Sunday, January 24, 2010

Risks of bariatric rurgery reduced by preoperative weight loss before surgery

Trenton, NJ
As part of the preoperative process for preparing for bariatric (weight loss) surgery, many programs require a strict diet to promote weight loss before the procedure. A new study published in the Archives of Surgery finds that this protocol could reduce the risk of surgical complications.

Dr. Peter Benotti of the Saint Francis Medical Center in Trenton NJ reviewed the medical records of 881 patients who had gastric bypass surgery between 2002 and 2006 for weight loss. All patients completed a 6-month multidisciplinary program that encouraged a 10% preoperative weight loss.

Those who lost more than 10% of their excess body weight were less likely to have postoperative complications such as infections, blood clots, and kidney problems. Conversely, the post-surgery complication rate was nearly twofold higher in patients who gained weight.

The study also affirmed that patients who undergo Laparoscopic bariatric surgery have fewer complications than those who have the more invasive open surgery. This correlation was found regardless of preoperative weight loss. Patients who have open surgery are typically older men with a higher body mass index, according to the results of the study.

Bariatric surgery can be an effective and durable treatment for morbid obesity and the number of operations each year is increasing. According to the American Society for Metabolic and Bariatric Surgery, the number of bariatric procedures in the Unites States increased from 12,775 in 1998 to about 220,000 in 2008. Because Medicare has approved weight loss surgery when performed in a high-volume approved center, patients seeking the surgery have become older and sicker.

In an accompanying editorial commentary, Dr. Patricia L. Turner says “Strategies to further improve outcomes after bariatric surgery are of significant interest. Post operative complications can be particularly difficult to manage and deadly.” As more of the high risk patients seek out surgical weight loss options, doctors are faced with a need to identify risk factors and help patients prepare for successful surgery. The current study suggests that preoperative weight loss may be one step that will help achieve good outcomes.
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