title: Laparoscopic Roux-en-Y gastric bypass surgery in the obesity center Wuerzburg--patient selection and results.
abstract: BACKGROUND
  The choice between different bariatric procedures for each patient is an important question in bariatric surgery. In this article, we explain criteria for patient selection for laparoscopic Roux-en-Y gastric bypass at the Obesity Center Wuerzburg and compare the corresponding outcomes for these selection criteria.
  
  
  METHODS
  60 consecutive patients underwent gastric bypass surgery (34 female, 26 male; mean age 45.1 +/- 10.2 years). Mean preoperative BMI was 53.7 +/- 8.7 kg/m2. Selection criteria were age > 40, male sex,BMI > 50, metabolic syndrome, and/or reduced compliance.
  
  
  RESULTS
  42 patients (70%) were >40 years old, 26 patients(43%) were male, 42 patients (70%) had a BMI > 50, and 28 patients had a metabolic syndrome (47%). 10 out of these 60 patients were reoperated after failed gastric banding. Overall weight loss was 43.7 +/- 18.7 kg, BMI loss was 15.0 +/- 6.4 kg/m2,and excess body weight loss (EBWL) was 54.3 +/- 19.7%. There were 34 patients with an EBWL of > or = 50%. Age, sex, and presence or absence of metabolic syndrome were irrelevant for postoperative weight loss. Although the EBWL was slightly higher in patients with a BMI < 50, patients with a BMI > 50 lost significantly more weight.
  
  
  CONCLUSIONS
  The indication for a gastric bypass may be substantiated by the higher weight reduction in patients with a BMI > 50. Other selection criteria had no influence on the postoperative outcome.
authors.affiliation: Department of Surgery, University of Wuerzburg Hospital, Germany. fein@chirurgie.uni-wuerzburg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Fein
authors.forename: Marco
authors.initials: M
authors.lastname: Bueter
authors.forename: Christian
authors.initials: C
authors.lastname: Jurowich
authors.forename: Alexander
authors.initials: A
authors.lastname: Wierlemann
authors.forename: Annette
authors.initials: A
authors.lastname: Gerlach
authors.forename: Andreas
authors.initials: A
authors.lastname: Thalheimer
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000601:surgery*; D018579:Patient Selection; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss