Early Complications in Bariatric Surgery:

Santo, Marco Aurélio; Pajecki, Dênis; Riccioppo, Daniel; Cleva, Roberto de; Kawamoto, Flávio; Cecconello, Ivan

doi:10.1590/s0004-28032013000100010

Cited by 22 publications

(19 citation statements)

References 16 publications

(22 reference statements)

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“…Considering the entire period of study, mortality from causes related to surgery was 1.0% and from violent death was 0.3%. Early mortality rate was similar to that observed in other studies of patients who underwent the same surgical procedure (21-23). Some studies reported higher mortality rates such as 0.9% (5), 1.9% (8), 3.7% (11), and 4.1% (12), but they included patients operated on much earlier, from 1980 to the early 2000s, when surgical conditions were probably less developed than today (5,8).…”

Section: Discussionsupporting

confidence: 88%

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Mortality rate after open Roux-in-Y gastric bypass: a 10-year follow-up

Kelles

Diniz

Machado

et al. 2014

Braz J Med Biol Res

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The prevalence of obesity has increased to epidemic status worldwide. Thousands of morbidly obese individuals undergo bariatric surgery for sustained weight loss; however, mid- and long-term outcomes of this surgery are still uncertain. Our objective was to estimate the 10-year mortality rate, and determine risk factors associated with death in young morbidly obese adults who underwent bariatric surgery. All patients who underwent open Roux-in-Y gastric bypass surgery between 2001 and 2010, covered by an insurance company, were analyzed to determine possible associations between risk factors present at the time of surgery and deaths related and unrelated to the surgery. Among the 4344 patients included in the study, 79% were female with a median age of 34.9 years and median body mass index (BMI) of 42 kg/m2. The 30-day and 10-year mortality rates were 0.55 and 3.34%, respectively, and 53.7% of deaths were related to early or late complications following bariatric surgery. Among these, 42.7% of the deaths were due to sepsis and 24.3% to cardiovascular complications. Male gender, age ≥50 years, BMI ≥50 kg/m2, and hypertension significantly increased the hazard for all deaths (P<0.001). Age ≥50 years, BMI ≥50 kg/m2, and surgeon inexperience elevated the hazard of death from causes related to surgery. Male gender and age ≥50 years were the factors associated with increased mortality from death not related to surgery. The overall risk of death after bariatric surgery was quite low, and half of the deaths were related to the surgery. Older patients and superobese patients were at greater risk of surgery-related deaths, as were patients operated on by less experienced surgeons.

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Section: Discussionsupporting

confidence: 88%

“…Male gender has been associated with lower survival rates after bariatric procedure in several studies (6,7,21), when analyzing all causes of death. This may be explained by factors not related to the bariatric surgery itself.…”

Section: Discussionmentioning

confidence: 99%

Mortality rate after open Roux-in-Y gastric bypass: a 10-year follow-up

Kelles

Diniz

Machado

et al. 2014

Braz J Med Biol Res

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“…By retrospectively analyzing major complications (fistula, cavitary abscess, bleeding and deep wound infection) and mortality in the group of patients (n = 538) operated on before the beginning of this protocol ( 17 ) and by stratifying this group by BMI, we noted that the BMI >50 kg/m 2 group had a greater incidence of all major complications and represented the patient group with the majority of complications in our series. The fistula rate was 2.19% for all the patients (non-SO and SO), and the subgroup analysis revealed a 1% fistula rate in the non-SO group (n = 345), representing 30.76% of the total number of fistulas.…”

Section: Discussionmentioning

confidence: 97%

“…In a retrospective analysis of the data from patients operated on five years prior to the start of the preoperative weight loss program, we found that the incidence of complications in SO patients was approximately 4-fold higher compared with morbidly obese group (BMI<50 kg/m 2 ), and that 80% of the deaths occurred in super obese ( 17 ).…”

Section: Introductionmentioning

confidence: 93%

Preoperative weight loss in super-obese patients: study of the rate of weight loss and its effects on surgical morbidity

Santo¹,

Riccioppo²,

Pajecki³

et al. 2014

Clinics

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OBJECTIVES:The incidence of obesity and particularly super obesity, has increased tremendously. At our institution, super obesity represents 30.1% of all severely obese individuals in the bariatric surgery program. In super obesity, surgical morbidity is higher and the results are worse compared with morbid obesity, independent of the surgical technique. The primary strategy for minimizing complications in these patients is to decrease the body mass index before surgery. Preoperative weight reduction can be achieved by a hypocaloric diet, drug therapy, an intragastric balloon, or hospitalization. The objective of this study was to analyze the results of a period of hospitalization for preoperative weight loss in a group of super-obese patients.METHODS:Twenty super-obese patients were submitted to a weight loss program between 2006 and 2010. The mean patient age was 46 years (range 21-59). The mean BMI was 66 kg/m2 (range 51-98) and 12 were women. The average hospital stay was 19.9 weeks and the average weight loss was 19% of the initial weight (7-37%). The average caloric intake was 5 kcal/kg/day. After the weight loss program, the patients underwent gastric bypass surgery.RESULTS:The statistical analysis revealed that after 14 weeks of treatment (15% loss of initial weight), the weight loss was not significant. All patients had satisfactory surgical recovery and were discharged after an average of 4.6 days.CONCLUSION:In super obesity, preoperative weight loss is an important method for reducing surgical risks. Hospitalization and a hypocaloric diet are safe and effective. After 14 weeks, the weight loss rate stabilized, signaling the time of surgical intervention in our study.

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“…88 Early complication rates (< 30 days) after bariatric surgery were reported to be < 10% 73,94 and tended to be lower in restrictive surgeries compared with in hybrid surgeries. 50,73 Most common early complications reported are gastric and anastomosis leak (1.6% to 5.1%), 73,95,96 bleeding (0.5% to 3.5%), 50,73,97 and pulmonary embolism (0.2% to 1.0%).…”

Section: Mortalitymentioning

confidence: 99%