Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery.
OBJECTIVE
Modest, preoperative weight loss will improve perioperative outcomes among high-risk, morbidly obese patients undergoing Roux-en-Y gastric bypass.


METHODS
A prospective, longitudinal assessment of characteristics and outcomes of gastric bypass patients.


METHODS
All patients undergoing open or laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity or its comorbid medical problems at Geisinger Medical Center in Danville, Pennsylvania, during a 3-year period from May 31, 2002, to February 24, 2006, were included in this analysis. Patients were required to participate in a standardized multidisciplinary preoperative program that encompasses medical, psychological, nutritional, and surgical interventions and education. In addition, patients were encouraged to achieve a 10% loss of excess body weight prior to surgical intervention.


RESULTS
Of the 884 subjects, 425 (48%) lost more than 10% of their excess body weight prior to the operation. After surgery (mean follow-up, 12 months), this group was more likely to achieve 70% loss of excess body weight (P < .001). Those who lost more than 5% of excess body weight prior to surgery were statistically less likely to have a length of stay of greater than 4 days (P = .03).


CONCLUSIONS
This study shows that high-risk morbidly obese candidates for bariatric surgery who are able to achieve a loss of 5% to 10% excess body weight prior to surgery have a higher probability of a shorter length of hospital stay and more rapid postoperative weight loss.
Still
Christopher D
CD
Geisinger Health Care System, Department of Gastroenterology and Nutrition, 100 N Academy Rd, Mail Code 2111, Danville, PA 17882-2111, USA. cstill@geisinger.edu
Benotti
Peter
P
Wood
G Craig
GC
Gerhard
Glenn S
GS
Petrick
Anthony
A
Reed
Mary
M
Strodel
William
W
D000328:Adult; D000368:Aged; D031204:Caloric Restriction; D037001:Directive Counseling; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy*; D010353:Patient Education as Topic; D011300:Preoperative Care; D016896:Treatment Outcome; D015431:Weight Loss