Laparoscopic Roux-en-Y gastric bypass surgery in the obesity center Wuerzburg--patient selection and results.
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.
Fein
Martin
M
Department of Surgery, University of Wuerzburg Hospital, Germany. fein@chirurgie.uni-wuerzburg.de
Bueter
Marco
M
Jurowich
Christian
C
Wierlemann
Alexander
A
Gerlach
Annette
A
Thalheimer
Andreas
A
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