Obesity Surgery

, Volume 23, Issue 8, pp 1324–1332 | Cite as

Bariatric Surgery Outcomes in a European Centre of Excellence (CoE)

  • José Manuel Fort
  • Ramon Vilallonga
  • Albert Lecube
  • Oscar Gonzalez
  • Enric Caubet
  • Jordi Mesa
  • Manel Armengol
Review

Abstract

Bariatric Surgery Centres of Excellence have been promoted by the International Federation for the Surgery of Obesity and Metabolic Disorders European Chapter to improve outcomes and security of patients. A retrospective analysis of our prospective database has been performed. Between May 2001 and September 2012, we operated on 690 patients, first with open gastric bypass (2001–2005), then laparoscopy (2006–2009), introduced robotics and finally the Centre of Excellence period (2012). Complication rate was 18.9 % in the first period and 3 % in the last. We reoperated on 9 % of patients in two early periods and none in the last. Mortality rate was 2, 0.85, 0.47 and 0 % in the four periods. Teams that are just at the beginning of their experience in bariatric surgery in order to avoid complications and deal with better long-term results.

Keywords

Obesity Surgery Experience Complications Mortality Centre of Excellence 

Notes

Acknowledgments

We thank Dr. Jaume Clapès for helping us in the beginnings and Adoración Gromaz for her nutritional counselling to patients.

References

  1. 1.
    James PT. The epidemiology of obesity: the size of the problem. J Intern Med. 2008;263:336–52.PubMedCrossRefGoogle Scholar
  2. 2.
    Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355:763–78.PubMedCrossRefGoogle Scholar
  3. 3.
    Trogdon JG, Finkelstein EA, Hylands T, et al. Indirect costs of obesity: a review of the current literature. Obes Rev. 2008;9:489–500.PubMedCrossRefGoogle Scholar
  4. 4.
    Neira M, de Onis M. The Spanish strategy for nutrition, physical activity and the prevention of obesity. Br J Nutr. 2006;96 Suppl 1:S8–S11.PubMedCrossRefGoogle Scholar
  5. 5.
    Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.PubMedCrossRefGoogle Scholar
  6. 6.
    Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg. 2004;199:543–51.PubMedCrossRefGoogle Scholar
  7. 7.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;92:1724–37.CrossRefGoogle Scholar
  8. 8.
    No authors listed. Gastrointestinal surgery for severe obesity: National Institutes of Health Conference Statement. Am J Clin Nutr. 1992;55:615S–9S.Google Scholar
  9. 9.
    Sánchez-Pernaute A, Herrera MA, Pérez-Aguirre ME, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI’S). One to 3 year follow-up. Obes Surg. 2010;20:1720–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Centres for Medicaid and Medicare Services Bariatric Surgery National Coverage Determination. http:77www.cms.hhs.gov/manuals/downloads/ncd103c1_Part2.pdf. Accessed 26 Dec 2007.
  11. 11.
    Lecube A, Fort JM, Baena JA, et al. Initial experience with 150 consecutive gastric bypass: an approach to the learning curve of bariatric procedures. Obes Metab. 2007;3:175–82.Google Scholar
  12. 12.
    Vilallonga R, Rius J, Fort JM, et al. Single port access sleeve gastrectomy: is it reasonable? J Minim Access Surg. 2011;7:156–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Vilallonga R, Fort JM, Gonzalez O, et al. The initial learning curve for robot-assisted sleeve gastrectomy: a surgeon’s experience while introducing the robotic technology in a bariatric surgery department. Minim Invasive Surg. 2012;2012:347131. doi: 10.1155/2012/347131.PubMedGoogle Scholar
  14. 14.
    Patti MG, Corvera CU, Glasgow RE, et al. A hospital’s annual rate of esophagectomy influences the operative mortality rate. J Gastrointest Surg. 1998;2:186–92.PubMedCrossRefGoogle Scholar
  15. 15.
    Finlayson EV, Goodney PP, Birkmeyer JD. Hospital volume and operative mortality in cancer surgery: a national study. Arch Surg. 2003;138:721–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Livingston EH. Bariatric surgery outcomes at designated centers of excellence vs nondesignated programs. Arch Surg. 2009;144:319–25.PubMedCrossRefGoogle Scholar
  17. 17.
    Liu JH, Zingmond D, Etzioni DA, et al. Characterizing the performance and outcomes of obesity surgery in California. Ann Surg. 2003;69:823–8.Google Scholar
  18. 18.
    Nguyen NT, Paya M, Stevens CM, et al. The relationship between hospital volume and outcome in bariatric surgery at academic medical centres. Ann Surg. 2004;240:586–93.PubMedGoogle Scholar
  19. 19.
    Ciudin A, Baena-Fustegueras JA, Fort JM, et al. Successful treatment for the Dunnigan-type familial partial lipodystrophy with Roux-en-Y gastric bypass. Clin Endocrinol (Oxf). 2011;75(3):403–4. doi: 10.1111/j.1365-2265.2011.04057.x.CrossRefGoogle Scholar
  20. 20.
    Lecube A, Vilallonga R, Sturniolo G, et al. Renaissance of acromegaly after bariatric surgery. Endocr. 2013;43(1):239–41.CrossRefGoogle Scholar
  21. 21.
    Vilallonga R, Yeste D, Lecube A, et al. A bariatric surgery programme in adolescents. Preliminary results. Cir Esp. 2012. doi: 10.1016/j.ciresp.2012.06.003.Google Scholar
  22. 22.
    Livingston EH. Procedure, incidence and in-hospital complication rates of bariatric surgery in the United States. Am J Surg. 2004;188(2):105–10.PubMedCrossRefGoogle Scholar
  23. 23.
    Livingston E, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236:576–82.PubMedCrossRefGoogle Scholar
  24. 24.
    Fernandez AZ, Demaria EJ, Tichansky DS, et al. Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity. Ann Surg. 2004;239:698–703.PubMedCrossRefGoogle Scholar
  25. 25.
    Fernandez Jr AZ, DeMaria EJ, Tichansky DS, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18:193–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.PubMedCrossRefGoogle Scholar
  27. 27.
    Benotti PN, Wood GC, Rodriguez H, et al. Perioperative outcomes and risk factors in gastric surgery for morbid obesity: a 9-year experience. Surgery. 2006;139:340–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Wittgrove A, Clark W. Laparoscoic gastric bypass, roux-en-Y: 500 patients: technique and results, with a 3–60 month follow-up. Obes Surg. 2000;10:233–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic gastric banding: a comparative study of 1200 cases. J Am Coll Surg. 2003;197:536–47.PubMedCrossRefGoogle Scholar
  30. 30.
    Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomised study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–91.PubMedCrossRefGoogle Scholar
  31. 31.
    Jamal MK, DeMaria EJ, Johnson JM, et al. Impact of major co-morbidities on mortality and complications after gastric bypass. Surg Obes Relat Dis. 2005;1:73–6.CrossRefGoogle Scholar
  32. 32.
    Vilallonga R, Fort JM, Gonzalez O, et al. The initial learning curve for robot-assisted sleeve gastrectomy: a surgeon’s experience while introducing the robotic technology in a bariatric surgery department. Min Invasive Surg. 2012;2012(347131), 5 pages doi: 10.1155/2012/347131

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • José Manuel Fort
    • 1
  • Ramon Vilallonga
    • 1
  • Albert Lecube
    • 2
  • Oscar Gonzalez
    • 1
  • Enric Caubet
    • 1
  • Jordi Mesa
    • 2
  • Manel Armengol
    • 1
  1. 1.Endocrine, Metabolic and Bariatric Unit, General Surgery DepartmentHospital Universitari de la Vall d’Hebron, Center of Excellence for the EAC-BCBarcelonaSpain
  2. 2.Obesity Unit, Endocrinology DepartmentHospital Universitari de la Vall d’Hebron, Center of Excellence for the EAC-BCBarcelonaSpain

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