Experiencia en cirugía bariátrica en un hospital regional

Abstract

Background: Surgery is the most effective treatment in the long run, for morbid obesity. Aim: To report the results of open bariatric surgery for morbid obesity in a regional public hospital. Material and methods: Prospective study of the first 100 patients aged 14 to 62 years (84% women) undergoing bariatric surgery in Coquimbo hospital between September 1998 and December 2005. A Horizontal Gastroplasty without gastric resection was done in 13 patients, a 6/7 Gastrectomy in 58 and a 9/10 Gastrectomy in 29. A gastric bypass with Roux-en-Y anastomosis with a 160 cm long loop, was always performed. Results: Preoperative body mass index (BMI) was 46 kg/m2. Twenty nine percent had a BMI over 50 kg/m2. The average postoperative hospital stay was 7.6 days. Five percent had early complications. No patients died. The average excess weight loss at 6 months, one and three years after surgery was 60, 72 and 66% respectively. Patients subjected to a gastric resection had a higher percentage of excess weight loss than gastroplasty after 1 year (p <0.01). After 3 years, the greatest excess weight loss was seen in patients with a BMI below 50 kg/m2 subjected to Gastrectomy. The smaller excess weight loss was observed in patients with a BMI over 50 kg/m2 subjected to Gastroplasty. After 6 months and 1 year, patients undergoing larger Gastrectomies (9/10) had a significantly greater percentage weight loss than those subjected to smaller resections (6/7). Conclusions: These results obtained in a public hospital surgery service with bariatric procedures are comparable with those of national and international studies, both in terms of weight loss and complications.