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Benefits to patients choosing preoperative weight loss in gastric bypass

This month’s Journal of the American College of Surgeons explores benefits to patients choosing preoperative weight loss in gastric bypass surgery.

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Historically, preoperative weight loss has been encouraged for patients undergoing gastric bypass surgery to decrease liver mass, technically facilitating the procedure.

In an earlier prospective randomized trial investigating effects of preoperative weight loss on patients' clinical outcomes.

No differences were reported in postoperative complications or weight-loss profiles at 6-month follow-up.

This article demonstrates results of the same study, with 1-year follow-up.

Patients in the weight-loss group lost 8% of their excess body weight preoperatively
Journal of the American College of Surgeons

Dr Solomon and colleagues from California, USA selected 100 consecutive patients in an 18-month period preparing to undergo gastric bypass surgery at Stanford University Medical Center.

The researchers randomly assigned 50 patients to lose 10% or more of their excess body weight preoperatively, and 50 patients to no preoperative weight-loss requirements.

After 1 year, patient demographics and data on postoperative complications, cure or improvement of comorbidities, and differences in weight-loss profiles were collected.

The researchers found that at 1 year, the 2 groups had similar preoperative demographics and body mass indexes.

Patients in the weight-loss group, on average, lost 8% of their excess body weight preoperatively compared with the nonweight-loss group, which gained 1%.

After a year, the patients in both arms of the study showed no difference in weight, body mass indexes, excess weight-loss, and number of remaining comorbidites.

However, when patients were divided according to those who had lost at least 5% of their excess body weight preoperatively, the 1-year results for excess weight-loss, weight, and body mass indexes were much lower for the weight-loss group.

Dr Solomon’s team concluded, “Preoperative weight loss in patients undergoing gastric bypass surgery is safe and feasible.”

“It should be encouraged, because it will markedly improve longterm weight loss.”

J Am Coll of Surg 2009: 208(2): 241-5


03 February 2009

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