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Outcome of hand-assisted laparoscopic gastric bypass in super obese patients.
Surg Obes Relat Dis. 2008 Sep-Oct; 4(5):618-24.SO

Abstract

BACKGROUND

The optimal surgical treatment for super obese patients (body mass index [BMI] >or=50 kg/m2) has been a challenge and debate for most bariatric surgeons. To compare the outcomes of hand-assisted laparoscopic Roux-en-Y gastric bypass (HALGB) in super obese patients (BMI >or=50 kg/m2) to morbidly obese patients (BMI <50 kg/m2).

METHODS

A total of 295 patients who underwent HALGB from October 2003 to December 2005 were studied. These patients included 177 with a BMI of <or=49 kg/m2 (morbidly obese) and 118 with a BMI of >or=50 kg/m2 (super-obese). The patient demographics, complications, and outcomes were examined. Additionally, the 12-month postoperative outcomes included the percentage of excess weight loss and improvement of co-morbidities.

RESULTS

The patient age and gender were similar between the 2 groups. The super-obese patients had significantly more co-morbidities and required a greater number of medications. A significant difference was found in 3 early postoperative complications, with super-obese patients experiencing more wound infections (P = .039), nausea/vomiting (P = .003), and pulmonary failure (P = .010). Logistic regression analysis found, after controlling for significant risk factors, that the difference in the incidence of nausea/vomiting was still significant (odds ratio 14.33, 95% confidence interval 1.73-118.60, P = .01). Morbidly obese patients had a significantly greater percentage of excess weight loss at 12 months postoperatively compared with the super-obese patients (80% versus 55%, respectively, P <.001).

CONCLUSION

HALGB is a safe and effective procedure in the super obese but with less favorable outcomes compared with those for morbidly obese patients regarding the percentage of excess weight loss.

Authors+Show Affiliations

Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18226979

Citation

Hamed, Osama, et al. "Outcome of Hand-assisted Laparoscopic Gastric Bypass in Super Obese Patients." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 4, no. 5, 2008, pp. 618-24.
Hamed O, Kerlakian G, Engel A, et al. Outcome of hand-assisted laparoscopic gastric bypass in super obese patients. Surg Obes Relat Dis. 2008;4(5):618-24.
Hamed, O., Kerlakian, G., Engel, A., & Bollmer, C. (2008). Outcome of hand-assisted laparoscopic gastric bypass in super obese patients. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 4(5), 618-24. https://doi.org/10.1016/j.soard.2007.11.001
Hamed O, et al. Outcome of Hand-assisted Laparoscopic Gastric Bypass in Super Obese Patients. Surg Obes Relat Dis. 2008 Sep-Oct;4(5):618-24. PubMed PMID: 18226979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of hand-assisted laparoscopic gastric bypass in super obese patients. AU - Hamed,Osama, AU - Kerlakian,George, AU - Engel,Amy, AU - Bollmer,Cyndy, Y1 - 2008/01/28/ PY - 2007/08/03/received PY - 2007/10/22/revised PY - 2007/11/11/accepted PY - 2008/1/30/pubmed PY - 2008/12/17/medline PY - 2008/1/30/entrez SP - 618 EP - 24 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 4 IS - 5 N2 - BACKGROUND: The optimal surgical treatment for super obese patients (body mass index [BMI] >or=50 kg/m2) has been a challenge and debate for most bariatric surgeons. To compare the outcomes of hand-assisted laparoscopic Roux-en-Y gastric bypass (HALGB) in super obese patients (BMI >or=50 kg/m2) to morbidly obese patients (BMI <50 kg/m2). METHODS: A total of 295 patients who underwent HALGB from October 2003 to December 2005 were studied. These patients included 177 with a BMI of <or=49 kg/m2 (morbidly obese) and 118 with a BMI of >or=50 kg/m2 (super-obese). The patient demographics, complications, and outcomes were examined. Additionally, the 12-month postoperative outcomes included the percentage of excess weight loss and improvement of co-morbidities. RESULTS: The patient age and gender were similar between the 2 groups. The super-obese patients had significantly more co-morbidities and required a greater number of medications. A significant difference was found in 3 early postoperative complications, with super-obese patients experiencing more wound infections (P = .039), nausea/vomiting (P = .003), and pulmonary failure (P = .010). Logistic regression analysis found, after controlling for significant risk factors, that the difference in the incidence of nausea/vomiting was still significant (odds ratio 14.33, 95% confidence interval 1.73-118.60, P = .01). Morbidly obese patients had a significantly greater percentage of excess weight loss at 12 months postoperatively compared with the super-obese patients (80% versus 55%, respectively, P <.001). CONCLUSION: HALGB is a safe and effective procedure in the super obese but with less favorable outcomes compared with those for morbidly obese patients regarding the percentage of excess weight loss. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/18226979/Outcome_of_hand_assisted_laparoscopic_gastric_bypass_in_super_obese_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(07)00771-X DB - PRIME DP - Unbound Medicine ER -