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01-05-2016

Surgical management of super–super obese patients: Roux-en-Y gastric bypass versus sleeve gastrectomy

Authors: Raquel Gonzalez-Heredia, Lisa Sanchez-Johnsen, Valeria S. M. Valbuena, Mario Masrur, Melissa Murphey, Enrique Elli

Published in: Surgical Endoscopy | Issue 5/2016

Abstract

Introduction

Among morbidly obese adult patients (BMI >40 kg/m²), those who are super–super obese (BMI >60 kg/m²) present particular challenges for bariatric surgeons. Surgical management of super–super obese (SSO) patients has been associated with higher morbidity and mortality and increased surgical risk. The optimal surgical management of these patients is controversial. The aim of this study was to compare perioperative outcomes, percent excess weight loss (%EWL), and percent weight loss (%WL) in super–super obese patients who underwent either SG or RYGB.

Materials and methods

This study was a nonrandomized, controlled, retrospective review of 89 SSO patients who underwent SG or RYGB at the University of Illinois Hospital and Health Sciences System from January 2008 to June 2014. Patient demographics, pre-surgical comorbidities, perioperative parameters, post-operative complications (leak, conversion to open surgery, and 30-day mortality), and post-operative outcome months were examined.

Results

Seventy-seven patients underwent SG (nine robotic sleeve and 68 laparoscopic sleeve gastrectomy), and 12 underwent RYGB. The mean pre-operative BMI was 63.4 kg/m² (SD = 3.7 kg/m²). The mean operative time was 88.4 min (SD = 31.7) for the SG patients and 219.2 min (SD = 80.2) for the RYGB patients. There were no significant differences in complications or length of hospitalization between the groups. There were significant differences in %EWL and %WL at 12- and 24-month follow-up between groups (p’s < 0.05).

Conclusions

Based on the results from this sample of patients, SG and RYGB appear to be viable procedures for the surgical management of super–super obese patients. RYGB, however, provides a significantly higher %EWL and %WL at 12 and 24 months compared to SG, which in turn, yields acceptable but lower %EWL and %WL.

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Title: Surgical management of super–super obese patients: Roux-en-Y gastric bypass versus sleeve gastrectomy
Authors: Raquel Gonzalez-Heredia
Lisa Sanchez-Johnsen
Valeria S. M. Valbuena
Mario Masrur
Melissa Murphey
Enrique Elli
Publication date: 01-05-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4465-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Surgical management of super–super obese patients: Roux-en-Y gastric bypass versus sleeve gastrectomy

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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