title: Bariatric Surgery Among Obese Veterans: a Retrospective Review of Complications and Intermediate Term Results from a Single Institution.
abstract: The purpose of this study was to compare the results and complications among obese veterans undergoing sleeve gastrectomy and gastric bypass at a low-volume center.
  
  
  
  This is a retrospective review of bariatric procedures performed by a single surgeon from 2009-2013. Outcomes of interest were mortality, complications, and length of stay. Weight loss and comorbidity resolution were compared between sleeve gastrectomy (SG) and Roux-y gastric bypass (RYGB). Length of stay and distance traveled to receive services were analyzed. Distributed groups were compared with Student's t test. Welch's correction was used where variances were unequal via ANOVA. Complications were compared using Fisher's exact test.
  
  
  
  Eighty-five patients (SG = 51, RYGB = 34) were analyzed. Postoperatively, patients were seen in clinic, contacted by phone or email, and their electronic health care records were reviewed. Average length of follow-up was 114.3 weeks. Mortality was 0 %. Complication rates were comparable between groups. The percent total weight loss was 22.6 % for the SG and 27.5 % for the RYGB (p = 0.02). The percent excess weight loss was 49 % for SG and 55 % for RYGB (p = 0.149). Percent excess body mass index (BMI) loss was 54 and 61 % (p = 0.197) for SG and RYGB, respectively. Comorbidity resolution was similar between groups except for diabetes which was superior for RYGB (p = 0.03). Veterans lived an average of 141.3 miles from our VA, and all 85 patients were able to be contacted for follow-up.
  
  
  
  Despite long travel distances for high-risk veterans, bariatric surgery can be performed safely even at a low-volume VA hospital with acceptable morbidity and mortality and excellent follow-up. There was no difference in morbidity or mortality between patients undergoing SG vs RYGB.
authors.affiliation: Jesse Brown VA Medical Center, Chicago, IL, USA.
authors.forename: Dominic J
authors.initials: DJ
authors.lastname: Vitello
authors.affiliation: Jesse Brown VA Medical Center, Chicago, IL, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Beach-Bachmann
authors.affiliation: Department of Surgery, Jesse Brown VA Medical Center, 820 South Damen Avenue, Chicago, IL, 60612, USA. jvituic@comcast.net.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Vitello
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D007087:Illinois; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D014728:Veterans / Q000706:statistics & numerical data*; D015431:Weight Loss
keywords: Bariatric surgery; Complications; Morbid obesity; Sleeve gastrectomy; Veterans