title: Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity.
abstract: OBJECTIVE
  To determine prospectively the results of Roux-en-Y gastric bypass (RYGB) used as the primary weight-reducing operation in patients with medically complicated ("morbid") obesity. The RYGB procedure combines the advantages of a restrictive physiology (pouch of 10 mL) and a "dumping physiology" for high-energy liquids without requiring an externally reinforced (banded) stoma.
  
  
  METHODS
  Between April 1987 and December 1998, a total of 191 consecutive patients with morbid obesity (median weight, 138 kg [range, 91-240 kg]; median body mass index, 49 kg/m2 [range, 36-74 kg/m2]), all of whom had directly weight-related morbidity, underwent RYGB and prospective follow-up.
  
  
  RESULTS
  Hospital mortality was 0.5% (1/191), and hospital morbidity occurred in 10.5% (20/191). Good long-term weight loss was achieved, and patients adapted well to the required new eating habits. The mean +/- SD weight loss at 1 year after operation (113 patients) was 52 +/- 1 kg or 68% +/- 2% of initial excess body weight. By 3 years postoperatively (74 patients), weight loss was still 66% +/- 2% of excess body weight. Overall, 53 (72%) of 74 patients had achieved and maintained a weight loss of 50% or more of their preoperative excess body weight 3 years after the operation. In addition, only 1 (1%) of 98 patients had persistent postoperative vomiting 1 or more times per week.
  
  
  CONCLUSIONS
  We believe that RYGB is a safe, effective procedure for most patients with morbid obesity and thus may be the current procedure of choice in patients requiring bariatrics++ surgery for morbid obesity.
authors.affiliation: Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minn. 55905, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Balsiger
authors.forename: F P
authors.initials: FP
authors.lastname: Kennedy
authors.forename: H S
authors.initials: HS
authors.lastname: Abu-Lebdeh
authors.forename: M
authors.initials: M
authors.lastname: Collazo-Clavell
authors.forename: M D
authors.initials: MD
authors.lastname: Jensen
authors.forename: T
authors.initials: T
authors.lastname: O'Brien
authors.forename: D D
authors.initials: DD
authors.lastname: Hensrud
authors.forename: S F
authors.initials: SF
authors.lastname: Dinneen
authors.forename: G B
authors.initials: GB
authors.lastname: Thompson
authors.forename: F G
authors.initials: FG
authors.lastname: Que
authors.forename: D E
authors.initials: DE
authors.lastname: Williams
authors.forename: M M
authors.initials: MM
authors.lastname: Clark
authors.forename: J E
authors.initials: JE
authors.lastname: Grant
authors.forename: M S
authors.initials: MS
authors.lastname: Frick
authors.forename: R A
authors.initials: RA
authors.lastname: Mueller
authors.forename: J L
authors.initials: JL
authors.lastname: Mai
authors.forename: M G
authors.initials: MG
authors.lastname: Sarr
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D015992:Body Mass Index; D001835:Body Weight; D005069:Evaluation Studies as Topic; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D012449:Safety; D015996:Survival Rate; D016896:Treatment Outcome; D015431:Weight Loss