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Roux Limb Length in Roux-en-Y Gastric Bypass for Super-Obese

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Does Extended Roux Limb Length in Laparoscopic Roux-en-Y Gastric Bypass Help Super-Obese Patients to Lose More Weight

Increasing the length of the Roux limb in open Roux-en-Y gastric bypass (RYGB) effectively increases excess weight loss in superobese patients with a body mass index (BMI) >50 kg/m(2). Extending the RYGB limb length for obese patients with a BMI < 50 could produce similar results. The purpose of this study was to compare the outcomes of superobese patients undergoing laparoscopic Roux-en-Y gastric bypass with standard (</=100-cm) with those undergoing the procedure with an extended (150-cm) Roux limb length over 1-year period of follow-up.

Method

Retrospective data over 2.5 years were reviewed to identify patients with a BMI < 50 who underwent primary laparoscopic RYGB with 1-year follow-up. Forty-five patients (sRYGB group) received limb lengths </= 100 cm, including 45 cm, 50 cm, 60 cm, 65 cm, 70 cm, 75 cm, and 100 cm. Thirteen patients (eRYGB group) received 150-cm limbs. Postoperative weight loss was compared at 3 weeks, 3 months, 6 months, and 1 year.

Results

Comparing the sRYGB vs the eRYGB group (average +/- SD), respectively: There were no significant differences in age, preoperative weight, BMI, operative time, estimated blood loss or length of stay (median, 3 days). Body weight decreased over time in both groups, except in the sRYGB group between 3 and 6 months and 6 and 12 months after surgery and in the eRYGB group between 6 and 12 months. BMI also decreased over time, except in the eRYGB group between 6 and 12 months. Absolute weight loss leveled out between 6 and 12 months in both groups, with no increase after 6 months. Percent of excess weight loss did not increase in the eRYGB group after 6 months. An extended Roux limb did not significantly affect body weight, BMI, absolute weight loss, or precent of excess weight loss at any time point when the two groups were compared. A trend toward an increased proportion of patients with >50% excess weight loss was observed in the extended Roux limb group.

Conclusion

In this series, no difference in weight loss outcome variables were observed up to 1 year after laparoscopic Roux-en-Y gastric bypass. Thus, extending Roux limb length from </=100 cm to 150 cm did not significantly improve weight loss outcome in patients with a BMI < 50 kg/m(2).

Source:
Feng JJ, Gagner M, Pomp A, Korgaonkar NM, Jacob BP, Chu CA, Voellinger DC, Quinn T, Herron DM, Inabnet WB. Minimally Invasive Surgery Center, Department of Surgery, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1103, 5 East 98th Street, New York, NY 10029-6574, USA.
National Library of Medicine 2003

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources