[Gastric bypass surgery effective for morbid obesity].
OBJECTIVE
Evaluation of the results of Roux-en-Y gastric bypass in morbid obesity.


METHODS
Descriptive.


METHODS
All patients undergoing gastric bypass surgery in St. Antonius Hospital in Nieuwegein, the Netherlands, between 2002 and 2008 were analysed. Indications were a body mass index (BMI) >or= 40 kg/m2 or a BMI >or= 35 kg/m2 with severe co-morbidity. Principal outcomes were excess weight loss after at least 1 year of follow-up, surgery-related morbidity and mortality.


RESULTS
290 patients with a median age of 42.5 years (range: 21-66) underwent gastric bypass surgery (open: n = 233, laparoscopic: n = 57). The median preoperative overweight above standard weight was 78.7 kg (range: 30.1-190.3) and the median BMI was 49.5 kg/m2 (range: 33.2-84.9). This concerned a secondary intervention after a previous unsuccessful bariatric procedure in 99/290 patients (34.1%). There were 189 patients with a follow-up of more than 1 year. The procedure was successful (>or= 50% excess weight loss) in 135/189 patients (71.4%). The median excess weight loss was 58.6% (range: 7.7-102.4). The BMI decreased by a median of 16.2 kg/m(2) (range: 0.9-42.9). Patients undergoing primary surgery lost a higher percentage of excess weight than patients undergoing secondary surgery (median percentage excess weight loss 61.4% versus 53.5% , and a median decrease in BMI of 17.8 versus 11.9 kg/m2). The most frequently occurring early complications (within 30 days of surgery) were anastomotic leak (n = 15) and wound infection (n = 11). Late complications included anastomotic stricture (n = 18) and cicatricial hernia (n = 15). Mortality was 0.7% (n = 2).


CONCLUSIONS
Gastric bypass surgery was an effective treatment strategy for morbid obesity and had acceptable surgery-related morbidity and mortality.
van Doesburg
Ingrid A J
IA
St. Antonius Ziekenhuis, Afd. Chirurgie, Nieuwegein, The Netherlands. i.a.j.vandoesburg@hotmail.com
te Riele
Wouter W
WW
Boerma
Djamila
D
Eland
Ingo A
IA
Wiezer
M J René
MJ
van Ramshorst
Bert
B
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult