Tratamiento quirúrgico de la obesidad mórbida
- Díez-del-Val, I.
- Martínez-Blázquez, C.
- Sierra-Esteban, V.
- Vitores-López, J.M.
- Valencia-Cortejoso, J.
ISSN: 0304-4858, 2173-2302
Year of publication: 2005
Volume: 102
Issue: 1
Pages: 3-9
Type: Article
More publications in: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios
Sustainable development goals
Abstract
Surgery for morbid obesity represents the only possibility of success in the long term once conservative treatment has failed.We present the results of our experience, based on 559 operations in 507 patients, between April 1996 and November 2003.As a purely restrictive procedure, vertical bamded gatroplasty was abandoned due to inadequate results in weight loss and repetitivevomiting interfering with oral intake and social life. Forty out of 80 patients were converted to another procedure.Roux-en-Y gastric bypass is currently our technique of choise, with limp lenghts tailored to the body mass index (BMI). As a primaryprocedure, including 234 cases by the open approach and 186 by laparoscopy, we had a mortality rate of 0.5% and 8.8% of mayorcomplications, mainly haemorrhages (4.8%) and anastomotic leaks (1.7%).With laparoscopic gastric bypass, incisional hernias have decreased from 31% to 0.5%. The mean excess weight loss (EWL) after 4 years is71%. Considering the usual criteria of success, 85% of patients remain over 50% EWL and 79% reach a BMI lower than 35 kg/m2. Bothquality of life and comorbidities associated with morbid obesity improve signiflicantly.