A Schwartz1, L Etchechoury, D Collet. 1. Service de Chirurgie Digestive, Hôpital Haut Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
Abstract
GOAL: The surgical treatment of the super-super obese (SSO), defined by a body mass index (BMI) superior or equal to 60 kg/m2, is difficult. The goal of this study was to evaluate the results of laparoscopic gastric bypass (LGBP) in this setting. PATIENTS AND METHODS: Between June 2005 and December 2011, 20 SSO patients underwent LGBP by one surgeon. Postoperative complications, weight loss, evolution of co-morbidities and quality of life were analyzed. The Bariatric Analysis and Reporting Outcome System (BAROS) was used to classify outcomes. RESULTS: There were 15 women and five men (median age: 37.5 years). Median BMI was 63 kg/m2. Median duration of operation was 180 minutes. One patient was converted to laparotomy. Three complications occurred: one grade I, one grade II and one grade V. The median excess weight loss was 47.1% at 12 months, 55.3% at 24 months, 53.3% at 36 months and 55.3% at 48 months. Among the patients with a follow-up of at least 12 months (n=17), the median quality of life score was 1.75 and the median BAROS score was 5.75. Arterial hypertension and type II diabetes resolved or improved in all patients and sleep apnea resolved in almost half of patients (43%). CONCLUSIONS: LGBP appears feasible and effective for SSO, both in terms of weight loss and improvement of co-morbidities and quality of life as well, with a low rate of postoperative complications.
GOAL: The surgical treatment of the super-super obese (SSO), defined by a body mass index (BMI) superior or equal to 60 kg/m2, is difficult. The goal of this study was to evaluate the results of laparoscopic gastric bypass (LGBP) in this setting. PATIENTS AND METHODS: Between June 2005 and December 2011, 20 SSO patients underwent LGBP by one surgeon. Postoperative complications, weight loss, evolution of co-morbidities and quality of life were analyzed. The Bariatric Analysis and Reporting Outcome System (BAROS) was used to classify outcomes. RESULTS: There were 15 women and five men (median age: 37.5 years). Median BMI was 63 kg/m2. Median duration of operation was 180 minutes. One patient was converted to laparotomy. Three complications occurred: one grade I, one grade II and one grade V. The median excess weight loss was 47.1% at 12 months, 55.3% at 24 months, 53.3% at 36 months and 55.3% at 48 months. Among the patients with a follow-up of at least 12 months (n=17), the median quality of life score was 1.75 and the median BAROS score was 5.75. Arterial hypertension and type II diabetes resolved or improved in all patients and sleep apnea resolved in almost half of patients (43%). CONCLUSIONS: LGBP appears feasible and effective for SSO, both in terms of weight loss and improvement of co-morbidities and quality of life as well, with a low rate of postoperative complications.
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