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Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI > or =60
Daniel T Farkas1, Prathiba Vemulapalli, Ali Haider
1Montefiore Institute for Minimally Invasive Surgery, Albert Einstein College of Medicine, Bronx, NY, USA. dannyfarkas@hotmail.com
Background:
Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been shown to be safe and effective. There is little data on the outcomes in massively super-obese patients, with a body mass index (BMI) > or =60 kg/m2 (super-super-obese). The goal of this study was to determine the safety and effectiveness of LRYGBP in these patients, and compare these results to patients with a BMI <60.
Methods:
213 consecutive patients undergoing LRYGBP by a single surgeon at a university hospital were included in the study. The patients were divided into 2 groups: BMI <60 kg/m2 (n=167) and BMI > or =60 kg/m2 (n=46). The 2 groups were compared with regard to perioperative complications, and postoperative weight loss.
Results:
Both groups had statistically similar complication rates. There were major complications in 8 patients (5%) in the lower BMI group and in 3 patients (7%) in the higher BMI group. There were minor complications in 9 patients (5%) in the lower BMI group and in 4 patients (9%) in the higher BMI group. Mean percent excess weight loss (%EWL) was 64% at 1 year in the BMI <60 group and 53% in the BMI > or =60 group.
Conclusion:
LRYGBP can be performed safely and effectively in super-super-obese patients (BMI > or =60). Although these patients have less %EWL than lighter patients, they still end up with a good result. Therefore, LRYGBP should be considered a good surgical option even for patients with a BMI > or =60.
