title: Preoperative weight loss before bariatric surgery.
abstract: OBJECTIVE
  Preoperative weight loss reduces the frequency of surgical complications in patients undergoing bariatric surgery.
  
  
  METHODS
  Review of records of patients undergoing open or laparoscopic gastric bypass.
  
  
  METHODS
  A comprehensive, multidisciplinary obesity treatment center at a tertiary referral center that serves central Pennsylvania.
  
  
  METHODS
  A total of 881 patients undergoing open or laparoscopic gastric bypass from May 31, 2002, through February 24, 2006.
  
  
  METHODS
  All preoperative patients completed a 6-month multidisciplinary program that encouraged a 10% preoperative weight loss.
  
  
  METHODS
  Loss of excess body weight (EBW) and total and major complication rates.
  
  
  RESULTS
  Of the 881 patients, 592 (67.2%) lost 5% or more EBW and 423 (48.0%) lost more than 10% EBW. Patients referred for open gastric bypass (n = 466) were generally older (P < .001), had a higher body mass index (P < .001), and were more often men (P < .001) than those undergoing laparoscopic gastric bypass (n = 415). Total and major complication rates were higher in patients undergoing open gastric bypass (P < .001 and P = .03, respectively). Univariate analysis revealed that increasing preoperative weight loss is associated with reduced complication frequencies for the entire group for total complications (P =.004) and most likely for major complications (P = .06). Controlling for age, sex, baseline body mass index, and type of surgery in a multiple logistic regression model, increased preoperative weight loss was a predictor of reduced complications for any (P =.004) and major (P = .03) complications.
  
  
  CONCLUSIONS
  Preoperative weight loss is associated with fewer complications after gastric bypass surgery.
authors.affiliation: Department of Surgery, Saint Francis Medical Center, Trenton, New Jersey, USA. pbenotti@stfrancismedical.org
authors.forename: Peter N
authors.initials: PN
authors.lastname: Benotti
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Still
authors.forename: G Craig
authors.initials: GC
authors.lastname: Wood
authors.forename: Yasir
authors.initials: Y
authors.lastname: Akmal
authors.forename: Heather
authors.initials: H
authors.lastname: King
authors.forename: Hazem
authors.initials: H
authors.lastname: El Arousy
authors.forename: Horatiu
authors.initials: H
authors.lastname: Dancea
authors.forename: Glenn S
authors.initials: GS
authors.lastname: Gerhard
authors.forename: Anthony
authors.initials: A
authors.lastname: Petrick
authors.forename: William
authors.initials: W
authors.lastname: Strodel
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss