Status of bariatric surgery in Germany--results of the nationwide survey on bariatric surgery 2005-2007.
BACKGROUND
Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Ottovon-Guericke University of Magdeburg (Germany) since January 1, 2005.


METHODS
In this prospective multicenter observational study, the data obtained for all primary bariatric procedures, including all repeated operations, performed on consecutive patients with morbid obesity at participating hospitals from 2005 to 2007 were prospectively collected using an internet online data registry. Perioperative characteristics such as the spectrum of diagnostic measurements, type of surgical procedures, and short- and long-term outcomes were investigated.


RESULTS
During the study period 3,123 surgical procedures were performed. In 2005 and 2006, gastric banding (GB) was the operation performed most frequently, followed by the Roux-en-Y gastric bypass (RYGBP). In 2007, a RYGBP was carried out in 42.1% of all bariatric procedures. Among all patients, 74.4% were female. The mean BMI ranged from 48.5 kg/m2 in 2005 to 48.0 kg/m2 in 2007. Follow-up data after 12 months were available for 63.8% of the patients operated in 2005 and 2006. The mortality was 0.1% (30 days) and 0.16% (overall).


CONCLUSIONS
As indicated by the worldwide trend, there is an ongoing change from GB to sleeve gastrectomy (SG) and malabsorptive procedures. The BMI of German bariatric surgical patients is substantially higher than that of patients from most other countries. There were no differences in overall outcomes during follow-up as compared to published studies.
Stroh
Christine
C
Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Gera, Germany.
Birk
Dieter
D
Flade-Kuthe
Ricarda
R
Frenken
Michael
M
Herbig
Beate
B
Hohne
Stefan
S
Kohler
Hinrich
H
Lange
Volker
V
Ludwig
Kaja
K
Matkowitz
Ralf
R
Meyer
Gunther
G
Meyer
Frank
F
Pick
Peter
P
Horbach
Thomas
T
Krause
Stefan
S
Schafer
Lothar
L
Schlensak
Matthias
M
Shah
Edward
E
Sonnenberg
Thomas
T
Susewind
Martin
M
Voigt
Hans
H
Weiner
Rudolf A
RA
Wolff
Stefanie
S
Lippert
Hans
H
Wolf
Anna Maria
AM
Schmidt
Uwe
U
Manger
Thomas
T
D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D015992:Body Mass Index; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D008297:Male; D009765:Obesity / Q000401:mortality / Q000601:surgery*; D009862:Online Systems; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D018579:Patient Selection; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D012955:Societies, Medical; D013997:Time Factors; D016896:Treatment Outcome