Abstract
Background
Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined since January 1st, 2005 with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of Magdeburg (Germany).
Methods
In this prospective multicenter observational study, the data obtained for all primary bariatric procedures, including all repeated operations, performed on consecutive patients with morbid obesity at participating hospitals from 2005 to 2007 were prospectively collected using an Internet online data registry. In particular, perioperative characteristics, such as the spectrum of diagnostic measurements, type of surgical procedures, and short- and long-term outcomes, were investigated.
Results
During the study period, 629 surgical procedures were performed at 21 hospitals in 2005, 828 procedures at 32 hospitals in 2006, and 1,666 procedures at 35 hospitals in 2007. In 2005 and 2006, gastric banding was the most frequently performed operation, followed by the Roux-en-Y gastric bypass (RYGBP). In 2007, a RYGBP was carried out in 42.1% of all bariatric procedures. Among all patients, 74.4% were female. The mean body mass index (BMI) was 48.5 kg/m2 in 2005, 48.4 kg/m2 in 2006, and 48.0 kg/m2 in 2007. Follow-up data after 12 months were available for 63.8% of the patients in 2005 and 2006; these data showed greater reduction of BMI after malabsorptive rather than restrictive bariatric procedures. The mortality was 0.1% (30 days) and 0.16% (overall).
Conclusion
As indicated by the worldwide trend, there is an ongoing change from restrictive bariatric procedures to malabsorptive procedures and sleeve gastrectomy. Although the BMIs of German patients undergoing bariatric surgery appear to be substantially higher than those of patients from most other countries, there were no differences in intraoperative and short-term complications or in overall outcomes during follow-up when compared with published studies.
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References
Deitel M. Overweight and obesity worldwide now estimated to involve 1,7 billion people. Obes Surg 2003;13:329–30.
James PT, Rigby N, Leach R. The obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil 2004;11:3–8.
Buchwald H. Consensus conference statement. Bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surgery Obesity Related Diseases 2005;1:371–81.
Mensik GBM, Lampert T, Bergmann E. Übergewicht und Adipositas in Deutschland 1984–2003. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 2005;48:1348–56.
Benson K, Hartz AJ. A comparison of observational studies and randomized, controlled trials. N Eng J Med 2000;342:1878–86.
Ellis J, Mulligan I, Rowe J, et al. Inpatient general medicine is evidence based. A-Team, Nuffield Department of Clinical Medicine. Lancet 1995;346:407–10.
Christou N, Sampalis J, Liberman M, et al. Surgery decreases long-term mortality, morbidity and health care use in morbidly obese patients. Ann Surg 2004;240:416–24.
Sjoström L, Lindroos AK, Peltonen M. Swedish obese subjects study group. Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683–93.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–52.
Stroh C, Manger T. Studie zur Qualitätskontrolle der operativen Therapie der Adipositas. Mitt Dtsch Ges Chir 2004;33:389–91.
Feinstein AR. Epidemiologic analyses of causation: the unlearned scientific lesson of randomised trials. J Clin Epidemiol 1989;42:481–89.
Sauerland S, Angrisani L, Belachew M, et al. Obesity surgery. Evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 2005;19:200–21.
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery. A systematic review and meta-analysis. JAMA 2004;14:1724–37.
Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1200 cases. J Am Coll Surg 2003;4:536–47.
Stroh C, Hohmann U, Schramm H, et al. Long term results after gastric banding. Zentralbl Chir 2005;130:410–8.
Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 2006;16:829–35.
Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326–51.
Chevallier JM, Zinzindohoue F, Douard R, et al. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1000 patients over 7 years. Obes Surg 2004;14:407–14.
Clinical Issues Committee of American Society for Metabolic and Bariatric Surgery. Sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis 2007;3(6):573–6.
Mognol P, Vignes S, Chosidow D, et al. Rhabdomyolysis after laparoscopic bariatric surgery. Obes Surg 2004;14:91–4.
Stroh C, Hohmann U, Remmler K, et al. Rhabdomyolysis after biliopancreatic diversion with duodenal switch. Obes Surg 2005;15:1347–51.
Villalobos-Torres G, Kimura E, Mosqueda J, et al. Pressure-induced rhabdomyolysis after bariatric surgery. Obes Surg 2003;13:297–301.
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We thank all colleagues from the participating clinics and hospitals for their active support.
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Stroh, C., Birk, D., Flade-Kuthe, R. et al. A Nationwide Survey on Bariatric Surgery in Germany—Results 2005–2007. OBES SURG 19, 105–112 (2009). https://doi.org/10.1007/s11695-008-9736-z
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DOI: https://doi.org/10.1007/s11695-008-9736-z