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Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial
BACKGROUND: Proximal Roux-en-Y gastric bypass may not ensure adequate weight loss in superobese patients. Bypassing a longer segment of the small bowel may increase weight loss. The objective of the study was to compare the perioperative outcomes of laparoscopic proximal and distal gastric bypass in...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559572/ https://www.ncbi.nlm.nih.gov/pubmed/25761943 http://dx.doi.org/10.1007/s11695-015-1621-y |
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author | Svanevik, Marius Risstad, Hilde Hofsø, Dag Schou, Carl Fredrik Solheim, Brita Søvik, Torgeir T. Kristinsson, Jon Hjelmesæth, Jøran Mala, Tom Sandbu, Rune |
author_facet | Svanevik, Marius Risstad, Hilde Hofsø, Dag Schou, Carl Fredrik Solheim, Brita Søvik, Torgeir T. Kristinsson, Jon Hjelmesæth, Jøran Mala, Tom Sandbu, Rune |
author_sort | Svanevik, Marius |
collection | PubMed |
description | BACKGROUND: Proximal Roux-en-Y gastric bypass may not ensure adequate weight loss in superobese patients. Bypassing a longer segment of the small bowel may increase weight loss. The objective of the study was to compare the perioperative outcomes of laparoscopic proximal and distal gastric bypass in a double-blind randomized controlled trial of superobese patients. The study was conducted at two public tertiary care obesity centers in Norway. METHODS: Patients with body mass index (BMI) 50–60 kg/m(2) were randomly assigned to a proximal (150 cm alimentary limb) or a distal (150 cm common channel) gastric bypass. The biliopancreatic limb was 50 cm in both operations. Patients and follow-up personnel were blinded to the type of procedure. Thirty-day outcomes including complications are reported. RESULTS: We operated on 115 patients, of whom two were excluded at surgery, leaving 56 and 57 patients in the proximal group and distal group, respectively. The median (range) operating time was 72 (36–151) and 101 (59–227) min, respectively (p < 0.001). Two distal procedures were converted to laparotomy during the primary procedure. Median length of hospital stay was 2 (1–4) days in the proximal group and 2 (1–24) days in the distal group. The number of patients with complications and complications categorized according to the Contracted Accordion classification did not differ significantly. However, all six reoperations were performed in the distal group, of which three were completed by laparoscopy (p = 0.01 between groups). There were no deaths. CONCLUSIONS: In superobese patients with BMI between 50 and 60 kg/m(2), distal gastric bypass was associated with longer operating time and more severe complications resulting in reoperation than proximal gastric bypass. |
format | Online Article Text |
id | pubmed-4559572 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-45595722015-09-10 Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial Svanevik, Marius Risstad, Hilde Hofsø, Dag Schou, Carl Fredrik Solheim, Brita Søvik, Torgeir T. Kristinsson, Jon Hjelmesæth, Jøran Mala, Tom Sandbu, Rune Obes Surg Original Contributions BACKGROUND: Proximal Roux-en-Y gastric bypass may not ensure adequate weight loss in superobese patients. Bypassing a longer segment of the small bowel may increase weight loss. The objective of the study was to compare the perioperative outcomes of laparoscopic proximal and distal gastric bypass in a double-blind randomized controlled trial of superobese patients. The study was conducted at two public tertiary care obesity centers in Norway. METHODS: Patients with body mass index (BMI) 50–60 kg/m(2) were randomly assigned to a proximal (150 cm alimentary limb) or a distal (150 cm common channel) gastric bypass. The biliopancreatic limb was 50 cm in both operations. Patients and follow-up personnel were blinded to the type of procedure. Thirty-day outcomes including complications are reported. RESULTS: We operated on 115 patients, of whom two were excluded at surgery, leaving 56 and 57 patients in the proximal group and distal group, respectively. The median (range) operating time was 72 (36–151) and 101 (59–227) min, respectively (p < 0.001). Two distal procedures were converted to laparotomy during the primary procedure. Median length of hospital stay was 2 (1–4) days in the proximal group and 2 (1–24) days in the distal group. The number of patients with complications and complications categorized according to the Contracted Accordion classification did not differ significantly. However, all six reoperations were performed in the distal group, of which three were completed by laparoscopy (p = 0.01 between groups). There were no deaths. CONCLUSIONS: In superobese patients with BMI between 50 and 60 kg/m(2), distal gastric bypass was associated with longer operating time and more severe complications resulting in reoperation than proximal gastric bypass. Springer US 2015-03-12 2015 /pmc/articles/PMC4559572/ /pubmed/25761943 http://dx.doi.org/10.1007/s11695-015-1621-y Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Contributions Svanevik, Marius Risstad, Hilde Hofsø, Dag Schou, Carl Fredrik Solheim, Brita Søvik, Torgeir T. Kristinsson, Jon Hjelmesæth, Jøran Mala, Tom Sandbu, Rune Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial |
title | Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial |
title_full | Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial |
title_fullStr | Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial |
title_full_unstemmed | Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial |
title_short | Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50–60 kg/m(2)—A Double-Blind, Randomized Controlled Trial |
title_sort | perioperative outcomes of proximal and distal gastric bypass in patients with bmi ranged 50–60 kg/m(2)—a double-blind, randomized controlled trial |
topic | Original Contributions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559572/ https://www.ncbi.nlm.nih.gov/pubmed/25761943 http://dx.doi.org/10.1007/s11695-015-1621-y |
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