Impartial long-term review of vertical banded gastroplasty in a low volumecommunity hospital practice

Background: There is some concern whether bariatric surgery can be done wel l at low volumes or in a community hospital setting. This paper reports an impartial assessment of 25 vertical banded gastroplasties (VBG) over 13 yea rs in a 228-bed nonteaching community hospital. Methods: Charts were reviewed and patients interviewed by an independent in vestigator. Complications, weight loss, satisfaction and quality of life we re assessed. Results: There were no fatalities, no splenic tears, no stomal stenosis and no symptomatic gastroesophageal reflux. Two reoperations and five incision al hernias were noted. Hypertension was eliminated in 57% and dyspnea in 55 %. BMI fell from 44.3 to 34.9 kg/m(2) after 6.2 years. BMI decreased more t han 10 kg/m(2) (10-30) for 15 patients and less than 10 kg/m(2) for 10 pati ents (4-10 for 7, 0 for 1 and a gain for 2). 56% of patients were fully sat isfied with the results. Quality of life indicated excellent physical funct ion, physical role and lack of body pain, good general health, social funct ion, emotional role and mental health, but lower vitality. 100% felt better than a year ago. Conclusion: Results from a low-volume community hospital general surgical p ractice are similar to those from specialized series. Obesity is so common, its non-surgical treatment so ineffective and the VBG so well established, that excluding this intervention from community hospitals is untenable.