Anzeige
Erschienen in:
01.02.2008 | Research Article
Outcome of Duodenal Switch with a Transitory Vertical Gastroplasty, in Super-Super-Obese Patients in an 8-Year Series
Erschienen in: Obesity Surgery | Ausgabe 2/2008
Einloggen, um Zugang zu erhaltenAbstract
Background
In super-super obese (SSO) patients [body mass index (BMI) superior of 60 kg/m2] results of bariatric surgery are still controversial. This study evaluated safety and efficacy of open duodenal switch associated with transitory vertical gastroplasty (DS-TVG) after 8 years of follow-up.
Methods
A prospective observational study of 32 SSO patients who underwent an open DS-TVG from January 1999 till March 2006 was performed. Study endpoints included preoperative comorbidities [diabetes, hypertension, and obstructive sleep apnea syndrome (OSAS)], postoperative morbidity and mortality, and long-term results of BMI and percent of excess weight loss (%EWL) (median 48 months).
Results
Results in terms of BMI and %EWL were, respectively, after 12 months, 46.3 ± 10.2 and 57.1 ± 9.8; after 36 months (n = 21), 37.5 ± 7.5 and 73.5 ± 6.2; and after 84 months (n = 5), 31.7 ± 2.8 and 76.0 ± 4.1. With regard to comorbidities, we observed complete control of lipid alterations and type-2 diabetes (suspension therapy within 1 year). All patients with OSAS improved within 1 year without needing domiciliary oxygen therapy. Neither malnutrition nor mortality was observed during the follow-up. Major complications occurred in a total of 5 patients (15.6%): pulmonary embolism (2 cases—9.4%); gastrointestinal bleeding, requiring transfusions (1 case—3.1%); 1 case (3.1%) of abdominal rupture; and 1 case of acute pancreatitis (3.1%). Minor complications occurred in 4 patients (12.5%): 1 case of pneumonia, 1 urinary tract infection, and 2 wound infections.
Conclusion
Although this study evaluated the outcomes of a small series of patients after open DS-TVG, this procedure seems to be safe and effective in obese patients who have a BMI greater than 60 kg/m2. In our opinion, DS-TVG should be considered as a valid surgical option with two staged laparoscopic procedures.