A Decade of Change in Obesity Surgery |
| |
Authors: | Edward E Mason MD PhD Shenghui Tang MS Kathleen E Renquist BS Dwight T Barnes Joseph J Cullen MD Cornelius Doherty MD James W Maher MD |
| |
Institution: | (1) Department of Surgery Iowa City, Iowa, USA;(2) Preventive Medicine, Iowa City, Iowa, USA;(3) Department of Surgery Iowa City, Iowa, USA;(4) Department of Surgery Iowa City, Iowa, USA;(5) Department of Surgery Iowa City, Iowa, USA;(6) Department of Surgery Iowa City, Iowa, USA;(7) Department of Surgery Iowa City, Iowa, USA;(8) Department of Surgery Iowa City, Iowa, USA |
| |
Abstract: | Background: The International (formerly National) Bariatric Surgery Registry began collecting data in January 1986. The aim
of this study was to examine changes in the practice of surgical treatment of severe obesity that occurred during the decade
of 1986 through 1995, as observed in the IBSR data. Methods: All data submitted to the IBSR during the decade were transferred
to the IBM mainframe computer for analysis. Characteristics of operative type populations were compared over time using analysis
of variance (ANOVA) for age, body mass index (BMI), operative weight and Chi-square (χ2) test for gender. Results: There has been a steady increase over the decade in mean patient weight. The operations used have
changed from predominantly ‘simple’ operations to more frequent use of ‘complex’ operations. Within the categories of ‘simple’
and ‘complex’, an increase in the variety of operations occurred. As a group, patients with ‘simple’ operations have been
heavier, more often male and public pay patients than those who have undergone ‘complex’ operations. One year weight loss
was greater for Roux-en-Y gastric bypass (RGB) than vertical banded gastroplasty (VBG), but follow-up rates were too low to
study the relative merits of the operations used. The reported incidence of operative mortality and serious complications
(leak with peritonitis, abscess and pulmonary embolism) remained low. Conclusions: These observations and their implications
can be summarized in three statements which relate to action for improved patient care in the beginning of the new century:
(1) increasing weight of candidates for surgical treatment during this decade indicates the need for earlier use of operative
treatment before irreversible complications of obesity can develop; (2) low risk of obesity surgery, decreasing postoperative
hospital stay, and early weight control support the continued and increased use of surgical treatment; (3) continued widespread
use of both ‘simple’ and ‘complex’ operations with increased modifications of standard RGB and VBG procedures emphasizes the
need for standardized long-term data and analyses regarding both weight control and postoperative side-effects. |
| |
Keywords: | Complication gastric bypass gastroplasty morbid obesity obesity surgery |
本文献已被 SpringerLink 等数据库收录! |
|