Laparoscopic Roux-en-Y gastric bypass: results and learning curve of a high-volume academic program.
Arch Surg
; 140(4): 362-7, 2005 Apr.
Article
em En
| MEDLINE
| ID: mdl-15837887
ABSTRACT
HYPOTHESIS:
Laparoscopic Roux-en-Y gastric bypass is a complex procedure performed on a high-risk patient population. Good results can be attained with experience and volume.DESIGN:
Retrospective study.SETTING:
Tertiary care academic hospital. PATIENTS Seven hundred fifty consecutive morbidly obese patients undergoing surgery from March 1998 to April 2004.INTERVENTIONS:
All patients underwent laparoscopic Roux-en-Y gastric bypass. MAIN OUTCOMEMEASURES:
Perioperative deaths and complications.RESULTS:
The patient population was 85% women and had a mean body mass index of 47 kg/m2 (range, 32-86 kg/m2). The overall complication rate was 15% and the mortality was 0.3%. For the first 100 cases, the overall complication rate was 26% with a mortality of 1%. This complication rate decreased to approximately 13% and was stable for the next 650 patients. The incidence of major complications has also decreased since the first 100 cases. Leak decreased from 3% to 1.1%. Small-bowel obstruction decreased from 5% to 1.1%. Overall mean operating time was 138 minutes (range, 65-310 minutes). It decreased from 212 minutes for the first 100 cases to 132 minutes for the next 650 and 105 minutes (range, 65-200 minutes) for the last 100 cases.CONCLUSIONS:
Laparoscopic Roux-en-Y gastric bypass is a technically difficult operation. This review of a large series in a high-volume program demonstrated that the morbidity and mortality could be reduced by 50% with experience. The results are similar to those reported from other major centers. In addition, as reported elsewhere, the learning curve for this procedure may be 100 cases.
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Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Anastomose em-Y de Roux
/
Derivação Gástrica
/
Laparoscopia
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article