title: Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI > or =60.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been shown to be safe and effective. There is little data on the outcomes in massively super-obese patients, with a body mass index (BMI) > or =60 kg/m2 (super-super-obese). The goal of this study was to determine the safety and effectiveness of LRYGBP in these patients, and compare these results to patients with a BMI <60.
  
  
  METHODS
  213 consecutive patients undergoing LRYGBP by a single surgeon at a university hospital were included in the study. The patients were divided into 2 groups: BMI <60 kg/m2 (n=167) and BMI > or =60 kg/m2 (n=46). The 2 groups were compared with regard to perioperative complications, and postoperative weight loss.
  
  
  RESULTS
  Both groups had statistically similar complication rates. There were major complications in 8 patients (5%) in the lower BMI group and in 3 patients (7%) in the higher BMI group. There were minor complications in 9 patients (5%) in the lower BMI group and in 4 patients (9%) in the higher BMI group. Mean percent excess weight loss (%EWL) was 64% at 1 year in the BMI <60 group and 53% in the BMI > or =60 group.
  
  
  CONCLUSIONS
  LRYGBP can be performed safely and effectively in super-super-obese patients (BMI > or =60). Although these patients have less %EWL than lighter patients, they still end up with a good result. Therefore, LRYGBP should be considered a good surgical option even for patients with a BMI > or =60.
authors.affiliation: Montefiore Institute for Minimally Invasive Surgery, Albert Einstein College of Medicine, Bronx, NY, USA. dannyfarkas@hotmail.com
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Farkas
authors.forename: Prathiba
authors.initials: P
authors.lastname: Vemulapalli
authors.forename: Ali
authors.initials: A
authors.lastname: Haider
authors.forename: James M
authors.initials: JM
authors.lastname: Lopes
authors.forename: Karen E
authors.initials: KE
authors.lastname: Gibbs
authors.forename: Julio A
authors.initials: JA
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D011336:Probability; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss