) were superobese (group A) and 746 were morbidly obese (group B). There were significant differences in age (A, 40.8 years; B, 43.2 years; P=0.01), gender (males: A, 40.5%; B, 17.6%; P<0.0001), and type of access (laparoscopic RYGB: A, 4.1%; B, 34.2%; P<0.0001). Sleep apnea (A, 57%; B, 31.4%; P<0.0001) and venous insufficiency (A, 16.5%; B, 2.4%; P<0.0001) were more common in superobese patients. Hospital stay was similar (A, 6.3 days; B, 5.3 days) with adjustment for differences in type of access. Although morbidity was comparable, mortality was higher in the superobese group (A, 2.5%; B, 0.5%; P<0.05). At a comparable follow-up (A, 17.7 months; B, 18.25 months), percent EWL at 1 year was lower in the superobese group (A, 54.6%; B, 64.3%; P<0.0001), but it became similar at 3 years (A, 66.5%; B, 60.7%). Postoperative improvement of comorbidities was equally dramatic in both groups with the exception of venous insufficiency. In conclusion, complications are not increased in the superobese, but they are more often fatal. Superobese patients achieve their maximum weight loss in a longer period of time and reach their nadir at year 3. SN - 1091-255X UR - https://www.unboundmedicine.com/medline/citation/15623444/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1091-255X(04)00453-6 DB - PRIME DP - Unbound Medicine ER -