Weight Reduction after an Early Version of the Open Gastric Bypass for Morbid Obesity: Results after 23 Years |
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Authors: | Klaus Günther MD Jörg Vollmuth Rafael Weißbach Werner Hohenberger MD Bernhard Husemann MD Thomas Horbach MD |
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Institution: | (1) Department of Surgery, Clinical Center of Fürth, Germany;(2) Department of Surgery, University of Erlangen, Germany;(3) Institute of Business and Social Statistics, University of Dortmund, Germany;(4) Department of Surgery, University of Erlangen, Germany;(5) Department of Surgery, Dominikus Hospital Düsseldorf-Heerdt, Germany;(6) Department of Surgery, Dominikus Hospital Düsseldorf-Heerdt, Germany |
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Abstract: | Background: While numerous promising short-term results of open gastric bypass for morbid obesity were published, the long-term
outcome of earlier versions was somewhat disappointing. Thus, it was not until 1993 that this procedure was reintroduced with
current modifications and now performed laparoscopically. Published long-term results of gastric bypass are still lacking.
Methods: Out of an original population of 195 patients, we retrospectively analyzed the outcome of 98 patients (82 women,
16 men, mean age 32 years range 17-54], mean weight 132 kg range 65-200], mean BMI 46.6 kg/m2) operated on in Erlangen with mean follow-up 22.9 years (range 16.5-25.4). 3 different bariatric operations were performed:
horizontal gastroplasty (HGP, n=18), stapled Roux-en-Y gastric bypass (S-RYGBP, n=14) and transected Roux-en-Y gastric bypass
(T-RYGBP, n=66). BMI and percentage of excess weight loss (%EWL) were calculated at time 0, and after 1, 2, 3, 10, 15, 20
and 25 years. Results: Statistically significant weight loss was found for the whole patient population at every postoperative
time-point compared to preoperative values. Maximal weight loss was achieved mainly during the first 3 years. However, initial
and long-term outcome after HGP was significantly worse than after S-RYGBP or T-RYGBP. Gender did not significantly influence
the results. Conclusion: Traditional open gastric bypass resulted in acceptable and safe long-term weight reduction. It may
be assumed that laparoscopic gastric bypass with modern tiny pouch volumes based on the lesser curvature achieves even better
and life-long weight reduction. |
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Keywords: | MORBID OBESITY BARIATRIC SURGERY GASTRIC BYPASS HORIZONTAL GASTROPLASTY OUTCOME LONG-TERM RESULTS WEIGHT REDUCTION |
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