Xiaoxi Feng1, Amin Andalib2, Stacy A Brethauer1, Philip R Schauer1, Ali Aminian3. 1. Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. 2. Center for Bariatric Surgery, Department of Surgery, McGill University, Montreal, QC, Canada. 3. Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address: aminiaa@ccf.org.
Abstract
BACKGROUND: The safety profile of bariatric surgery in patients with class I obesity, or body mass index ≥30 and <35 kg/m2, is a matter of concern among patients and physicians. OBJECTIVE: To assess the safety profile of bariatric surgery in patients with class I obesity. SETTING: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data set. METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 to 2016 data sets were queried for class I obesity patients who underwent primary bariatric procedures. The 30-day postoperative safety profile, predictors of adverse events, and comparison between Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) were studied. RESULTS: A total of 8628 cases with a mean preoperative body mass index of 33.7 ± 1.1 kg/m2 were analyzed: 1838 (21.3%) underwent RYGB, 6243 (72.4%) underwent SG, 530 (6.1%) underwent gastric banding, and 17 (.2%) underwent duodenal switch; 33.9% had diabetes and 75% had hypertension. The composite morbidity rate (defined as presence of any of 24 postoperative adverse events) for the entire cohort was 3.8%, and the serious morbidity rate (presence of any of 9 serious complications) was .7%. The 30-day mortality rate was .05% (4 cases). Presence of chronic kidney disease was found to be associated with higher composite and serious morbidity (composite morbidity: odds ratio 5.1, 95% confidence interval 2.22-11.71; serious morbidity: odds ratio 5.66, 95% confidence interval 1.52-21.14). SG patients had significantly better short-term safety outcomes than RYGB patients. CONCLUSION: Findings from this study, the largest series to date, indicate that bariatric surgery is safe in patients with class I obesity, with very low risk of morbidity and mortality.
BACKGROUND: The safety profile of bariatric surgery in patients with class I obesity, or body mass index ≥30 and <35 kg/m2, is a matter of concern among patients and physicians. OBJECTIVE: To assess the safety profile of bariatric surgery in patients with class I obesity. SETTING: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data set. METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 to 2016 data sets were queried for class I obesitypatients who underwent primary bariatric procedures. The 30-day postoperative safety profile, predictors of adverse events, and comparison between Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) were studied. RESULTS: A total of 8628 cases with a mean preoperative body mass index of 33.7 ± 1.1 kg/m2 were analyzed: 1838 (21.3%) underwent RYGB, 6243 (72.4%) underwent SG, 530 (6.1%) underwent gastric banding, and 17 (.2%) underwent duodenal switch; 33.9% had diabetes and 75% had hypertension. The composite morbidity rate (defined as presence of any of 24 postoperative adverse events) for the entire cohort was 3.8%, and the serious morbidity rate (presence of any of 9 serious complications) was .7%. The 30-day mortality rate was .05% (4 cases). Presence of chronic kidney disease was found to be associated with higher composite and serious morbidity (composite morbidity: odds ratio 5.1, 95% confidence interval 2.22-11.71; serious morbidity: odds ratio 5.66, 95% confidence interval 1.52-21.14). SG patients had significantly better short-term safety outcomes than RYGB patients. CONCLUSION: Findings from this study, the largest series to date, indicate that bariatric surgery is safe in patients with class I obesity, with very low risk of morbidity and mortality.
Authors: Andrea Deledda; Stefano Pintus; Andrea Loviselli; Michele Fosci; Giovanni Fantola; Fernanda Velluzzi Journal: Int J Environ Res Public Health Date: 2021-11-17 Impact factor: 3.390
Authors: Erik Stenberg; Gustaf Bruze; Johan Sundström; Claude Marcus; Ingmar Näslund; Johan Ottosson; Martin Neovius Journal: JAMA Netw Open Date: 2022-07-01