title: Outcome and complications of gastric bypass in super-super obesity versus morbid obesity.
abstract: BACKGROUND
  Roux-en-Y gastric bypass (RYGBP) reduces the co-morbidities of obesity. Patients with super-super obesity (BMI>or=60) present additional technical and medical challenges. This study compares the results in super-super-obese patients with patients with a BMI of <60 over a 5.5-year period.
  
  
  METHODS
  Retrospective analysis was performed of the 504 patients who underwent open RYGBP from January 1999 through June 2004. Patients were divided into 2 groups: Group A (444 patients) had a BMI <60, and Group B (60 patients) had a BMI>or=60, and also had a greater percentage of males. The groups were otherwise similar in demographics and co-morbidities.
  
  
  RESULTS
  Concomitant ventral herniorrhaphy was performed in 23 patients (5%) in Group A and in 3 patients (5%) in Group B. Concomitant cholecystectomy was done in 11.2% in Group A and 10% in Group B. Group A patients had an incidence of leaks of 1.3%, and there were no leaks in Group B. Wound infection rate for Group A was 5% vs 1.7 % in Group B (NS). Mortality for both groups was similar. The stricture rate for Group A was 0.9% compared with 1.7 % for Group B. After 1 year, excess weight lost was 41.7% in Group A and 38.3% in Group B. The development of anemia was not statistically different (8.3% vs 11.0 %). Incidence of postoperative gallbladder disease and incisional hernia was similar.
  
  
  CONCLUSIONS
  Super-super-obese patients should not be excluded from RYGBP because of a perceived increased risk based upon BMI.
authors.affiliation: Department of Surgery, Beth Israel Medical Center, New York, NY 10003, and Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Jerome D
authors.initials: JD
authors.lastname: Taylor
authors.forename: I Michael
authors.initials: IM
authors.lastname: Leitman
authors.forename: Peter
authors.initials: P
authors.lastname: Hon
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
authors.forename: Georgia
authors.initials: G
authors.lastname: Panagopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome