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Prospective Evaluation of Roux-en-Y Gastric Bypass as Primary Operation for Medically Complicated Obesity

2000; Elsevier BV; Volume: 75; Issue: 7 Linguagem: Inglês

10.4065/75.7.673

1942-5546

Bruno M. Balsiger, Frank P. Kennedy, Haitham S. Abu-Lebdeh, Maria L. Collazo‐Clavell, Michael D. Jensen, Timothy O’Brien, Donald D. Hensrud, Séan F. Dinneen, Geoffrey B. Thompson, Florencia G. Que, Donald E. Williams, Matthew M. Clark, Jeanne E. Grant, Marsha S. Frick, Roger A. Mueller, L. Jane, Michael G. Sarr,

Body Contouring and Surgery

To determine prospectively the results of Roux-en-Y gastric bypass (RYGB) used as the primary weight-reducing operation in patients with medically complicated ("morbid") obesity. The RYGB procedure combines the advantages of a restrictive physiology (pouch of 10 mL) and a "dumping physiology" for high-energy liquids without requiring an externally reinforced (banded) stoma.Between April 1987 and December 1998, a total of 191 consecutive patients with morbid obesity (median weight, 138 kg [range, 91-240 kg]; median body mass index, 49 kg/m2 [range, 36-74 kg/m2]), all of whom had directly weight-related morbidity, underwent RYGB and prospective follow-up.Hospital mortality was 0.5% (1/191), and hospital morbidity occurred in 10.5% (20/191). Good long-term weight loss was achieved, and patients adapted well to the required new eating habits. The mean +/- SD weight loss at 1 year after operation (113 patients) was 52 +/- 1 kg or 68% +/- 2% of initial excess body weight. By 3 years postoperatively (74 patients), weight loss was still 66% +/- 2% of excess body weight. Overall, 53 (72%) of 74 patients had achieved and maintained a weight loss of 50% or more of their preoperative excess body weight 3 years after the operation. In addition, only 1 (1%) of 98 patients had persistent postoperative vomiting 1 or more times per week.We believe that RYGB is a safe, effective procedure for most patients with morbid obesity and thus may be the current procedure of choice in patients requiring bariatrics++ surgery for morbid obesity.