Outcomes of bariatric surgery in patients ?5 years

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• 作者：Lana G. Nelson ; D.O. ; M.S.P.H.^a ; Peter P. Lopez ; M.D.^b ; Krista Haines ; B.A. ; M.A.^a ; Bianca Stefan ; B.S.^a ; Taylor Martin ; B.S.^a ; Rodrigo Gonzalez ; M.D.^a ; Patricia Byers ; M.D. ; F.A.C.S.^b ; Michel M. Murr ; M.D. ; F.A.C.S.^a ; ^{mmurr@hsc.usf.edu}
• 关键词：Clinically significant obesity ; Bariatric surgery ; Roux-en-Y gastric bypass ; Age ; Elderly ; Medicare
• 刊名：Surgery for Obesity and Related Diseases
• 出版年：2006
• 出版时间：May-June 2006
• 年：2006
• 卷：2
• 期：3
• 页码：384-388
• 全文大小：109 K

文摘

Background

Although the Medicare Coverage Advisory Committee found that significant evidence supports the safety and effectiveness of bariatric surgery, few data are available on the outcomes of bariatric procedures in patients ?5 years. The aim of this study was to report on contemporary outcomes of Roux-en-Y gastric bypass (RYGB) in patients ?5 years.

Methods

We reviewed prospectively collected data from all patients ?5 years who underwent RYGB at two Florida university-based programs from 1999 to 2005. Similarly, the Florida Discharge Database was queried for patients ?5 years who had undergone RYGB from 1999 to 2005. The data are presented as the mean ¡À SEM.

Results

A total of 25 patients ?5 years had undergone RYGB at our institutions (age 68 ¡À 1 years, body mass index 50 ¡À 3 kg/m²). The overall complication rate was 20 % , and the length of stay was 7 ¡À 3 days. One patient (4 % ) died 5 weeks postoperatively of septic complications. For the 13 patients with a median follow-up of 21 months (range 9?1), the percentage of excess body weight loss was 51 % ¡À 7 % ; medication use for co-morbidities decreased from 9 ¡À 1 to 4 ¡À 1 medications/day (P <.01). The Florida Discharge Database reported 231 patients ?5 years who had undergone RYGB. In that group of patients, the mean age was 67 ¡À 0.2 years, the length of stay was 6 ¡À 1 days, in-hospital mortality rate was 1.3 % , and the overall complication rate was 15 % .

Conclusion

In a small cohort of patients ?5 years, RYGB resulted in significant weight loss and resolution of obesity-related co-morbidities. The findings from the mandatory reported Florida Discharge Database strongly confirmed the safety of RYGB in patients ?5 years.