Early Outcomes of Roux-en-Y Gastric Bypass in a Publically Funded Obesity Program

Abstract

Background. There is limited literature assessing the outcomes of bariatric surgery in a publically funded, North American, multidisciplinary bariatric program. Our objective was to assess outcomes of roux-en-Y gastric bypass (RYGB) in a publically funded bariatric program through a retrospective review of patient records. Methods. 293 patients spent a median of 13 months attending a multidisciplinary obesity clinic prior to undergoing laparoscopic RYGB surgery. The hospital was a Canadian, publically funded, level 2 trauma center with university teaching services. Results. 79% of the patients were female and the average BMI at first visit to clinic was 55.3 kg/m2. The average decrease in BMI was 19.2 ± 0.9 kg/m2. This was an average absolute weight loss of 56.1 kg or 35.5% of initial weight. The average excess weight loss was 63.4 ± 20.4%. Improvement or resolution of obesity related comorbidities occurred in 65.9% of type 2 diabetics and in 50% of hypertensive patients. Conclusion. Despite this being an unconventional setting of a publically funded program in a large Canadian teaching hospital, early outcomes following RYGB were appropriate in severely obese patients. Ongoing work will identify areas of improvement for enhanced efficiencies within this system.

Endoscopic therapeutic interventions for management of postoperative bariatric surgery complications

“…Anastomotic or staple line leaks are a major complication of bariatric surgery and occur in up to 4.8% of RYGB and 2.4% in LSG [14][15][16]. These leaks are characterized by a discontinuity at the surgical line anastomosis resulting in a spillage of luminal content into the peritoneum [17].…”

Earlier Provision of Gastric Bypass Surgery in Canada Enhances Surgical Benefit and Leads to Cost and Comorbidity Reduction

“…Reviews of bariatric surgery in Canada have suggested the procedure is under-accessed and under-utilized as an effective strategy to manage patient weight and correspondingly, prevalence of obesity-related comorbidities ( 5 ). Numerous reports have acknowledged the issue of limited bariatric service capacity and its impact on patient health, including additional costs and mortality while awaiting surgery ( 6 – 10 ). After referral for surgery, some patients in Canada do not complete the program for various reasons including dropout or seeking surgery elsewhere.…”