TY  - JOUR
T1  - PReoperative weight loss before bariatric surgery
AU  - Benotti PN, Still CD, Wood G, et al
Y1  - 2009/12/21
N1  - 10.1001/archsurg.2009.209
JO  - Archives of Surgery
SP  - 1150
EP  - 1155
VL  - 144
IS  - 12
N2  - Hypothesis 
    Preoperative weight loss reduces the frequency of surgical complications in patients undergoing bariatric surgery.Design 
    Review of records of patients undergoing open or laparoscopic gastric bypass.Setting 
    A comprehensive, multidisciplinary obesity treatment center at a tertiary referral center that serves central Pennsylvania.Patients 
    A total of 881 patients undergoing open or laparoscopic gastric bypass from May 31, 2002, through February 24, 2006.Intervention 
    All preoperative patients completed a 6-month multidisciplinary program that encouraged a 10% preoperative weight loss.Main Outcome Measures 
    Loss of excess body weight (EBW) and total and major complication rates.Results 
    Of the 881 patients, 592 (67.2%) lost 5% or more EBW and 423 (48.0%) lost more than 10% EBW. Patients referred for open gastric bypass (n = 466) were generally older (P < .001), had a higher body mass index (P < .001), and were more often men (P < .001) than those undergoing laparoscopic gastric bypass (n = 415). Total and major complication rates were higher in patients undergoing open gastric bypass (P < .001 and P = .03, respectively). Univariate analysis revealed that increasing preoperative weight loss is associated with reduced complication frequencies for the entire group for total complications (P =.004) and most likely for major complications (P = .06). Controlling for age, sex, baseline body mass index, and type of surgery in a multiple logistic regression model, increased preoperative weight loss was a predictor of reduced complications for any (P =.004) and major (P = .03) complications.Conclusion 
    Preoperative weight loss is associated with fewer complications after gastric bypass surgery.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2009.209
UR  - http://dx.doi.org/10.1001/archsurg.2009.209
ER  -