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Published in: Obesity Surgery 5/2008

01-05-2008 | Research Article

Preoperative Weight Loss Decreases the Operative Time of Gastric Bypass at a Veterans Administration Hospital

Authors: Sergio Huerta, Serag Dredar, Elizabeth Hayden, Ali A. Siddiqui, Thomas Anthony, Massimo Asolati, J. Esteban Varela, Edward H. Livingston

Published in: Obesity Surgery | Issue 5/2008

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Abstract

Background

This study assessed whether preoperative weight loss resulted in favorable outcomes after open Roux-en Y gastric bypass (RYGB).

Methods

A retrospective review of all patients who underwent RYGB at the DVAMC was undertaken. Patients were divided into: patients who did not lose weight within 3 months preoperatively (n = 25) and group II, those who did (n = 15).

Results

Both groups had similar demographics, body mass index, comorbid conditions, and American Society of Anesthesiology class. Group II lost 28.2 ± 6.5 lbs (8.3% of body weight) within 3 months before RYGB. Operative time was longer in group I compared to group II (180.0 ± 0.0 vs 161.0 ± 0.0 min; p = 0.05). Both groups had the same rate of postoperative complications and the same long-term weight loss at a 2-year follow-up (n = 6 both groups).

Conclusions

An 8% reduction of body weight is associated with a decrease in operative time. These preliminary data suggest that preoperative weight loss results in a technically less challenging operation in the super-obese patient.
Literature
1.
go back to reference Wang A, Kinsinger LS, Kahwati LC, et al. Obesity and weight control practices in 2000 among veterans using VA facilities. Obes Res 2005;13:1405–11.PubMed Wang A, Kinsinger LS, Kahwati LC, et al. Obesity and weight control practices in 2000 among veterans using VA facilities. Obes Res 2005;13:1405–11.PubMed
2.
go back to reference Huerta S, Kohan D, Siddiqui A, et al. Assessment of comorbid conditions in veteran patients after Roux-en-Y gastric bypass. Am J Surg 2007;194:48–52.PubMedCrossRef Huerta S, Kohan D, Siddiqui A, et al. Assessment of comorbid conditions in veteran patients after Roux-en-Y gastric bypass. Am J Surg 2007;194:48–52.PubMedCrossRef
3.
go back to reference Alami RS, Morton JM, Sanchez BR, et al. Laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs and high-volume academic facilities: a comparison of institutional outcomes. Am J Surg 2005;190:821–5.PubMedCrossRef Alami RS, Morton JM, Sanchez BR, et al. Laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs and high-volume academic facilities: a comparison of institutional outcomes. Am J Surg 2005;190:821–5.PubMedCrossRef
4.
go back to reference Gallagher SF, Banasiak M, Gonzalvo JP, et al. The impact of bariatric surgery on the Veterans Administration healthcare system: a cost analysis. Obes Surg 2003;13:245–8.PubMedCrossRef Gallagher SF, Banasiak M, Gonzalvo JP, et al. The impact of bariatric surgery on the Veterans Administration healthcare system: a cost analysis. Obes Surg 2003;13:245–8.PubMedCrossRef
5.
go back to reference Safadi BY, Kieran JA, Hall RG, et al. Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility. Am J Surg 2004;188:606–10.PubMedCrossRef Safadi BY, Kieran JA, Hall RG, et al. Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility. Am J Surg 2004;188:606–10.PubMedCrossRef
6.
go back to reference Podnos YD, Jimenez JC, Wilson SE, et al. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg 2003;138:957–61.PubMedCrossRef Podnos YD, Jimenez JC, Wilson SE, et al. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg 2003;138:957–61.PubMedCrossRef
7.
go back to reference Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142:547–59.PubMed Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142:547–59.PubMed
8.
go back to reference Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg 2002;236:576–82.PubMedCrossRef Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg 2002;236:576–82.PubMedCrossRef
9.
go back to reference Arteaga JR, Huerta S, Basa NR, et al. Interval jejunoileal bypass reduces the morbidity and mortality of Roux-en-Y gastric bypass in the super-obese. Am Surg 2003;69:873–8.PubMed Arteaga JR, Huerta S, Basa NR, et al. Interval jejunoileal bypass reduces the morbidity and mortality of Roux-en-Y gastric bypass in the super-obese. Am Surg 2003;69:873–8.PubMed
10.
go back to reference Nguyen NT, Longoria M, Gelfand DV, et al. Staged laparoscopic Roux-en-Y: a novel two-stage bariatric operation as an alternative in the super-obese with massively enlarged liver. Obes Surg 2005;15:1077–81.PubMedCrossRef Nguyen NT, Longoria M, Gelfand DV, et al. Staged laparoscopic Roux-en-Y: a novel two-stage bariatric operation as an alternative in the super-obese with massively enlarged liver. Obes Surg 2005;15:1077–81.PubMedCrossRef
11.
go back to reference Huerta S, Li Z, Livingston EH. Outcome of portal injuries following bariatric operations. Obes Surg 2006;16:105–9.PubMedCrossRef Huerta S, Li Z, Livingston EH. Outcome of portal injuries following bariatric operations. Obes Surg 2006;16:105–9.PubMedCrossRef
12.
go back to reference National Heart, Lung, and Blood Institute. Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. Washington, DC: National Heart, Lung and Blood Institute (ref type: generic); 1998. National Heart, Lung, and Blood Institute. Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. Washington, DC: National Heart, Lung and Blood Institute (ref type: generic); 1998.
13.
go back to reference Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403.PubMedCrossRef Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403.PubMedCrossRef
14.
go back to reference Alvarado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg 2005;15:1282–6.PubMedCrossRef Alvarado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg 2005;15:1282–6.PubMedCrossRef
15.
go back to reference Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis 2007;3:141–5.PubMedCrossRef Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis 2007;3:141–5.PubMedCrossRef
16.
go back to reference Lujan JA, Frutos MD, Hernandez Q, et al. Laparoscopic versus open gastric bypass in the treatment of morbid obesity: a randomized prospective study. Ann Surg 2004;239:433–7.PubMedCrossRef Lujan JA, Frutos MD, Hernandez Q, et al. Laparoscopic versus open gastric bypass in the treatment of morbid obesity: a randomized prospective study. Ann Surg 2004;239:433–7.PubMedCrossRef
17.
go back to reference Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg 2001;234:279–89.PubMedCrossRef Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg 2001;234:279–89.PubMedCrossRef
18.
go back to reference Westling A, Gustavsson S. Laparoscopic vs open Roux-en-Y gastric bypass: a prospective, randomized trial. Obes Surg 2001;11:284–92.PubMedCrossRef Westling A, Gustavsson S. Laparoscopic vs open Roux-en-Y gastric bypass: a prospective, randomized trial. Obes Surg 2001;11:284–92.PubMedCrossRef
19.
go back to reference Huerta S, Heber D, Sawicki MP, et al. Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center. Am Surg 2001;67:1128–35.PubMed Huerta S, Heber D, Sawicki MP, et al. Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center. Am Surg 2001;67:1128–35.PubMed
Metadata
Title
Preoperative Weight Loss Decreases the Operative Time of Gastric Bypass at a Veterans Administration Hospital
Authors
Sergio Huerta
Serag Dredar
Elizabeth Hayden
Ali A. Siddiqui
Thomas Anthony
Massimo Asolati
J. Esteban Varela
Edward H. Livingston
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 5/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9334-5

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