Perioperative outcomes and risk factors in gastric surgery for morbid obesity: a 9-year experience.
OBJECTIVE
Surgical treatment of severe obesity is the most rapidly growing specialty area of surgery. The rapid expansion of bariatric surgery has raised questions and concerns regarding possible increased surgical mortality and morbidity rates in both academic and community settings. The purpose of this study was to evaluate postoperative outcomes and risk factors for bariatric gastric surgery for severe obesity.


METHODS
A community experience of 1009 consecutive patients who underwent open surgical treatment of morbid obesity during a 9-year period was reviewed from a prospective database. The series included 858 primary gastric bypass operations and 151 revision operations. Perioperative outcomes, late complications, and weight loss results were recorded. Morbidity and mortality rates were analyzed according to patient age, body mass index (BMI), and gender.


RESULTS
The mortality rate in the series was 0.6%, and the morbidity rate was 20%. The major complication rate was 6.6%. There were no deaths in the 151 revision patients. The gastrointestinal leak rate was 0.8%, and the thromboembolism rate was 1%. Statistical analysis indicates that BMI is a risk factor for surgical complications.


CONCLUSIONS
Open gastric surgery for morbid obesity can be carried out in the community setting with low mortality and morbidity rates. BMI is a proven surgical risk factor.
Department of Surgery and the Center for Health Research and Rural Advocacy, Geisinger Medical Center, 100 N. Academy Avenue, Danville, PA 17822, USA. pnbenotti@geisinger.edu
Peter N
PN
Benotti
G Craig
GC
Wood
Hector
H
Rodriguez
Nino
N
Carnevale
Eduardo
E
Liriano
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors