RT Journal
A1 Turner PL
T1 Slimming down for safer surgery: Comment on “preoperative weight loss before bariatric surgery”
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD December 21
VO 144
IS 12
SP 1155
OP 1156
DO 10.1001/archsurg.2009.214
UL http://dx.doi.org/10.1001/archsurg.2009.214
AB 
Morbid obesity is a significant health problem for which bariatric surgery has been demonstrated to be the most effective and durable treatment. This surgery reduces excess body weight and improves comorbidities, satisfaction, and quality of life. The number of weight-loss operations performed yearly continues to escalate, and previously held limitations on patient selection—age, BMI, and presence of preoperative disease—are now being reconsidered because of the significant health benefits conferred by successful weight loss and treatment of the metabolic syndrome. Strategies to further improve outcomes after bariatric surgery are, therefore, of significant interest, because there is often less room for adverse events with morbidly obese patients than in patients with fewer comorbidities or those of healthy weight. Postoperative complications in the former population can be particularly difficult to manage and deadly. The authors retrospectively review data from hundreds of consecutive patients who had undergone an open or laparoscopic weight-loss procedure and demonstrate that complications can be reduced with aggressive preoperative weight loss.