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Weight loss before bariatric surgery linked to shorter hospital stay, faster weight loss
October 16, 2007High-risk morbidly obese patients who lose 5 to 10 percent of their excess body weight before undergoing gastric bypass surgery appear to have shorter hospital stays and more rapid postoperative weight loss, according to a report in the October issue of Archives of Surgery, a theme issue on bariatric surgery.
Bariatric surgery is an effective long-term treatment for morbidly obese patients with co-occurring medical problems, according to background information in the article. "To that end, older and higher-risk patients with multiple uncontrolled medical problems (such as diabetes mellitus, obstructive sleep apnea, steatohepatitis [liver inflammation], degenerate joint disease, venous stasis disease [loss of vein function in the legs] and cardiopulmonary vascular disease) are opting for bariatric surgery," the authors write. "Moreover, patients are seeking referral for bariatric surgery when the disease burden from their comorbidities eliminates meaningful quality of life." These patients may face more complications following surgery.
Christopher D. Still, D.O., and colleagues at Geisinger Health System, Danville, Penn., assessed patients who underwent open or laparoscopic gastric bypass surgery between 2002 and 2006. "Patients were required to participate in a standardized multidisciplinary preoperative program that encompasses medical, psychological, nutritional and surgical interventions and education," the authors write. "In addition, patients were encouraged to achieve a 10 percent loss of excess body weight prior to surgical intervention."
Of the 884 patients (average age 45), 169 (19 percent) lost 5 to 10 percent of their excess body weight prior to the operation and 425 (48 percent) lost 10 percent or more of excess weight prior to the operation. Those who lost more than 5 percent were less likely to stay in the hospital longer than four days, whereas those who lost more than 10 percent of their excess weight before surgery were more than twice as likely to have lost 70 percent of excess weight one year afterward, compared with those who lost between none and 5 percent of their excess pounds before surgery.
The authors speculate that physiologic improvements associated with weight loss decreased surgical complications, reducing the length of hospital stay. "Numerous reports have confirmed the beneficial effects of even limited weight loss on co-morbid medical conditions, such as hypertension [high blood pressure], diabetes mellitus, degree of visceral [among internal organs] fat, liver size, thromboembolism [blood clot] predisposition and severity of sleep apnea," the authors write. "Additional studies will be required to pinpoint which comorbidity (or comorbidities) is responsible for reduced lengths of stay."
In addition, further research is needed to determine how preoperative weight loss could help with long-term weight loss following surgery, they note.
JAMA and Archives Journals
Of the 884 patients (average age 45), 169 (19 percent) lost 5 to 10 percent of their excess body weight prior to the operation and 425 (48 percent) lost 10 percent or more of excess weight prior to the operation. Those who lost more than 5 percent were less likely to stay in the hospital longer than four days, whereas those who lost more than 10 percent of their excess weight before surgery were more than twice as likely to have lost 70 percent of excess weight one year afterward, compared with those who lost between none and 5 percent of their excess pounds before surgery.
The authors speculate that physiologic improvements associated with weight loss decreased surgical complications, reducing the length of hospital stay. "Numerous reports have confirmed the beneficial effects of even limited weight loss on co-morbid medical conditions, such as hypertension [high blood pressure], diabetes mellitus, degree of visceral [among internal organs] fat, liver size, thromboembolism [blood clot] predisposition and severity of sleep apnea," the authors write. "Additional studies will be required to pinpoint which comorbidity (or comorbidities) is responsible for reduced lengths of stay."
In addition, further research is needed to determine how preoperative weight loss could help with long-term weight loss following surgery, they note.
JAMA and Archives Journals
Bariatric Surgery Current Events and Bariatric Surgery News RSSRobotic Surgery Lowers Risk of a Rare but Serious Complication of Gastric Bypass
The use of a robot to assist with the most commonly performed weight-loss surgery appears to significantly lower a patient's risk of developing a rare but serious complication, according to a study published in the most recent edition of the Journal of Robotic Surgery.
Johns Hopkins researchers suppress 'hunger hormone'
Johns Hopkins scientists report success in significantly suppressing levels of the "hunger hormone" ghrelin in pigs using a minimally invasive means of chemically vaporizing the main vessel carrying blood to the top section, or fundus, of the stomach.
Study shows that surgical weight loss does not eliminate obstructive sleep apnea
A study in the August 15 issue of the Journal of Clinical Sleep Medicine shows that surgical weight loss results in an improvement of obstructive sleep apnea (OSA), but most patients continue to have moderate to severe OSA one year after undergoing bariatric surgery.
Bariatric patients have 65% lower chance of complications at top hospitals: HealthGrades study
Bariatric surgery patients treated at highly rated hospitals have, on average, a 65 percent lower chance of experiencing serious complications compared to patients who undergo surgery at poorly rated hospitals according to a study released today by HealthGrades, the nations leading independent healthcare ratings organization.
ASGE issues guidelines on the role of endoscopy in the bariatric surgery patient
The American Society for Gastrointestinal Endoscopy (ASGE) has issued guidelines on the role of endoscopy in the bariatric surgery patient.
Study links gastric bypass surgery to increased risk of kidney stones
Morbidly obese patients who undergo a particular type of gastric bypass surgery called Roux-en-Y gastric bypass (RYGB) are at an increased risk of developing kidney stones - small, pebble-like deposits that can result in severe pain and require an operation to remove them - earlier than previously thought.
Weight-loss surgery can cut cancer risk
Successful bariatric surgery allows morbidly obese patients to lose up to 70 percent of their excess weight and to maintain weight loss.
Weight loss after gastric bypass surgery may protect against infection and cancer
Another health benefit of bariatric weight-loss surgery may be a heightened immune defense against cancer and infections, a new study suggests. The results will be presented at The Endocrine Society's 90th Annual Meeting in San Francisco.
Surgeons complete the first Lap-Band weight-loss surgery in Texas using single incision as entry point
UT Southwestern Medical Center surgeons have completed the first single-incision Lap-Band weight-loss surgery in Texas.
New technique determines that the number of fat cells remains constant in all body types
The radioactive carbon-14 produced by above-ground nuclear testing in the 1950s and '60s has helped researchers determine that the number of fat cells in a human's body, whether lean or obese, is established during the teenage years. Changes in fat mass in adulthood can be attributed mainly to changes in fat cell volume, not an increase in the actual number of fat cells.
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