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Primary laparoscopic gastric bypass can be performed safely in patients with BMI >or= 60.
J Am Coll Surg. 2009 Feb; 208(2):236-40.JA

Abstract

BACKGROUND

Several studies suggest patients with a body mass index (BMI; calculated as kg/m(2)) >or= 60 have a greater operative risk and so advocate a staged approach to bariatric procedures. This requires two separate operations and all associated risks. At our institution, we do not perform staged bariatric operations for these patients; we execute a single-stage laparoscopic Roux-en-Y gastric bypass (LGBP). Here, we analyze our experience in this population with a single-stage LGBP.

STUDY DESIGN

Ninety-five patients with a BMI >or= 60 were compared with 1,311 patients with BMI < 60 undergoing LGBP from December 2001 to May 2007. Data recorded included age, BMI, estimated blood loss, operating time, length of stay, and complications within the first 30 days after operation. Analyses of the data were performed using unpaired Student's t-test, with p < 0.05 as significant.

RESULTS

There were no statistically significant differences in age (42.6 versus 42.8 years), estimated blood loss (68.5 versus 69.5 mL), length of stay (3.1 versus 3.1 days), overall complications (12.7% versus 13.7%), or 30-day mortality (0.2% versus 0%) for patients with BMI < 60 as compared with patients with BMI >or= 60. The difference in operating time between the 2 groups was statistically significant (111 versus 118.7 minutes; p = 0.02) but likely reflected the learning curve.

CONCLUSIONS

In our experience, there were no differences in the incidence of complications or mortality for patients with a BMI >or= 60 undergoing LGBP as compared with those with a BMI < 60. These high-risk patients can safely undergo a single-stage LGBP.

Authors+Show Affiliations

Department of Surgery, Center for Minimally Invasive Obesity Surgery, Tufts Medical Center, Boston, MA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19228535

Citation

Abeles, Deborah, et al. "Primary Laparoscopic Gastric Bypass Can Be Performed Safely in Patients With BMI >or= 60." Journal of the American College of Surgeons, vol. 208, no. 2, 2009, pp. 236-40.
Abeles D, Kim JJ, Tarnoff ME, et al. Primary laparoscopic gastric bypass can be performed safely in patients with BMI >or= 60. J Am Coll Surg. 2009;208(2):236-40.
Abeles, D., Kim, J. J., Tarnoff, M. E., Shah, S., & Shikora, S. A. (2009). Primary laparoscopic gastric bypass can be performed safely in patients with BMI >or= 60. Journal of the American College of Surgeons, 208(2), 236-40. https://doi.org/10.1016/j.jamcollsurg.2008.10.020
Abeles D, et al. Primary Laparoscopic Gastric Bypass Can Be Performed Safely in Patients With BMI >or= 60. J Am Coll Surg. 2009;208(2):236-40. PubMed PMID: 19228535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary laparoscopic gastric bypass can be performed safely in patients with BMI >or= 60. AU - Abeles,Deborah, AU - Kim,Julie J, AU - Tarnoff,Michael E, AU - Shah,Sajani, AU - Shikora,Scott A, Y1 - 2008/12/18/ PY - 2008/07/08/received PY - 2008/10/03/revised PY - 2008/10/07/accepted PY - 2009/2/21/entrez PY - 2009/2/21/pubmed PY - 2009/3/17/medline SP - 236 EP - 40 JF - Journal of the American College of Surgeons JO - J. Am. Coll. Surg. VL - 208 IS - 2 N2 - BACKGROUND: Several studies suggest patients with a body mass index (BMI; calculated as kg/m(2)) >or= 60 have a greater operative risk and so advocate a staged approach to bariatric procedures. This requires two separate operations and all associated risks. At our institution, we do not perform staged bariatric operations for these patients; we execute a single-stage laparoscopic Roux-en-Y gastric bypass (LGBP). Here, we analyze our experience in this population with a single-stage LGBP. STUDY DESIGN: Ninety-five patients with a BMI >or= 60 were compared with 1,311 patients with BMI < 60 undergoing LGBP from December 2001 to May 2007. Data recorded included age, BMI, estimated blood loss, operating time, length of stay, and complications within the first 30 days after operation. Analyses of the data were performed using unpaired Student's t-test, with p < 0.05 as significant. RESULTS: There were no statistically significant differences in age (42.6 versus 42.8 years), estimated blood loss (68.5 versus 69.5 mL), length of stay (3.1 versus 3.1 days), overall complications (12.7% versus 13.7%), or 30-day mortality (0.2% versus 0%) for patients with BMI < 60 as compared with patients with BMI >or= 60. The difference in operating time between the 2 groups was statistically significant (111 versus 118.7 minutes; p = 0.02) but likely reflected the learning curve. CONCLUSIONS: In our experience, there were no differences in the incidence of complications or mortality for patients with a BMI >or= 60 undergoing LGBP as compared with those with a BMI < 60. These high-risk patients can safely undergo a single-stage LGBP. SN - 1879-1190 UR - https://www.unboundmedicine.com/medline/citation/19228535/Primary_laparoscopic_gastric_bypass_can_be_performed_safely_in_patients_with_BMI_>or=_60_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(08)01534-2 DB - PRIME DP - Unbound Medicine ER -