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Obesity: gastric surgery complications

Gastric surgery to treat morbid obesity involves risks and complications that should be discussed in detail with patients.

Morbid obesity is defin7ed as having a body mass index (BMI) above 40 kg/m² (weight in kilos divided by the square of the height in metres). It is associated with a high risk of diabetes, lipidic disorders (dyslipidaemia), cardiovascular and osteoarticular disorders, etc.

The July issue of la revue Prescrire reviews gastric surgery for morbid obesity and its complications, following the publication of French data which confirms the main international evidence examined by la revue.

In France, some 10,000 operations take place each year, 95% of which are to reduce stomach size, most often with a gastric ring. The level of complications such as organ wounds, stomach perforations, anaesthesia-related events and hospital-related infection is around 5%, with a 0.2% mortality rate.

In the longer term, nearly 65% of patients suffer adverse effects or complications, in particular gastrointestinal disorders, complications affecting the abdominal wall or associated with the surgical technique.

Around 7% of patients undergo a second digestive operation during the first year, most often for a complication. Short and long-term mortality rises with the age of the patient. There is little data available for periods of over one year after surgery.

Gastric surgery for obesity is an option in cases of morbid obesity, but it involves risks that should be carefully weighed up for patients who need close monitoring, especially with regard to diet.

©Prescrire July 2007

Source: "Chirurgie gastrique de l’obésité : des complications" Rev Prescrire 2007 ; 27 (285) : 513-515.

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