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Published in: Obesity Surgery 11/2008

01-11-2008 | Research Article

Laparoscopic vs Open Gastric Bypass in the Management of Morbid Obesity: A 7-year Retrospective Study of 1,364 Patients from a Single Center

Authors: Emmanuel Atta Agaba, Hazem Shamseddeen, Charmaine Victoria Gentles, Venketesh Sasthakonar, Larry Gellman, Dominick Gadaleta

Published in: Obesity Surgery | Issue 11/2008

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Abstract

Methods

We performed a retrospective analysis of 1,364 consecutive morbidly obese patients who underwent restrictive–malabsorptive Roux-en-Y gastric bypass (RYGBP) between January 1998 and December 2004. A selective use of open and laparoscopic approaches was employed since 2001. Patients were seen in the office at 1 week; 2, 3, 6, 9, 12, and 24 months; and yearly thereafter. During visits, each patient was weighed and dietary intake and exercise regimen were recorded.

Results

We report a sustained weight reduction in over 90% of patients. The anastomotic leak rate was 0.15%, the 30-day readmission rate was 1.17%, and the overall mortality rate was 0.15%. Minor surgical site infection rate was 0.5%, and revision to long limb RYGBP rate was 0.07%.

Conclusions

Morbid obesity represents a significant health issue. None of the medical methods of weight reduction provide a lasting weight reduction. Surgery offers the only achievable long-term solution. Although not yet universally employed, laparoscopic RYGBP is rapidly becoming the standard operation for the surgical treatment of clinically severe obesity.
Literature
1.
go back to reference Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology and demographics. Pediatrics. 1998;101(3 Pt 2):497–504.PubMed Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology and demographics. Pediatrics. 1998;101(3 Pt 2):497–504.PubMed
2.
go back to reference Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.PubMedCrossRef Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.PubMedCrossRef
3.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
4.
go back to reference Pories WJ, MacDonald KG Jr, Morgan EJ, et al. Surgical treatment of obesity and its effect on diabetes: 10-y follow-up. Am J Clin Nutr. 1992;55:582S–5S.PubMed Pories WJ, MacDonald KG Jr, Morgan EJ, et al. Surgical treatment of obesity and its effect on diabetes: 10-y follow-up. Am J Clin Nutr. 1992;55:582S–5S.PubMed
5.
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
6.
go back to reference DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–47.PubMedCrossRef DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–47.PubMedCrossRef
7.
go back to reference Higa KD, Ho T, Boone KB. Laparoscopic Roux-en-Y gastric bypass technique and 3-year follow-up. J Laparoendosc Adv Surg Tech. 2001;11:377–82.CrossRef Higa KD, Ho T, Boone KB. Laparoscopic Roux-en-Y gastric bypass technique and 3-year follow-up. J Laparoendosc Adv Surg Tech. 2001;11:377–82.CrossRef
8.
go back to reference Lujan JA, Frutos D, Hernandes 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 D, Hernandes 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
9.
go back to reference Flum DR, Salem L, Brockel Elrod J, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRef Flum DR, Salem L, Brockel Elrod J, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294:1909–17.CrossRef
10.
go back to reference Lawson ML, Kirk S, Mitchell T, et al. One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group. J Pediatr Surg. 2006;41:137–43.PubMedCrossRef Lawson ML, Kirk S, Mitchell T, et al. One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group. J Pediatr Surg. 2006;41:137–43.PubMedCrossRef
11.
go back to reference Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the super obese. A prospective randomized study. Ann Surg. 1992;215(4):387–95.PubMedCrossRef Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the super obese. A prospective randomized study. Ann Surg. 1992;215(4):387–95.PubMedCrossRef
12.
go back to reference Sugerman HJ, Kellum JM, DeMaria EJ. Conversion of proximal to distal gastric bypass for failed gastric bypass for super obesity. J Gastrointest Surg. 1997;6:517–52.CrossRef Sugerman HJ, Kellum JM, DeMaria EJ. Conversion of proximal to distal gastric bypass for failed gastric bypass for super obesity. J Gastrointest Surg. 1997;6:517–52.CrossRef
13.
go back to reference Buckwalter JA, Herbst CA Jr. Leaks occurring after gastric bariatric operations. Surgery. 1988;103:156–60.PubMed Buckwalter JA, Herbst CA Jr. Leaks occurring after gastric bariatric operations. Surgery. 1988;103:156–60.PubMed
14.
go back to reference Kellum JM, DeMaria EJ, Sugerman HJ. The surgical treatment of morbid obesity. Curr Probl Surg. 1998;35:791–858.PubMedCrossRef Kellum JM, DeMaria EJ, Sugerman HJ. The surgical treatment of morbid obesity. Curr Probl Surg. 1998;35:791–858.PubMedCrossRef
15.
go back to reference Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.PubMedCrossRef Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.PubMedCrossRef
16.
go back to reference Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y-500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10:233–9.PubMedCrossRef Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y-500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10:233–9.PubMedCrossRef
17.
go back to reference Wu EC, Barba CA. Current practices in the prophylaxis of venous thromboembolism in bariatric surgery. Obes Surg. 2000;10(1):7–13.PubMedCrossRef Wu EC, Barba CA. Current practices in the prophylaxis of venous thromboembolism in bariatric surgery. Obes Surg. 2000;10(1):7–13.PubMedCrossRef
18.
go back to reference Westling A, Bergqvist D, Bostrom A, et al. Incidence of deep venous thrombosis in patients undergoing obesity surgery. World J Surg. 2002;26:470–3.PubMedCrossRef Westling A, Bergqvist D, Bostrom A, et al. Incidence of deep venous thrombosis in patients undergoing obesity surgery. World J Surg. 2002;26:470–3.PubMedCrossRef
19.
go back to reference Hill NH, Plug JJ, Jeyasingh K, et al. Prevention of deep vein thrombosis by intermittent pneumatic compression of calf. BMJ. 1972;1:131–5.CrossRef Hill NH, Plug JJ, Jeyasingh K, et al. Prevention of deep vein thrombosis by intermittent pneumatic compression of calf. BMJ. 1972;1:131–5.CrossRef
20.
go back to reference Sue-Ling HM, Johnston D, McMahon MJ, et al. Pre-operative identification of patients at high risk of deep venous thrombosis after elective major abdominal surgery. Lancet. 1986;24(1):1173–6.CrossRef Sue-Ling HM, Johnston D, McMahon MJ, et al. Pre-operative identification of patients at high risk of deep venous thrombosis after elective major abdominal surgery. Lancet. 1986;24(1):1173–6.CrossRef
21.
go back to reference Keeling WB, Haines K, Stone PA, et al. Current indications for preoperative inferior vena cava filter insertion in patients undergoing surgery for morbid obesity. Obes Surg. 2005;15:1009–12.PubMedCrossRef Keeling WB, Haines K, Stone PA, et al. Current indications for preoperative inferior vena cava filter insertion in patients undergoing surgery for morbid obesity. Obes Surg. 2005;15:1009–12.PubMedCrossRef
22.
go back to reference Schwartz ML, Drew RL, Chazin-Caldie M. Factors determining conversion from laparoscopic to open Roux-en-Y gastric bypass. Obes Surg. 2004;14:1193–7.PubMedCrossRef Schwartz ML, Drew RL, Chazin-Caldie M. Factors determining conversion from laparoscopic to open Roux-en-Y gastric bypass. Obes Surg. 2004;14:1193–7.PubMedCrossRef
Metadata
Title
Laparoscopic vs Open Gastric Bypass in the Management of Morbid Obesity: A 7-year Retrospective Study of 1,364 Patients from a Single Center
Authors
Emmanuel Atta Agaba
Hazem Shamseddeen
Charmaine Victoria Gentles
Venketesh Sasthakonar
Larry Gellman
Dominick Gadaleta
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 11/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9455-5

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