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Therapeutic strategy for an obese patient
Evidence in bariatric surgery (part 1)
Evidence in bariatric surgery (part 2)
Major options in the treatment of obesity
Frequency, cost and social consequences of obesity
The connexion between overweight and mortality
The benefits of surgery in morbidly obese patients
Causes and mechanisms of obesity
Regulation of the appetite
Causes and mechanisms of obesity
Measuring obesity
Home > Generalities > The benefits of surgery in morbidly obese patients

The benefits of surgery in morbidly obese patients

[The benefits of surgery in morbidly obese patients]

Review of litterature: Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Christou NV, Sampalis JS, Liberman M, Look D, Auger S, Mac Lean APH, Mac Lean LD. Annals of Surgery 2004; 240: 416-424.

This very interesting papers deals with the hypothesis that weight-reduction induced by bariatric surgery is a strong factor of good results in terms of long-term mortality and health related diseases in morbidly obese patients.

The study includes two groups of patients (respectively 1035 et 5746 patients), the first one represented by patients having undergone bariatric surgery between 1986 and 2002 in a University Hospital in Montreal (Canada), the second one beeing a control-group of morbid obese patients (no surgery). The vast majority of procedures has been gastric bypass: 79% (through laparotomy= open procedure till 2002, then through the laparoscopic approach).
The group of operated patients achieved a 67% excess weight reduction. Defining success by a BMI of less than 35 in morbidly obese patients, 83% had a successful outcome after surgery. There was a significant difference between the two groups in developping cardiovascular, cancer, endocrine, infectious, psychiatric and mental disorders.The rate of subsequent hospitalizations was cut down by half in the surgical group. Associated health costs such as fees, drugs, etc. wre also reduced, which had been shown in previous studies. The mortality rate of the group I was 0,68% against 6,17% in group II, meaning a reduction of 89% in the relative risk of death. Unfortunately, long-term weight-reduction has not been evaluated in the control group, but the authors stressed the very poor results already available in the litterature in this regard...
This study is retrospective and corroborates the famous SOS (Swedish Obese Subjects), which is prospective but mixes several centers, whereas there were 4 surgeons involved in this study. Nevertheless the SOS study results are similar and demonstrate a long-term benefit of bariatric surgery as well.

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