title: Five-year outcomes of gastric bypass for super-super-obesity (BMI≥60 kg/m²): a case matched study.
abstract: BACKGROUND
  Laparoscopic gastric bypass (LRYGB) is feasible for patients with body mass index (BMI)≥60 kg/m² (super-super-obesity [SSO]) but long-term data are lacking. The objective of this study was to compare the 5-year weight loss and changes in obesity-related co-morbidities after LRYGB for SSO and non-SSO patients.
  
  
  METHODS
  From January 2004 to November 2008, 32 SSO and 320 non-SSO patients underwent LRYGB. We matched 30 SSO patients undergoing LRYGB (case group) with 60 non-SSO patients (control group) for age, sex, and presence of type 2 diabetes.
  
  
  RESULTS
  Baseline data indicate that case and control groups did not differ for age (42±12.4 versus 41.8±11.5 yr; P=.92) or sex ratio (80% female, P=.99). Preoperative BMI were 64.1±4.1 and 46.3±5.6 kg/m² in SSO and non-SSO groups, respectively (P<.0001). The rates of coexisting conditions in the 2 groups were comparable except for hypertension (76.7% versus 53.3%; P=.03). At 5 years after surgery, the percentage of initial weight loss (%IWL) (27.4±11.8 versus 29.7±9.2; P=.35) for the groups were comparable whereas percentage of excess weight loss (%EWL) (44.9±19.9 versus 66.5±21.2; P<.0001) was higher for non-SSO patients. Rates of remission or improvement of coexisting conditions, including diabetes and hypertension, did not differ significantly different between groups.
  
  
  CONCLUSIONS
  According to %IWL and rate of partial or complete remission of diabetes and hypertension, our study shows similar outcomes for LRYGB in SSO and non-SSO patients 5 years after surgery. The %EWL does not seem to be an adequate indicator for evaluation of LRYGB outcomes in patients with extreme obesity, such as SSO.
authors.affiliation: Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Thereaux
authors.affiliation: Department of Nutrition, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France; Centre for Research in Epidemiology and Population Health (INSERM U1018), Paul Brousse Hospital, Villejuif, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Czernichow
authors.affiliation: Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France.
authors.forename: Nicola
authors.initials: N
authors.lastname: Corigliano
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique- Hôpitaux de Paris, Pierre-et-Marie-Curie-Paris 6 University, Human Nutrition Research Center Île-de-France (CRNH IdF), Institute of Cardiometabolic Disease and Nutrition (ICAN), Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Poitou
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique- Hôpitaux de Paris, Pierre-et-Marie-Curie-Paris 6 University, Human Nutrition Research Center Île-de-France (CRNH IdF), Institute of Cardiometabolic Disease and Nutrition (ICAN), Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.affiliation: Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France. Electronic address: jl.bouillot@apr.aphp.fr.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bouillot
mesh_terms: D000328:Adult; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Bariatric surgery; Gastric bypass; Long-term outcome; Super-super obesity