Weight-loss surgery generally safe: US audit

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Operations intended to help very overweight people shed unhealthy pounds—termed bariatric surgery—carry a low risk of death when they’re performed at high-volume academic medical centers, according to a new review.

“We found that the 30-day mortality was less than 0.5 percent (1 in every 200 patients), which is considered an acceptable mortality rate as reported from many single institutional series,” said Dr. Ninh T. Nguyen from the University of California-Irvine Medical Center in Orange.

“Bariatric surgery can be performed with low morbidity and mortality at specialized centers; however, the safety of bariatric surgery at the national level have been questioned,” Nguyen explained. 

The current review covered 1144 cases performed at 29 institutions. “The important message from our study is that bariatric surgery for the treatment of morbid obesity is safe at the national level,” the surgeon said.

Nguyen and his colleagues reviewed weight-loss surgeries performed between October 1, 2003 and March 31, 2004 in subjects between 17 and 65 years of age with a body mass index of 35 to 70. A BMI of 30 to 34 is classified as overweight, and 35 and up is considered obese.

Gastric bypass surgery made up 92 percent of the surgeries, while stomach-restricting procedures (mainly gastric banding) made up the remainder.

Among gastric bypass patients, four deaths (0.4 percent) occurred within 30 days of surgery. The complication rate was 16 percent, and the 30-day readmission rate was 7 percent.

Among restrictive surgery patients, there were no deaths at 30 days. The complication rate was 3 percent, and the 30-day readmission rate was 4 percent, according to the report, published in the Archives of Surgery.

“There are many reasons why I think bariatric surgery is safe,” Nguyen told Reuters Health.

“The majority of bariatric operations are now being performed laparoscopically and most surgeons have overcome the learning curve of the laparoscopic technique, and many young surgeons are now taking an additional year of training (fellowship) to learn this specialized specialty,” he explained.

Also, “there are now certifying bodies that have developed criteria qualifying centers that are performing bariatric surgery to become centers of excellence,” Nguyen noted.

SOURCE: Archives of Surgery, May 2006.

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