A Westling1, S Gustavsson. 1. Department of Surgery, University Hospital, 751 85 Uppsala, Sweden. agneta.westling@kirurgi.uu.se
Abstract
BACKGROUND: The feasibility of laparoscopic Roux-en-Y gastric bypass (Lap-RYGBP) for morbid obesity is well documented. In a prospective randomized trial, we compared laparoscopic and open surgery. METHODS:51 patients (48 females, mean (+/- SD) age 36 +/- 9 years and BMI 42 +/- 4 kg/m2) were randomly allocated to either laparoscopy (n = 30) or open surgery (n = 21). All patients were followed for a minimum of 1 year. RESULTS: In the laparoscopy group, 7 patients (23%) were converted to open surgery due to various procedural difficulties. In an analysis, with the converted patients excluded, the morphine doses used postoperatively were significantly (p < 0.005) lower in the laparoscopic group compared to the open group. Likewise, postoperative hospital stay was shorter (4 vs 6 days, p < 0.025). Six patients in the laparoscopy group had to be re-operated due to Roux-limb obstruction in the mesocolic tunnel within 5 weeks. The weight loss expressed in decrease in mean BMI units after 1 year was 14 +/- 3 and 13 +/- 3 after laparoscopy and open surgery, respectively (not significant). CONCLUSIONS: Both laparoscopic and open RYGBP are effective and well received surgical procedures in morbid obesity. Reduced postoperative pain, shorter hospital stay and shorter sick-leave are obvious benefits of laparoscopy but conversions and/or reoperations in 1/4 of the patients indicate that Lap-RYGBP at present must be considered an investigational procedure.
RCT Entities:
BACKGROUND: The feasibility of laparoscopic Roux-en-Y gastric bypass (Lap-RYGBP) for morbid obesity is well documented. In a prospective randomized trial, we compared laparoscopic and open surgery. METHODS: 51 patients (48 females, mean (+/- SD) age 36 +/- 9 years and BMI 42 +/- 4 kg/m2) were randomly allocated to either laparoscopy (n = 30) or open surgery (n = 21). All patients were followed for a minimum of 1 year. RESULTS: In the laparoscopy group, 7 patients (23%) were converted to open surgery due to various procedural difficulties. In an analysis, with the converted patients excluded, the morphine doses used postoperatively were significantly (p < 0.005) lower in the laparoscopic group compared to the open group. Likewise, postoperative hospital stay was shorter (4 vs 6 days, p < 0.025). Six patients in the laparoscopy group had to be re-operated due to Roux-limb obstruction in the mesocolic tunnel within 5 weeks. The weight loss expressed in decrease in mean BMI units after 1 year was 14 +/- 3 and 13 +/- 3 after laparoscopy and open surgery, respectively (not significant). CONCLUSIONS: Both laparoscopic and open RYGBP are effective and well received surgical procedures in morbid obesity. Reduced postoperative pain, shorter hospital stay and shorter sick-leave are obvious benefits of laparoscopy but conversions and/or reoperations in 1/4 of the patients indicate that Lap-RYGBP at present must be considered an investigational procedure.
Authors: Matthew M Hutter; Sheldon Randall; Shukri F Khuri; William G Henderson; William M Abbott; Andrew L Warshaw Journal: Ann Surg Date: 2006-05 Impact factor: 12.969
Authors: Juan C Rodríguez-Sanjuán; Marcos Gómez-Ruiz; Soledad Trugeda-Carrera; Carlos Manuel-Palazuelos; Antonio López-Useros; Manuel Gómez-Fleitas Journal: World J Gastroenterol Date: 2016-02-14 Impact factor: 5.742