Study Explores Complications Associated With Weight-Loss Surgery

May 13, 2003

WORCESTER, Mass.— As the number of Americans considered morbidly obese continues to rise, so does the prevalence of gastric bypass surgery. The procedure aids in weight loss by surgically reducing the size of the stomach, thereby limiting the amount of food a person consumes at one time.  In a new study of the procedure, researchers and surgeons at the University of Massachusetts Medical School and the UMass Memorial Medical Center have identified three factors associated with complications from the weight-loss surgery. Namely, the experience of the surgeon, sleep apnea, and hypertension. The results of the study are reported in the May issue of The Archives of Surgery, a publication of the Journal of the American Medical Association.

The study was conducted by Assistant Professor of Surgery Richard A. Perugini, MD, and his colleagues at UMMS, who reviewed cases of 188 patients with severe obesity who met the National Institutes of Health guidelines for undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) surgery.  The researchers recorded all complications that required intervention, and the amount of weight lost in the year following surgery.

The researchers found that of the 188 patients, 50 (26.6 percent) developed complications that required an invasive intervention.  The most common complication requiring intervention, occurring in 27 patients (14.4 percent) was stricture of the gastrojejunal anastomosis— a closing of the passageway in the newly restricted stomach that requires additional surgery to reopen. The researchers identified surgeon experience, and the patient’s history of sleep apnea and/or hypertension as predictors of complications.

“Laparoscopic RYGB is a challenging procedure, demanding a long learning curve,” the authors wrote. “To our knowledge, this is the first series that has implicated (these) factors associated with complications after laparoscopic RYGB.”

Weight loss data were available for 93 of the 115 patients whose surgery had occurred one year prior.  For those patients, their Body Mass Index (BMI) dropped from an average of 53 before surgery to 35 at one year after surgery.  The average percentage of body weight lost after one year was 61 percent.  The researchers also found that diabetes mellitus was negatively correlated with percentage of excess body weight lost after one year.

Obesity is a major health problem in the United States, and is estimated to account for approximately 280,000 deaths per year, according to information in the paper.  Obesity is associated with many other health risks, including hypertension and type 2 diabetes mellitus.  RYGB surgery is one of the most commonly offered surgical procedures for the treatment of obesity and appears to offer the best long-term results.  To read the entire paper see  http://archsurg.ama-assn.org/

The University of Massachusetts Medical School ( www.umassmed.edu ) is one of the fastest growing medical schools in the country, attracting more than $143 million in research funding annually.  A perennial top finisher in the annual US News & World Report ranking of primary care medical schools, UMMS comprises a medical school, graduate school of nursing, graduate school of biomedical sciences and an active research enterprise, and is a leader in health sciences education, research and public service.

UMass Memorial Health Care ( www.umassmemorial.org ) is central Massachusetts’ largest not-for-profit health care delivery system, covering the complete health care continuum with teaching hospitals, affiliated community hospitals, freestanding primary care practices, ambulatory outpatient clinics, long-term care facilities, home health agencies, hospice programs, a rehabilitation group and mental health services.  UMass Memorial is the clinical partner of the University of Massachusetts Medical School.

 

Contact: Michael Cohen, 508-856-2000