[Bariatric surgery in France: results of a nationwide prospective survey].
OBJECTIVE
To compare the actual practice of bariatric surgery in France with the guidelines of scientific societies regarding surgical indications and followup.


METHODS
This a prospective descriptive transversal study performed within a two month period (December 2002 - January 2003) in all patients for which a consent demand has been sent to the Medical Insurance Services (examined by an administrative consultant) and/or patients operated on for morbid obesity (with or without administrative consent).


RESULTS
One thousand and three patients have been examined by an administrative consultant before obesity surgery and 1238 patients have been operated in 263 centres including 79 public (non-profit) centres and 184 private centres. In 16.7 % of the cases, there were wrong indications according to recognized criteria (BMI<35 kg/m(2) or lack of comorbidities for BMI between 35 and 39) or even contraindications because of other diseases. Patient informed consent was retrieved in only 54 % of medical files and follow up protocol was done in only 47 % of the cases. Because of several missing data, the practice of bariatric surgery followed the guidelines in only 34 % of cases. In hospital morbidity rate was 5 %. Two patients died postoperatively (mortality rate 0.2 %).


CONCLUSIONS
This study demonstrates that the practice of bariatric surgery needs to be improved in France.
Rodde-Dunet
M-H
MH
Direction du service médical de la caisse nationale d'assurance maladie (CNAMTS), 50 rue du Professeur-A.-Lemierre, 75986 Paris cedex 20, France. mh.rodde-dunet@cnamts.fr
Marty
M
M
Païta
M
M
Fender
P
P
Allemand
H
H
D000293:Adolescent; D000328:Adult; D049088:Bariatrics / Q000592:standards*; D002648:Child; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires