Gastroplasty as a treatment for massive obesity. A clinical and biochemical evaluation

Twenty-four grossly obese patients were operated on with horizontal gastroplasty. One patient died postoperatively of pulmonary embolism. The remaining 23 were extensively studied before and repeatedly after surgery. Eighteen months postoperatively the average weight loss was 34.4 kg (range, 1-71 kg). Seven patients had a weight reduction of less than 20% after 18 months. Postoperatively, biochemical variables reflecting glucose and lipid metabolism and liver function improved. B-hemoglobin, S-iron levels, and serum concentrations of folate and cobalamins decreased significantly. No negative histological changes could be found in the gastric mucosa during the follow-up period. Although only positive metabolic changes have been registered, we feel that gastroplasty, which is not without early postoperative complications and has a failure rate of about 30%, cannot be generally recommended until the problem of postoperative dilation of the stoma has been successfully solved.