Evaluation of the results of Roux-en-Y gastric bypass in morbid obesity.

Descriptive.

All patients undergoing gastric bypass surgery in St. Antonius Hospital in Nieuwegein, the Netherlands, between 2002 and 2008 were analysed. Indications were a body mass index (BMI) ≥ 40 kg/m² or a BMI ≥ 35 kg/m² with severe co-morbidity. Principal outcomes were excess weight loss after at least 1 year of follow-up, surgery-related morbidity and mortality.

290 patients with a median age of 42.5 years (range: 21-66) underwent gastric bypass surgery (open: n = 233, laparoscopic: n = 57). The median preoperative overweight above standard weight was 78.7 kg (range: 30.1-190.3) and the median BMI was 49.5 kg/m² (range: 33.2-84.9). This concerned a secondary intervention after a previous unsuccessful bariatric procedure in 99/290 patients (34.1%). There were 189 patients with a follow-up of more than 1 year. The procedure was successful (≥ 50% excess weight loss) in 135/189 patients (71.4%). The median excess weight loss was 58.6% (range: 7.7-102.4). The BMI decreased by a median of 16.2 kg/m² (range: 0.9-42.9). Patients undergoing primary surgery lost a higher percentage of excess weight than patients undergoing secondary surgery (median percentage excess weight loss 61.4% versus 53.5% , and a median decrease in BMI of 17.8 versus 11.9 kg/m²). The most frequently occurring early complications (within 30 days of surgery) were anastomotic leak (n = 15) and wound infection (n = 11). Late complications included anastomotic stricture (n = 18) and cicatricial hernia (n = 15). Mortality was 0.7% (n = 2).

Gastric bypass surgery was an effective treatment strategy for morbid obesity and had acceptable surgery-related morbidity and mortality.