Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity.
OBJECTIVE
To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months.


BACKGROUND
The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic approach has significant potential to reduce perioperative complications and recovery time.


METHODS
Consecutive patients (n = 275) who met NIH criteria for bariatric surgery were offered laparoscopic Roux-en-Y gastric bypass between July 1997 and March 2000. A 15-mL gastric pouch and a 75-cm Roux limb (150 cm for superobese) was created using five or six trocar incisions.


RESULTS
The conversion rate to open gastric bypass was 1%. The start of an oral diet began a mean of 1.58 days after surgery, with a median hospital stay of 2 days and return to work at 21 days. The incidence of early major and minor complications was 3.3% and 27%, respectively. One death occurred related to a pulmonary embolus (0.4%). The hernia rate was 0.7%, and wound infections requiring outpatient drainage only were uncommon (5%). Excess weight loss at 24 and 30 months was 83% and 77%, respectively. In patients with more than 1 year of follow-up, most of the comorbidities were improved or resolved, and 95% reported significant improvement in quality of life.


CONCLUSIONS
Laparoscopic Roux-en-Y gastric bypass is effective in achieving weight loss and in improving comorbidities and quality of life while reducing recovery time and perioperative complications.
Schauer
P R
PR
Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15213-2582, USA. schauerpr@msx.upmc.edu
Ikramuddin
S
S
Gourash
W
W
Ramanathan
R
R
Luketich
J
J
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss