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P2
Surgery for Obesity and Related Diseases 3 (2007) 299 –344
POSTER SESSION 2007 P1.
GENDER DIFFERENCES IN OUTCOMES FOLLOWING HAND ASSISTED LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS SURGERY. Kevin Tymitz, MD; George Kerlakian, MD; Amy Engel, MA; Cyndy Bollmer, RN Good Samaritan Hospital, Cincinnati, OH Background: Male gender has been associated with a higher morbidity and mortality rate after bariatric surgery including laparoscopic and open procedures. This study, however, focused on hand assisted laparoscopic Roux-en-Y gastric bypass and morbidity and mortality among genders. Methods: Hand assisted laparoscopic Roux-en-Y gastric bypass operations (N⫽319) were evaluated from October 2003 to March 2006. Comparison between males (N⫽54) and females (N⫽265) were conducted using t-test or Fishers exact test and chi-square analysis. Results: Patients’ average age was 42.3 ⫾ 10.3 and the average BMI was 49.2 ⫾ 7.9 kg/m2. There was no significant difference between males and females in age or BMI. Males did have a significantly greater average weight than females (p⬍0.001), and were also significantly more likely to experience sleep apnea (p⫽0.006) and have heart disease (p⫽0.017). For operative risk factors, males had a significantly longer anesthesia time (p⫽0.003), operative time (p⫽0.027), and length of Roux limb (p⫽0.038). There was no significant difference between males and females on any hospital outcome. At six and 12 months post surgery there was no significant difference between males and females with any complication. Although BMI did not differ significantly, males continued to weigh significantly more than females and lost significantly more pounds than did females at both six and 12 months post-operation. Conclusion: Given their larger size and tendency to accumulate fat in the abdominal compartment that increases the technical difficulty of the procedure, males are historically associated with a higher morbidity and mortality following bariatric surgery. Based on the current study, however, there was no difference in outcome among genders following hand assisted laparoscopic Roux-en-Y gastric bypass. PII: S1550-7289(07)00242-0 P2.
BARIATRIC SURGERY IN ADOLESCENTS: AN HISTORIC CASE SERIES. Anita P Courcoulas, MD, MPH; Jessie K Eagleton; Anthony O Udekwu, MD1; Madelyn Fernstrom, PhD University of Pittsburgh Medical Center, Pittsburgh, PA; 1Geisinger Medical Center, Danville, PA
Background: The epidemic of morbid obesity is increasingly impacting the adolescent population. It is important to review past program experiences to demonstrate both weight and health improvement and to plan future prospective studies. Methods: We retrospectively reviewed our program data over 15 years (1992-2006) for all adolescents between the ages of 13 and 21. Those patients with severe obesity and a BMI ⬎ 35 kg/m2 underwent either vertical banded gastroplasty (VBG), early in the experience, or gastric bypass (GBP). Outcome measures included percent excess weight loss, complications, and long-term health evaluations. Results: Twenty-five adolescents (14 female, 11 male; 22 White, 3 Black) ranging in age from 16 to 21 years underwent bariatric surgery (19 GBP, 6 VBG; 10 open, 14 laparoscopic) during this period. Mean BMI was 53⫹13 kg/m2 (range 35-92). Two patients were lost to follow-up. Preoperative comorbid conditions included: 10 arthritis, 9 depression, 9 reflux, 6 hypertension, 5 sleep apnea, 5 hypercholesterolemia, 2 diabetes. Mean follow-up was 4 years with 48% excess weight lost and 83% of all documented comorbid conditions improved/resolved. There were no deaths or anastomotic leaks. Short-term complications included 2 wound infections in the open patients and 5 other minor problems. Major late complications included one small bowel obstruction requiring operation and 5 patients (4 VBGs) who regained more than 20% of their excess weight lost. Five female patients achieved successful pregnancies 3-11 years following surgery. Conclusion: Historic bariatric surgery data in adolescents demonstrates its safety and efficacy and highlights the need for systematic data collection and long-term follow up. PII: S1550-7289(07)00243-2 P3.
GASTRIC POUCH DILATION AFTER LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS. Patricio Fajnwaks, MD; Olga Tucker, MD; Tomas Escalante-Tattersfield, MD; Samuel Szomstein, MD; Raul J Rosenthal, MD Cleveland Clinic Florida, Weston, FL Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) achieves weight loss by restricted intake, and a degree of malabsorption. The creation of a small 15-30ml proximal pouch is key. We reviewed our series of LRYGB to evaluate the influence of pouch size and dilation, on outcome. Methods: A retrospective review of a prospectively maintained database was performed from January 2001 to October 2006 on all patients undergoing primary LRYGB. All primary LRYGB were performed from 2001-2003. Results: Of the1,763 primary procedures, 21 patients (1.1%) required revision for pouch dilation; mean age 38 (range 21-52)
1550-7289/07/$ – see front matter © 2007 American Society for Bariatric Surgery. All rights reserved.
POSTER SESSION 2007 P1.
GENDER DIFFERENCES IN OUTCOMES FOLLOWING HAND ASSISTED LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS SURGERY. Kevin Tymitz, MD; George Kerlakian, MD; Amy Engel, MA; Cyndy Bollmer, RN Good Samaritan Hospital, Cincinnati, OH Background: Male gender has been associated with a higher morbidity and mortality rate after bariatric surgery including laparoscopic and open procedures. This study, however, focused on hand assisted laparoscopic Roux-en-Y gastric bypass and morbidity and mortality among genders. Methods: Hand assisted laparoscopic Roux-en-Y gastric bypass operations (N⫽319) were evaluated from October 2003 to March 2006. Comparison between males (N⫽54) and females (N⫽265) were conducted using t-test or Fishers exact test and chi-square analysis. Results: Patients’ average age was 42.3 ⫾ 10.3 and the average BMI was 49.2 ⫾ 7.9 kg/m2. There was no significant difference between males and females in age or BMI. Males did have a significantly greater average weight than females (p⬍0.001), and were also significantly more likely to experience sleep apnea (p⫽0.006) and have heart disease (p⫽0.017). For operative risk factors, males had a significantly longer anesthesia time (p⫽0.003), operative time (p⫽0.027), and length of Roux limb (p⫽0.038). There was no significant difference between males and females on any hospital outcome. At six and 12 months post surgery there was no significant difference between males and females with any complication. Although BMI did not differ significantly, males continued to weigh significantly more than females and lost significantly more pounds than did females at both six and 12 months post-operation. Conclusion: Given their larger size and tendency to accumulate fat in the abdominal compartment that increases the technical difficulty of the procedure, males are historically associated with a higher morbidity and mortality following bariatric surgery. Based on the current study, however, there was no difference in outcome among genders following hand assisted laparoscopic Roux-en-Y gastric bypass. PII: S1550-7289(07)00242-0 P2.
BARIATRIC SURGERY IN ADOLESCENTS: AN HISTORIC CASE SERIES. Anita P Courcoulas, MD, MPH; Jessie K Eagleton; Anthony O Udekwu, MD1; Madelyn Fernstrom, PhD University of Pittsburgh Medical Center, Pittsburgh, PA; 1Geisinger Medical Center, Danville, PA
Background: The epidemic of morbid obesity is increasingly impacting the adolescent population. It is important to review past program experiences to demonstrate both weight and health improvement and to plan future prospective studies. Methods: We retrospectively reviewed our program data over 15 years (1992-2006) for all adolescents between the ages of 13 and 21. Those patients with severe obesity and a BMI ⬎ 35 kg/m2 underwent either vertical banded gastroplasty (VBG), early in the experience, or gastric bypass (GBP). Outcome measures included percent excess weight loss, complications, and long-term health evaluations. Results: Twenty-five adolescents (14 female, 11 male; 22 White, 3 Black) ranging in age from 16 to 21 years underwent bariatric surgery (19 GBP, 6 VBG; 10 open, 14 laparoscopic) during this period. Mean BMI was 53⫹13 kg/m2 (range 35-92). Two patients were lost to follow-up. Preoperative comorbid conditions included: 10 arthritis, 9 depression, 9 reflux, 6 hypertension, 5 sleep apnea, 5 hypercholesterolemia, 2 diabetes. Mean follow-up was 4 years with 48% excess weight lost and 83% of all documented comorbid conditions improved/resolved. There were no deaths or anastomotic leaks. Short-term complications included 2 wound infections in the open patients and 5 other minor problems. Major late complications included one small bowel obstruction requiring operation and 5 patients (4 VBGs) who regained more than 20% of their excess weight lost. Five female patients achieved successful pregnancies 3-11 years following surgery. Conclusion: Historic bariatric surgery data in adolescents demonstrates its safety and efficacy and highlights the need for systematic data collection and long-term follow up. PII: S1550-7289(07)00243-2 P3.
GASTRIC POUCH DILATION AFTER LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS. Patricio Fajnwaks, MD; Olga Tucker, MD; Tomas Escalante-Tattersfield, MD; Samuel Szomstein, MD; Raul J Rosenthal, MD Cleveland Clinic Florida, Weston, FL Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) achieves weight loss by restricted intake, and a degree of malabsorption. The creation of a small 15-30ml proximal pouch is key. We reviewed our series of LRYGB to evaluate the influence of pouch size and dilation, on outcome. Methods: A retrospective review of a prospectively maintained database was performed from January 2001 to October 2006 on all patients undergoing primary LRYGB. All primary LRYGB were performed from 2001-2003. Results: Of the1,763 primary procedures, 21 patients (1.1%) required revision for pouch dilation; mean age 38 (range 21-52)
1550-7289/07/$ – see front matter © 2007 American Society for Bariatric Surgery. All rights reserved.