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The risk of dying within 30 days of weight
loss surgery is less than 1 percent for patients who
have the surgery done at an academic medical center, a U.S.
study shows.
Bariatric surgeries such as gastric banding or bypass have
become increasingly popular, say researchers at the University
of California, Irvine.
Reporting in the May issue of the journal Archives of Surgery,
they analyzed the medical records of 1,144 patients who had
bariatric surgery at 29 U.S. academic medical centers between
Oct. 1, 2003, and March 31, 2004. The patients were ages 17
to 65 and had a body mass index (BMI) of 35 to 70 (a BMI of
30 is considered the threshold for obesity).
Most of the patients (91.7 percent) had gastric bypass surgery,
in which a small portion of the stomach is sectioned off into
a pouch that connects directly to the small intestine. Seventy-five
percent of these bypass surgeries were performed laparoscopically
-- the surgeon does the procedure using a laparoscope inserted
through small incisions.
About 8 percent of the patients had restrictive procedures,
including gastric banding. This involves placement of a band-like
device around the stomach, which divides the stomach into
two smaller compartments. Ninety-two percent of the restrictive
procedures were performed laparoscopically.
Among the patients in the study who had gastric bypass, four
(0.4 percent) died within 30 days of the procedure. Sixteen
percent developed complications, including wound infection,
pneumonia, irregular heartbeat, intestinal obstruction, urinary
tract infection, or leakage at the "anastomosis site"
-- the suture line at the newly-created attachment site of
the stomach and intestine.
The 30-day death rate for patients who received restrictive
procedures was 0 percent and the complication rate was 3.2
percent.
"This analysis demonstrates that bariatric surgery at
predominately high-volume academic centers and in a subset
of patients with BMI of 35 to 70 is associated with low morbidity
and mortality," the study authors concluded.
"The practice of bariatric surgery at academic centers
has shifted from open surgery to laparoscopic surgery, with
gastric bypass the primary bariatric surgical procedure,"
the authors added.
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