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Obesity Surgery

, Volume 24, Issue 5, pp 712–717 | Cite as

Laparoscopic Gastric Bypass vs. Sleeve Gastrectomy in the Super Obese Patient: Early Outcomes of an Observational Study

  • Carlos ZerrweckEmail author
  • Elisa M. Sepúlveda
  • Hernán G. Maydón
  • Francisco Campos
  • Antonio G. Spaventa
  • Verónica Pratti
  • Itzel Fernández
Original Contributions

Abstract

Background

Super obesity [body mass index (BMI) > 50 kg/m2] can yield to higher morbidity/mortality in bariatric surgery, this could be related to patient's characteristics and/or surgeon's experience. In morbid obesity, both techniques proved to have a positive impact and sometimes comparable outcomes during the first 2 years. This has not been clearly analyzed in the super obese patient.

Methods

Retrospective study comparing the records of 77 consecutive super obese patients (BMI: 50–59.9 kg/m2) submitted to either laparoscopic gastric bypass (LGBP, n = 32) or laparoscopic sleeve gastrectomy (LSG, n = 45) between 2010 and 2012 at a single institution. The primary objective was to analyze baseline demographics, comorbidities, operative outcomes, and early complications (<30 days). Secondarily, weight loss [BMI and % excess weight loss (%EWL)] was also described and compared during the first year.

Results

Female sex comprised 72.7 % of all cases. Both groups had comparable BMI (52.7 ± 2.1 kg/m2 for LGBP vs. 53.87 ± 2.8 kg/m2 for LSG; p = 0.087) and homogeneous baseline characteristics. Operative time was lower for the LSG group (113.1 ± 35.3 vs. 186.9 ± 39 min for LGBP; p ≤ 0.001). Overall, early complications were observed in 16.8 % of patients (LGBP 9 % vs. LSG 22 %; p = 0.217). There were four major complications (two in each group), with two reinterventions. Weight loss (%EWL) at 6, 9, and 12 months was significantly higher in the LGBP group (51.6 ± 12.9 %, 56.5 ± 13 %, 63.9 ± 13.3 %, respectively) than in the LSG group (40 ± 12.8 %, 45.1 ± 15.5 %, 43.9 ± 10.4 %, respectively).

Conclusions

Just like in morbid obesity, LGBP and LSG are effective and safe procedures in super obese patients. LGBP had better weight loss at 1 year.

Keywords

Super obesity Laparoscopic gastric bypass Sleeve gastrectomy 

Notes

Conflict of Interest

The author (Carlos Zerrweck) and coauthors (Elisa Sepulveda, Hernan Maydon, Antonio Spaventa, Francisco Campos, Veronica Pratti, and Itzel Fernandez) have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Carlos Zerrweck
    • 1
    • 2
    Email author
  • Elisa M. Sepúlveda
    • 2
  • Hernán G. Maydón
    • 2
  • Francisco Campos
    • 1
    • 2
  • Antonio G. Spaventa
    • 1
  • Verónica Pratti
    • 1
  • Itzel Fernández
    • 1
  1. 1.The Obesity Clinic at Hospital General “Dr. Rubén Leñero”Mexico CityMexico
  2. 2.The Obesity Clinic at Hospital General TláhuacMexico CityMexico

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