Faculty Collaboration Database

The Risk of Post-operative Complications in Super-Super Obesity Compared to Super Obesity in Accredited Bariatric Surgery Centers. Obes Surg 2019 Sep;29(9):2964-2971

Date

05/28/2019

Pubmed ID

31134478

DOI

10.1007/s11695-019-03942-0

Scopus ID

2-s2.0-85071710606 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

BACKGROUND: The prevalence of super obesity (SO, BMI > 50.0 kg/m²) and super-super obesity (SSO, BMI > 60 kg/m²) is increasing. Current data are limited and discrepant on the relationship between SSO and post-bariatric surgery complication risk. We hypothesized there would be increased complications for both laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) in SSO compared to SO, but the relative risk (RR) would support the use of LSG in SSO patients.

METHODS: Metabolic and Bariatric Surgery Accreditation and Quality Improvement 2016 data were queried for SO and SSO patients undergoing LRYGB or LSG. Thirty-day post-operative complications were calculated. Univariate analyses were performed with a χ² or Student's t test. Comparisons between multiple groups were performed using a one-way ANOVA. Statistical significance was defined as p < 0.05.

RESULTS: A total of 5723 patients with SSO and 24,940 with SO were included for analysis. Patients with SSO had more co-morbidities. Patients with SSO had a higher likelihood of complications compared to SO patients (15.2% vs 12.6%, p < 0.0005). SSO patients, and specifically SSO RYGB, were significantly more likely to experience an unplanned intubation, prolonged ventilation, and unplanned ICU admission. Compared to SO LRYGB, the RR for complications in SSO LRYGB and LGS were 1.19 and 0.76 respectively (p < 0.0005).

DISCUSSION: We found SSO patients had increased 30-day post-operative complications after both LRYGB and LSG compared to SO patients. LSG may be the preferred procedure for this high-risk population.

Author List

Wilkinson KH, Helm M, Lak K, Higgins RM, Gould JC, Kindel TL

Authors

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Rana Higgins MD Associate Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Kathleen L. Lak MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Body Mass Index
Comorbidity
Female
Gastrectomy
Gastric Bypass
Humans
Laparoscopy
Male
Middle Aged
Obesity, Morbid
Postoperative Complications
Prevalence
Risk Factors
Treatment Outcome
Weight Loss