Preoperative loss of >10% excess body weight in morbidly obese patients undergoing gastric bypass was associated with a higher likelihood of achieving 70% postoperative excess weight loss (P<0.001).
Cohort (n=884)
No
Does preoperative weight loss improve postoperative weight loss and reduce length of hospital stay in high-risk morbidly obese patients undergoing gastric bypass surgery?
Preoperative weight loss of 5% to 10% of excess body weight in high-risk morbidly obese patients is associated with shorter hospital stays and greater postoperative weight loss.
p-value: p=<.001
HYPOTHESIS: Modest, preoperative weight loss will improve perioperative outcomes among high-risk, morbidly obese patients undergoing Roux-en-Y gastric bypass. DESIGN: A prospective, longitudinal assessment of characteristics and outcomes of gastric bypass patients. SETTING: All patients undergoing open or laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity or its comorbid medical problems at Geisinger Medical Center in Danville, Pennsylvania, during a 3-year period from May 31, 2002, to February 24, 2006, were included in this analysis. Patients were required to participate in a standardized multidisciplinary preoperative program that encompasses medical, psychological, nutritional, and surgical interventions and education. In addition, patients were encouraged to achieve a 10% loss of excess body weight prior to surgical intervention. RESULTS: Of the 884 subjects, 425 (48%) lost more than 10% of their excess body weight prior to the operation. After surgery (mean follow-up, 12 months), this group was more likely to achieve 70% loss of excess body weight (P < .001). Those who lost more than 5% of excess body weight prior to surgery were statistically less likely to have a length of stay of greater than 4 days (P = .03). CONCLUSIONS: This study shows that high-risk morbidly obese candidates for bariatric surgery who are able to achieve a loss of 5% to 10% excess body weight prior to surgery have a higher probability of a shorter length of hospital stay and more rapid postoperative weight loss.
Christopher D. Still (2007) conducted a cohort in Morbid obesity (n=884). Preoperative weight loss (>10% or >5% excess body weight) vs. Patients who did not achieve the specified preoperative weight loss was evaluated on Achieving 70% loss of excess body weight after surgery (p=<.001). Preoperative loss of >10% excess body weight in morbidly obese patients undergoing gastric bypass was associated with a higher likelihood of achieving 70% postoperative excess weight loss (P<0.001).