Obesity

Obesity

      

• Lloyd
  D MacLean, Barbara M Rhode, and Carl W Nohr (The
  Department of Surgery, Royal Victoria Hospital and
  McGill University, Montreal, Quebec, Canada)
  
  Late
  Outcome of Isolated Gastric Bypass
  
  Annals of Surgery, April 2000, vol.231(4), 524-528.
  
     
  
  This study was conducted to study the long term
  (> 5 years) results of isolated gastric bypass
  operation performed for severe obesity.
  
     
  
  The
  study focussed on documentation of weight loss and
  the final approximation to normal, defined as Body
  Mass Index (BMI) of 20-25 kg/m2.
  In addition the lowest weight and the time of
  its occurrence, late weight gain, death and need for
  additional operations was also recorded.
  
     
  
  243
  patients were classified as obese (BMI 36-39 kg/m²),
  morbidily obese (BMI 40-49 kg/m²) and
  superobese (>50kg/m²). 
  One patient died of pulmonary embolism on the
  second postoperative day.
  There were 2 late deaths, one from a suicide
  4.75 years postoperative and another from alcoholic
  cirrhosis of the liver 6 years after surgery.
  
    
  
  60%
  of obese and morbidity obese patients achieved an
  excellent result (BMI < 30kg/m²), 33%
  had a good result (BMI 30-35 kg/m²) and
  7% had poor results (BMI 735 kg/m²). 
  The superobese showed excellent results in
  26%, a good result in 31% and poor result in 43%.  The conclusion was that the operation was successful in 93%
  of obese and morbidity obese and in 57% of
  superobese patients.
  
    
  
  Late
  operations were required in several patients-59(24%)
  required a cholecystectomy, 52(21%) required
  excision of debilitating abdominal panniculus, 40
  (16%) required repair of ventral hernia, 2% had
  small gut obstruction and 2% had gastrogastric
  fistula.