JAMA article comparing surgeries

[Gracey 7]

I really wish I'd seen this article before having the crapband surgery! Just found this posted on OH...

sleep apnea).

Data Sources and Study Selection - Electronic literature search of MEDLINE, Current Contents, and the Cochrane Library databases plus manual reference checks of all articles on bariatric surgery published in the English language between 1990 and 2003. Two levels of screening were used on 2738 citations.

Data Extraction - A total of 136 fully extracted studies, which inluded 91 overlapping patient populations (kin studies), were included for a total of 22,094 patients. Nineteen percent of the patients were men and 72.6% were women, with a mean age of 39 years (range, 16-64 years). Sex was not reported for 1537 patients (8%). The baseline mean body mass index for 16 944 patients was 46.9 (range, 32.3-68.8).

Data Synthesis - A random effects model was used in the meta-analysis. The mean (95% confidence interval) percentage of excess weight loss was:

47.5% (40.7%-54.2%) for patients who underwent gastric banding;

61.6% (56.7%-66.5%), gastric bypass;

68.2% (61.5%-74.8%), gastroplasty (VSG); and

70.1% (66.3%-73.9%), biliopancreatic diversion or duodenal switch.

Operative mortality (</=30 days) in the extracted studies was 0.1% for the purely restrictive procedures, 0.5% for gastric bypass, and 1.1% for biliopancreatic diversion or duodenal switch.

Conclusions - Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery. A substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.