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Study Explores Complications Associated With Weight-Loss Surgery

May 13, 2003 | As the number of Americans considered morbidly obese continues to rise, so does the prevalence of gastric bypass surgery. The procedure aids in weight loss by surgically reducing the size of the stomach, thereby limiting the amount of food a person consumes at one time.

In a new study of the procedure, researchers and surgeons at the University of Massachusetts Medical School and the UMass Memorial Medical Center have identified three factors associated with complications from the weight-loss surgery. Namely, the experience of the surgeon, sleep apnea, and hypertension. The results of the study are reported in the May issue of The Archives of Surgery, a publication of the Journal of the American Medical Association.

The study was conducted by Assistant Professor of Surgery Richard A. Perugini, MD, and his colleagues at UMMS, who reviewed cases of 188 patients with severe obesity who met the National Institutes of Health guidelines for undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) surgery. The researchers recorded all complications that required intervention, and the amount of weight lost in the year following surgery.

The researchers found that of the 188 patients, 50 (26.6 percent) developed complications that required an invasive intervention. The most common complication requiring intervention, occurring in 27 patients (14.4 percent) was stricture of the gastrojejunal anastomosis, a closing of the passageway in the newly restricted stomach that requires additional surgery to reopen. The researchers identified surgeon experience, and the patient’s history of sleep apnea and/or hypertension as predictors of complications.

“Laparoscopic RYGB is a challenging procedure, demanding a long learning curve,” the authors wrote. “To our knowledge, this is the first series that has implicated (these) factors associated with complications after laparoscopic RYGB.”

Weight loss data were available for 93 of the 115 patients whose surgery had occurred one year prior. For those patients, their Body Mass Index (BMI) dropped from an average of 53 before surgery to 35 at one year after surgery. The average percentage of body weight lost after one year was 61 percent. The researchers also found that diabetes mellitus was negatively correlated with percentage of excess body weight lost after one year.

Obesity is a major health problem in the United States, and is estimated

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