title: Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data.
abstract: BACKGROUND
  Short- and mid-term data on Roux-en-Y gastric bypass (RYGB) indicate sustained weight loss and improvement in co-morbidities. Few long-term studies exist, some of which are outdated, based on open procedures or different techniques.
  
  
  OBJECTIVE
  To investigate long-term weight loss, co-morbidity remission, nutritional status, and complication rates among patients undergoing RYGB.
  
  
  METHODS
  An academic, university hospital in the United States.
  
  
  METHODS
  Between October 2000 and January 2004, patients who underwent RYGB≥10 years before study onset were eligible for chart review, office visits, and telephone interviews. Revisional surgery was an endpoint, ceasing eligibility for study follow-up. Outcomes included weight loss measures and rates of co-morbidity remission, complications, and nutritional deficiencies.
  
  
  RESULTS
  RYGB was performed in 328 patients with a mean preoperative body mass index of 47.5 kg/m(2). Of 294 eligible patients, 134 (46%) were contacted for follow-up at ≥ 10 years (10+Year follow-up). Mean percentage excess weight loss (%EWL) was 58.9% at 10+Year. Higher %EWL was achieved by non-super-obese versus super-obese (61.3% versus 52.9%, P = .034). Blood pressure, lipid panel, and hemoglobin A1c improved significantly. At 10 years, remission of co-morbidities was 46% for hypertension and hyperlipidemia and 58% for diabetes mellitus. Thirty patients (9%) had revisional surgery for weight regain. Sixty-four patients (19.5%) had long-term complications requiring surgery. All-cause mortality was 2.7%. Nutritional deficiencies were seen in 87% of patients.
  
  
  CONCLUSIONS
  Weight loss after RYGB appears to be significant and sustainable, especially in the non-super-obese. Co-morbidities are improved, with a substantial number in remission a decade later. Nutritional deficiencies are almost universal.
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York. Electronic address: Nabeel.Obeid@nyumc.org.
authors.forename: Nabeel R
authors.initials: NR
authors.lastname: Obeid
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York.
authors.forename: Waqas
authors.initials: W
authors.lastname: Malick
authors.affiliation: Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Concors
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York.
authors.forename: George A
authors.initials: GA
authors.lastname: Fielding
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York.
authors.forename: Marina S
authors.initials: MS
authors.lastname: Kurian
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Ren-Fielding
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss; D055815:Young Adult
keywords: Co-morbidity; Complications; Gastric bypass; Long-term; Nutrition; Weight loss