Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Surgical study highlights pros and cons of gastric bypass surgery for severe obesity

18.11.2008
Severely obese patients who underwent two different gastric bypass techniques had lost up to 31 per cent of their Body Mass Index (BMI) after four years, with no deaths reported among the 50 study subjects, according to the November issue of the British Journal of Surgery.

The number of patients suffering from high blood pressure fell by 76 per cent, diabetes fell by 90 per cent and cases of dyslipidaemia – abnormal concentrations of lipids or lipoproteins in the blood – fell by 77 per cent.

However 29 complications were reported in 27 patients, including minor wound infections and narrowing of the anastomotic suture, and ten patients had to be operated on again in the four-year period after surgery.

Surgeons at the University Hospital Zurich, Switzerland, carried out the study to compare two techniques and find out whether varying the length of the small bowel limb during surgery could offer superior weight loss.

It had been suggested by several studies that a longer length would reduce the body’s ability to absorb certain sugars and fats.

As a result of the four-year study, they now perform proximal gastric bypass as the operation of first choice, having decided that the distal gastric bypass technique, with its longer alimentary limb, doesn’t offer any significant advantages but does have a number of drawbacks.

“There has been an ongoing debate about whether having a longer limb offers the patient greater weight loss and we decided to compare both techniques” explains Dr Markus Muller from the University’s Department of Visceral and Transplant Surgery.

Fifty patients having laparoscopic gastric bypass surgery were match-paired, with 25 undergoing the proximal technique and 25 undergoing the distal technique. The alimentary limb length in the proximal surgery group was 150cm and this increased to between 200cm and 400cm in the distal group.

The study subjects’ BMIs averaged 45.9 in the proximal group and 45.8 in the distal group. All had been obese for more than five years and had failed to lose weight using conventional methods for at least two years. Forty were female, their average age was 38 and their average weight was 126kg.

Key findings included:

•BMI decreased from 45.9 to 31.7 in the proximal group (31 per cent) and from 45.8 to 33.1 in the distal group (28 per cent).

•Average operating time was significantly longer in patients undergoing distal than proximal bypass surgery (242 minutes versus 170 minutes) and distal patients stayed in hospital longer (nine days versus eight days).

•Over the four-year follow-up, 29 complications were reported in 11 patients in the proximal group and 16 patients in the distal group. 12 repeat operations were necessary, four in the proximal group and eight in the distal group. Two patients - one in each group - had two operations for both early and late complications.

•Sixteen early complications were reported in the first 30 days after surgery - eight in each group. Eight of these were wound infections, there were two cases each of internal hernia, narrowing of the anastomotic suture and pulmonary embolism and one case each of staple-line bleeding and intra-abdominal abscess. Three reoperations and two endoscopic dilatations were required.

•Thirteen late complications were reported 48 months after surgery, including seven internal hernias and three cases where the anastomotic suture had narrowed. There was also one case each of anastomotic ulcer, foreign body (part of a suction drain) and severe malnutrition. Nine reoperations and three endoscopic dilatations were required.

•Before they received their gastric bypass, 29 patients had been suffering from high blood pressure. Two years after surgery this had dropped to seven patients (from 14 to two in the proximal group and 15 to five in the distal group).

•Diabetes declined from 19 patients to two (from ten to two in the proximal group and nine to zero in the distal group).

•The number of patients with dyslipidaemia – abnormal concentrations of lipids or lipoproteins in the blood – fell from 39 to nine (from 20 to four in the proximal group and 19 to five in the distal group).

“Our study found that both laparoscopic and distal bypass operations were feasible and safe with no deaths” says Dr Muller. “There were no significant statistical differences between the two techniques when it came to weight loss or reducing health issues such as high blood pressure or diabetes.

“However, we were very concerned that one of the distal patients developed severe protein malnutrition, because malnourished patients have high complication rates after surgery. A further operation was carried out to convert the distal bypass to a proximal bypass.

“As a result we now perform proximal gastric bypass surgery as the operation of first choice in morbidly obese patients.”

Annette Whibley | alfa
Further information:
http://www.bjs.co.uk

More articles from Studies and Analyses:

nachricht Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT

nachricht Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>