Results of bariatric surgery

OBJECTIVE: To present the results of bariatric surgery performed in our hos pital over the last ten years. DESIGN: Longitudinal, clinical intervention with obesity surgery. SUBJECTS: To date in our hospital we have performed bariatric surgery on 49 6 patients. Ninety-seven percent of them received a restrictive method and 3% a combined procedure. The mean age of our patients was 39 +/- 9y. The me an weight was 144 +/- 28 kg which corresponds to a mean BMI of 51 +/- 8 kg/ m(2). The gender distribution is 18% male and 82% female patients. MEASUREMENTS: Success of surgery with early and late complications, no labo ratory measurements. RESULTS: The early postoperative complications were the following: wound in fection 3%, lethality 1.2%, pleural infusion 0.7% and evisceration 0.5%. Th e important late complications were pouch dilatation and stomastenosis in 1 8% and staple line disruption in 11%. Slippage of the adjustable silicone g astric banding (ASGB) amounted to 5% and hernias emerged in 7% of patients. A migration and band infection occurred in 0.7%. Reoperations were necessa ry in 10% of the silastic ring vertical gastroplasty (SRVG) and in 39% of t he ASGB patients. Patients were followed up every two months in the first y ear and later, annually. Blood samples were taken after 25%, 50%, 75% and 1 00% loss of excess weight. To date, 91% of our patients have reached an exc ess weight loss of 25%. 71% lost half of their overweight and one third (32 %) were able to reduce it by 75%. 8% of our patients attained normal weight . CONCLUSIONS: For long term compliance and to avoid regain of weight, a clos e follow-up is necessary. We therefore offer special care which, in additio n to the postoperative surgical care, includes visits by dieticians, intern ists, psychologists as well as exercise therapy. Knowledge of morbid obesit y and skill in bariatric surgery are prior conditions to avoid complication s and for success in bariatric surgery.