Safety and efficacy of bariatric surgery in Mexico: A detailed analysis of 500 surgeries performed at a high-volume center

Introduction and objectives: Bariatric surgery is the best method for treating obesity and its comorbidities. Our aim was to provide a detailed analysis of the perioperative outcomes in Mexican patients that underwent surgery at a high-volume hospital center. Materials and methods: A retrospective s...

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Bibliographic Details
Main Authors: L. Guilbert, P. Joo, C. Ortiz, E. Sepúlveda, F. Alabi, A. León, T. Piña, C. Zerrweck
Format: Article
Language:English
Published: Elsevier 2019-07-01
Series:Revista de Gastroenterología de México (English Edition)
Online Access:http://www.sciencedirect.com/science/article/pii/S2255534X18301221
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Summary:Introduction and objectives: Bariatric surgery is the best method for treating obesity and its comorbidities. Our aim was to provide a detailed analysis of the perioperative outcomes in Mexican patients that underwent surgery at a high-volume hospital center. Materials and methods: A retrospective study was conducted on all the patients that underwent bariatric surgery at a single hospital center within a time frame of 4 and one-half years. Demographics, the perioperative variables, complications (early and late), weight loss, failure, and type 2 diabetes mellitus remission were all analyzed. Results: Five hundred patients were included in the study, 83.2% of whom were women. Mean patient age was 38.8 years and BMI was 44.1 kg/m2. The most common comorbidities were high blood pressure, dyslipidemia, and diabetes. Laparoscopic gastric bypass surgery was performed in 85.8% of the patients, sleeve gastrectomy in 13%, and revision surgeries in 1%. There were 9.8% early complications and 12.2% late ones, with no deaths. Overall weight loss as the excess weight loss percentage at 12 and 24 months was 76.9 and 77.6%. The greatest weight loss at 12 months was seen in the patients that underwent laparoscopic gastric bypass. A total of 11.4% of the patients had treatment failure. In the patients with type 2 diabetes mellitus, 68.7% presented with complete disease remission and 9.3% with partial remission. There was improvement in 21.8% of the cases. Conclusions: In our experience at a high-volume hospital center, bariatric surgery is safe and effective, based on the low number of adverse effects and consequent weight loss and type 2 diabetes mellitus control. Long-term studies with a larger number of patients are needed to determine the final impact of those procedures. Resumen: Introducción y objetivos: La cirugía bariátrica es el mejor método contra la obesidad y sus comorbilidades. El objetivo fue analizar detalladamente los resultados perioperatorios y la evolución de pacientes latinos sometidos a cirugía en un centro de alto volumen. Material y métodos: Estudio retrospectivo, con todos los pacientes sometidos a cirugía bariátrica en un solo centro, durante 4 años y medio. Se realizó análisis demográfico, perioperatorio, de complicaciones (tempranas y tardías), pérdida de peso, falla y remisión de diabetes mellitus tipo 2. Resultados: Se incluyeron 500 pacientes, un 83.2% mujeres, con edad media de 38.8 años e IMC de 44.1 kg/m2. Las comorbilidades mayormente observadas fueron hipertensión, dislipidemia y diabetes. Se realizó bypass gástrico laparoscópico en el 85.8%, manga gástrica en el 13% y cirugía revisional en el 1%. Hubo un 9.8% de complicaciones tempranas y un 12.2% de tardías, sin mortalidad. La pérdida de peso global en porcentaje de exceso de peso perdido a 12 y 24 meses fue del 76.9% y 77.6%; el BPGL tuvo mayor pérdida de peso a los 12 meses. La falla al tratamiento fue del 11.4%. En los pacientes con DM2 existió remisión completa en el 68.7%, remisión parcial en el 9.3% y una mejoría en el 21.8% de los casos. Conclusiones: En nuestra experiencia como centro de alto volumen, la cirugía bariátrica es segura y efectiva basada en el bajo número de efectos adversos, y la pérdida de peso con control de la DM2. Estudios a largo plazo y con un mayor número de pacientes son necesarios para determinar el impacto final de dichos procedimientos. Keywords: Bariatric surgery, Laparoscopic gastric bypass, Laparoscopic sleeve gastrectomy, Complications, Diabetes remission, Obesity surgery, Palabras clave: Cirugía bariátrica, Bypass gástrico laparoscópico, Manga gástrica laparoscópica, Complicaciones, Remisión de diabetes, Cirugía de obesidad
ISSN:2255-534X