title: Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult.
  
  
  OBJECTIVE
  Evaluate long-term LRYGB outcomes using standard outcome reporting definitions.
  
  
  METHODS
  Integrated multispecialty health system.
  
  
  METHODS
  A retrospective review of our institution's prospective bariatric surgery registry and integrated multispecialty electronic medical record system was completed for patients who underwent LRYGB from 2001 to 2015. Data were defined according to the 2015 Standards for Outcome Reporting.
  
  
  RESULTS
  During the study period, 1402 patients underwent primary LRYGB; mean age and preoperative body mass index were 44.5±10.3 years and 47.5±6.2 kg/m2, respectively. Early complications included anastomotic leak (0.2%), venous thromboembolism (0.6%), surgical site infections (1.4%), and urinary tract infections (1.6%). The 30-day readmission rate was 3.5%. There were no 30-day mortalities. Follow-up weight data were available for>70% of eligible patients through 12 years postoperative. The highest mean percent excess weight loss and lowest body mass index were reached at 18 months postoperative at 79% and 30.1 kg/m2, respectively. Remission of diabetes, dyslipidemia, and hypertension were observed through 8 years postoperatively.
  
  
  CONCLUSIONS
  This is the first report of long-term (>10-year) outcomes from a single integrated health system using the 2015 Standards for Outcome Reporting. LRYGB results in significant, sustained weight loss and durable improvement and remission of obesity-related co-morbidities. Integrated healthcare systems provide an optimal environment for data collection and long-term follow-up.
authors.affiliation: Department of General Surgery, Gundersen Health System, La Crosse, Wisconsin. Electronic address: snkothar@gundersenhealth.org.
authors.forename: Shanu N
authors.initials: SN
authors.lastname: Kothari
authors.affiliation: Department of Research, Gundersen Medical Foundation, La Crosse, Wisconsin.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Borgert
authors.affiliation: Department of Research, Gundersen Medical Foundation, La Crosse, Wisconsin.
authors.forename: Kara J
authors.initials: KJ
authors.lastname: Kallies
authors.affiliation: Department of General Surgery, Gundersen Health System, La Crosse, Wisconsin.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Baker
authors.affiliation: Department of General Surgery, Gundersen Health System, La Crosse, Wisconsin.
authors.forename: Brandon T
authors.initials: BT
authors.lastname: Grover
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000209:etiology; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008134:Long-Term Care; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000209:etiology; D054556:Venous Thromboembolism / Q000209:etiology; D015431:Weight Loss / Q000502:physiology
keywords: Comorbidities; Complications; Long-term outcomes; Obesity; Roux-en-Y gastric bypass; Weight loss