Introducing laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs medical facility
| Autor: | Evelyn Shinoda, Paul J. Johnson, Robert G. Hall, Bassem Y. Safadi, John M. Morton, Sherry M. Wren, Jennefer A. Kieran, Nina Bellatorre, Myriam J. Curet |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Hospitals Veterans Gastric Bypass Risk Assessment Cohort Studies Postoperative Complications Diabetes mellitus Weight Loss medicine Humans Minimally Invasive Surgical Procedures Laparoscopy Veterans Affairs Probability Retrospective Studies Chi-Square Distribution medicine.diagnostic_test business.industry Anastomosis Roux-en-Y General Medicine Length of Stay Middle Aged medicine.disease Roux-en-Y anastomosis Obesity Surgery Endoscopy Obesity Morbid Obstructive sleep apnea Treatment Outcome Female business Body mass index Follow-Up Studies |
| Zdroj: | American journal of surgery. 188(5) |
| ISSN: | 0002-9610 |
| Popis: | Background Previous studies have shown that advanced age, diabetes, and male gender are associated with higher morbidity and mortality after bariatric surgery. Those risk factors are characteristic of patients in the Veterans Affairs (VA) health care system. Laparoscopic Roux-en-Y gastric bypass (RYGB) has become an established treatment modality for morbid obesity. Our objective was to review the initial experience with laparoscopic (RYGB) for morbid obesity at our VA facility. Methods A retrospective review was used. Results Between May of 2002 and April of 2004, 40 patients underwent laparoscopic RYGB. All patients met National Institutes of Health consensus statement guidelines for bariatric surgery. There were 30 (75%) male and 10 (25%) female patients, with an average age of 49.9 ± 8.7 years and an average body mass index (BMI) of 48.1 ± 8.5 kg/m 2 . Preoperative comorbidities included diabetes mellitus (DM) in 59%, hypertension in 79%, and obstructive sleep apnea in 74.4%. The procedure was converted to an open procedure in 3 patients (7.5%). There were no mortalities. Immediate (within 30 days) complications developed in 9 (22.5%) patients, necessitating abdominal re-operation in 3 patients (7.5%). The median length of hospital stay was 3 days. Late complications (>30 days) developed in 8 (20%) patients. Percent excess weight loss at 3, 6, and 12 months was 44% (n = 34), 59% (n = 29), and 70.0% (n = 22), respectively. In 23 patients who were followed-up for more than 3 months, DM resolved in 79% and improved in 21% at a mean follow-up evaluation of 13 months. Conclusions Laparoscopic RYGB can be performed with acceptable morbidity and with good short-term results in a VA hospital setting. Morbid obesity is prevalent in the VA patient population and access to bariatric surgery should be an available alternative. |
| Databáze: | OpenAIRE |
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