Printer Friendly

Modest weight loss before bariatric surgery predicts postoperative success.

High-risk morbidly obese patients who lose 10% or more of their excess body weight before undergoing bariatric surgery shed postoperative weight more rapidly than do those who do not lose the excess weight preoperatively, reported Dr. Christopher D. Still and his associates.

The investigators, of the center for nutrition and weight management at the Geisinger Medical Center in Danville, Pa., said patients who lose that "modest" amount in the preoperative period also are less likely to have a long hospital stay, probably because they have fewer complications.

"Optimal preparation for high-risk individuals with significant comorbid medical problems remains controversial," they noted. Geisinger Medical Center's preoperative program encourages modest short-term weight loss to help control existing medical problems such as diabetes, sleep apnea, steatohepatitis, and cardiometabolic syndrome.

Dr. Still and his associates assessed the postoperative course in 884 patients who underwent open or laparoscopic Roux-en-Y gastric bypass between 2002 and 2006 at their center. Preoperative weight loss was initially attempted by means of a prudent low-fat diet and modest exercise. If that approach was ineffective, patients were instructed to follow a 1,000-1,500-kcal liquid diet.

The mean patient age was 45 years, and mean body mass index was 51.3 kg/[m.sup.2]. Patients were followed for an average of 1 year after the operation. Nearly half (425 patients) achieved a short-term weight loss of 10% or more of their excess body weight before surgery. Those who did so were more than twice as likely to achieve 70% excess body weight loss during follow-up.

They also were less likely to need a long hospital stay, possibly because of a reduced rate of postoperative complications, Dr. Still and his associates said (Arch. Surg. 2007;142:994-8).

It is possible that those who lost weight preoperatively were the most motivated and compliant patients, and thus the most likely to have successful surgical results. Longer follow-up should answer this question, they said.

BY MARY ANN MOON

Contributing Writer
Adjusted Hazard Ratios for More Than 70% Excess Body Weight Loss After
Gastric Bypass Surgery

Preoperative Excess Body Weight Loss

> 5% gain (n = 67) 1.16
0%-5% gain (n = 86) 1.08
0%-5% loss (n = 137) 1.00 reference
5%-10% loss (n = 169) 1.20
> 10% loss (n = 425) 2.12

Note: Based on a mean 12-month follow-up.
Source: Archives of Surgery
ELSEVIER GLOBAL MEDICAL NEWS

Note: Table made from bar graph.
COPYRIGHT 2007 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2007 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Gastroenterology
Author:Moon, Mary Ann
Publication:Internal Medicine News
Article Type:Clinical report
Geographic Code:1USA
Date:Dec 15, 2007
Words:401
Previous Article:Gastric bypass may curb mortality from disease.
Next Article:Suicides, CHD deaths up after gastric bypass.
Topics:


Related Articles
Bariatric surgery halves risk of coronary heart disease.
Excess suicide and CHD deaths associated with bariatric surgery.
Endoluminal tactics may cut bariatric morbidity.
Post-bariatric surgery guidelines previewed.
Chart predicts long-term bariatric outcomes.
Single-incision laparoscopic banding safe, but not suitable for all patients.
Lap banding effective even in superobese.

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters