Guest guest Posted December 23, 2003 Report Share Posted December 23, 2003 Dear and Trena, I went to CNN.com and found these two articles about gastric bypass. Neither one says 1 in 50 have complications. Though the percentage used to be 1 in 200, apparently now the ASBS is stating it is 1 in 100. Still, they say, some people die just waiting for the surgery from the complications of their obesity. I would think, if they had actual statistics on that, the mortality rate would be much, much higher than 1 in 100. Anyway, I found these two articles very interesting: ------------------------------------ More obese choose stomach stapling: Number of procedures nearly quadruple in 5 years Monday, December 1, 2003 Posted: 12:05 PM EST (1705 GMT) BOSTON, Massachusetts (AP) -- Ken Powers knew the potential dangers of having his stomach stapled, but to a man who had tipped the scales at 475 pounds, those risks didn't much matter. " I had this thought: If I die on the operating table, having the surgery to try to better my life, I thought it was a better thing to do than to live the way I was living, which, in my opinion, I was kind of waiting to die anyway, " he said. By the tens of thousands, morbidly obese people who have failed at diets, support groups and exercise programs are turning to surgery to lose weight. In 1998, there were 25,800 obesity-related operations, most of them gastric-bypass procedures commonly known as stomach stapling. This year, the American Society for Bariatric Surgery estimates 103,200 operations. Questions about the risks and growing use of the procedures surfaced in recent weeks after two patients in New England died during stomach-stapling surgeries. However, obesity specialists say the procedure is safer than it has ever been -- and that is contributing to the growing popularity. And for most patients, the risk of not having the surgery is greater. " It's an operation that helps cure people of this disease which is life-threatening. People see it as some type of cosmetic surgery, when it's not. More patients die waiting for surgery than die after surgery, " said Dr. Janey Pratt, a surgeon at the Massachusetts General Hospital Weight Center in Boston, which does about 300 gastric bypasses a year. The operation involves using staples or stitches to close off part of the stomach to form a small pouch about the size of an egg, which limits how much food the person can eat. A part of the small intestine also is bypassed to reduce nutrient absorption. Risks include wound infections, stomach leaks and occasionally life-threatening blood clots. The International Bariatric Surgery Registry estimates one in 1,000 patients will die within four weeks of the surgery, and three in 1,000 will die within three months. Some surgeons in the field put the fatality rate as high as one in 100 who have the surgery. Not for just a few extra pounds Powers, 42, of Worcester, was lucky. Even carrying more than 400 pounds on his 5-foot-11 frame, he had not developed many of the common ailments associated with obesity. Still, sleep was fitful, and walking, particularly upstairs, was exhausting. And he lived in a fourth-floor apartment. Powers underwent laparoscopic gastric bypass surgery in May 2001 and now weighs 280 pounds. He believes the surgery likely staved off the onset of diabetes, and he has had no complications. Surgery is not used to treat minor obesity. Candidates must be 100 pounds above their ideal body weight and have failed at other attempts at weight loss. Still, an estimated 15 million people would qualify for the surgery, said Dr. Shikora, head of bariatric surgery at Tufts-New England Medical Center in Boston. Tufts, which has the city's largest obesity surgery program, closed to new patients for nearly six months earlier this year to catch up with its backlog of patients. At one point, there was a waiting list of 500 patients, Shikora said. " It's no longer considered snake oil or some out there treatment that doesn't work, " Shikora said. Many insurance carriers have started to cover the procedures, finding it cheaper to pay for the surgery than treating obesity-related health problems such as diabetes and high blood pressure. Companies continue to feel pressure to cover more obesity surgeries, but are cautious because of the risks, said Pisano, spokeswoman for the combined American Association of Health Plans, Health Insurance Association of America. " When we do read about people who do have complications, I think that only serves to reinforce the caution, " she said. Powers agrees. He worries that the growing popularity and the success of celebrities such as NBC " Today " weatherman Al Roker and singer Carnie may make it look like a simple, convenient option, especially for young people. " I don't think you see all the pain involved. You see the finished product, " he said. " Carnie looks great and Al Roker looks like a million bucks, but you don't see the post-op stuff. You eat half an English muffin and you throw up. There's certain foods it takes you a year to eat again. It's not a diet. You have to be ready to abandon the way that you've lived with food for the rest of your life. " ------------------------------------------------------------------------ - Surgical treatments for obesity May 4, 1999 Web posted at: 12:15 p.m. EDT (1615 GMT) (WebMD) -- The history of surgical treatments for obesity includes numerous techniques quickly adopted and then rapidly abandoned after evidence proved them ineffective or harmful. Today, three operations are considered fairly effective and safe treatments for obesity: Gastric bypass Vertical-banded gastroplasty Kuzmak's adjustable silastic banding All three procedures are considered reasonably safe and have produced significant post-surgery weight loss. They can be performed with less than a 1 percent chance of surgery-related death in low-risk patients (those without concurrent health conditions, such as hypertension and diabetes) and less than 2 percent chance in high-risk patients. The goal of these surgeries is to reduce the stomach reservoir, which creates a sense of fullness from a smaller volume of food. When do obese people qualify for surgical intervention? When their body mass index (BMI) is 40 or greater. When their BMI is 35 or greater and they suffer from an obesity-related condition, such as diabetes or hypertension. Gastric bypass Gastric bypass surgery is becoming the procedure of choice for weight-loss surgeons, partly because of its results. Of 608 patients, the average weight fell from 304.4 pounds to 204.7 pounds over 14 years after this surgery, according to one study. Most of this weight loss occurred the first year. Gastric bypass surgery uses staples to create a small pouch out of the upper portion of the stomach and attaches a part of the large intestine to the pouch. Unlike the other two techniques, this procedure reduces the amount of calories absorbed by the body through " bypassing " the first portion of the intestine. After eating the equivalent of half a hamburger, the person with the small pouch stomach would feel full. Bypassing the first part of the intestine can lead to poor absorption of nutrients and vitamins. " Dumping " -- diarrhea caused by the insufficient absorption of fluid from the intestine -- is common and occurs in 70.6 percent of these patients. Vitamin supplements are recommended for patients who have this surgery. Vertical-banded gastroplasty With vertical-banded gastroplasty, food passes through the intestines normally but the stomach's flow is restricted. The procedure uses staples to create a small pouch from the stomach's upper portion. A mesh ring encloses the stomach's middle part so that food must pass through a 5-centimeter opening to reach the stomach's lower portion. Recent studies four years after surgery indicate that 36 percent of patients require repeat surgery either because of an excessive narrowing of the opening or a failure to lose weight. Overall weight loss after vertical banded gastroplasty is 10 to 15 percent less than the loss after gastric bypass surgery. Kuzmak adjustable silastic band The Kuzmak adjustable silastic band is another restrictive technique that uses an inflatable ring around the stomach to reduce the stomach's size and limit food intake. Unlike the other two surgeries, this procedure can be performed with the aid of laparoscopy, a visual/video aid that allows surgeons to see the patient's internal cavity. Laparoscopic surgery is less invasive than other kinds of abdominal surgery. One study showed that 76 percent of patients experienced vomiting after having the procedure. The average weight loss after Kuzmak adjustable silastic band surgery is 10 to 15 percent less than the loss after gastric bypass surgery. Ask your doctor Of the three, no single procedure stands out as significantly better than the others. Your doctor can discuss the pros and cons of each type of surgery. The choice, as with all surgeries, should be based on the patient's individual needs. Copyright 1999 by WebMD, Inc. All rights reserved. live each day like it's your last... love like you've never been hurt... Deb in Hazlet, NJ " Debbie Dancer " distal rny September 3, 2002 386/212/165 BMI 60/31/24 -174 -92.5 " Angel to Bill, Debbie, Ilene, Roy, and Ro Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2003 Report Share Posted December 23, 2003 Dear and Trena, I went to CNN.com and found these two articles about gastric bypass. Neither one says 1 in 50 have complications. Though the percentage used to be 1 in 200, apparently now the ASBS is stating it is 1 in 100. Still, they say, some people die just waiting for the surgery from the complications of their obesity. I would think, if they had actual statistics on that, the mortality rate would be much, much higher than 1 in 100. Anyway, I found these two articles very interesting: ------------------------------------ More obese choose stomach stapling: Number of procedures nearly quadruple in 5 years Monday, December 1, 2003 Posted: 12:05 PM EST (1705 GMT) BOSTON, Massachusetts (AP) -- Ken Powers knew the potential dangers of having his stomach stapled, but to a man who had tipped the scales at 475 pounds, those risks didn't much matter. " I had this thought: If I die on the operating table, having the surgery to try to better my life, I thought it was a better thing to do than to live the way I was living, which, in my opinion, I was kind of waiting to die anyway, " he said. By the tens of thousands, morbidly obese people who have failed at diets, support groups and exercise programs are turning to surgery to lose weight. In 1998, there were 25,800 obesity-related operations, most of them gastric-bypass procedures commonly known as stomach stapling. This year, the American Society for Bariatric Surgery estimates 103,200 operations. Questions about the risks and growing use of the procedures surfaced in recent weeks after two patients in New England died during stomach-stapling surgeries. However, obesity specialists say the procedure is safer than it has ever been -- and that is contributing to the growing popularity. And for most patients, the risk of not having the surgery is greater. " It's an operation that helps cure people of this disease which is life-threatening. People see it as some type of cosmetic surgery, when it's not. More patients die waiting for surgery than die after surgery, " said Dr. Janey Pratt, a surgeon at the Massachusetts General Hospital Weight Center in Boston, which does about 300 gastric bypasses a year. The operation involves using staples or stitches to close off part of the stomach to form a small pouch about the size of an egg, which limits how much food the person can eat. A part of the small intestine also is bypassed to reduce nutrient absorption. Risks include wound infections, stomach leaks and occasionally life-threatening blood clots. The International Bariatric Surgery Registry estimates one in 1,000 patients will die within four weeks of the surgery, and three in 1,000 will die within three months. Some surgeons in the field put the fatality rate as high as one in 100 who have the surgery. Not for just a few extra pounds Powers, 42, of Worcester, was lucky. Even carrying more than 400 pounds on his 5-foot-11 frame, he had not developed many of the common ailments associated with obesity. Still, sleep was fitful, and walking, particularly upstairs, was exhausting. And he lived in a fourth-floor apartment. Powers underwent laparoscopic gastric bypass surgery in May 2001 and now weighs 280 pounds. He believes the surgery likely staved off the onset of diabetes, and he has had no complications. Surgery is not used to treat minor obesity. Candidates must be 100 pounds above their ideal body weight and have failed at other attempts at weight loss. Still, an estimated 15 million people would qualify for the surgery, said Dr. Shikora, head of bariatric surgery at Tufts-New England Medical Center in Boston. Tufts, which has the city's largest obesity surgery program, closed to new patients for nearly six months earlier this year to catch up with its backlog of patients. At one point, there was a waiting list of 500 patients, Shikora said. " It's no longer considered snake oil or some out there treatment that doesn't work, " Shikora said. Many insurance carriers have started to cover the procedures, finding it cheaper to pay for the surgery than treating obesity-related health problems such as diabetes and high blood pressure. Companies continue to feel pressure to cover more obesity surgeries, but are cautious because of the risks, said Pisano, spokeswoman for the combined American Association of Health Plans, Health Insurance Association of America. " When we do read about people who do have complications, I think that only serves to reinforce the caution, " she said. Powers agrees. He worries that the growing popularity and the success of celebrities such as NBC " Today " weatherman Al Roker and singer Carnie may make it look like a simple, convenient option, especially for young people. " I don't think you see all the pain involved. You see the finished product, " he said. " Carnie looks great and Al Roker looks like a million bucks, but you don't see the post-op stuff. You eat half an English muffin and you throw up. There's certain foods it takes you a year to eat again. It's not a diet. You have to be ready to abandon the way that you've lived with food for the rest of your life. " ------------------------------------------------------------------------ - Surgical treatments for obesity May 4, 1999 Web posted at: 12:15 p.m. EDT (1615 GMT) (WebMD) -- The history of surgical treatments for obesity includes numerous techniques quickly adopted and then rapidly abandoned after evidence proved them ineffective or harmful. Today, three operations are considered fairly effective and safe treatments for obesity: Gastric bypass Vertical-banded gastroplasty Kuzmak's adjustable silastic banding All three procedures are considered reasonably safe and have produced significant post-surgery weight loss. They can be performed with less than a 1 percent chance of surgery-related death in low-risk patients (those without concurrent health conditions, such as hypertension and diabetes) and less than 2 percent chance in high-risk patients. The goal of these surgeries is to reduce the stomach reservoir, which creates a sense of fullness from a smaller volume of food. When do obese people qualify for surgical intervention? When their body mass index (BMI) is 40 or greater. When their BMI is 35 or greater and they suffer from an obesity-related condition, such as diabetes or hypertension. Gastric bypass Gastric bypass surgery is becoming the procedure of choice for weight-loss surgeons, partly because of its results. Of 608 patients, the average weight fell from 304.4 pounds to 204.7 pounds over 14 years after this surgery, according to one study. Most of this weight loss occurred the first year. Gastric bypass surgery uses staples to create a small pouch out of the upper portion of the stomach and attaches a part of the large intestine to the pouch. Unlike the other two techniques, this procedure reduces the amount of calories absorbed by the body through " bypassing " the first portion of the intestine. After eating the equivalent of half a hamburger, the person with the small pouch stomach would feel full. Bypassing the first part of the intestine can lead to poor absorption of nutrients and vitamins. " Dumping " -- diarrhea caused by the insufficient absorption of fluid from the intestine -- is common and occurs in 70.6 percent of these patients. Vitamin supplements are recommended for patients who have this surgery. Vertical-banded gastroplasty With vertical-banded gastroplasty, food passes through the intestines normally but the stomach's flow is restricted. The procedure uses staples to create a small pouch from the stomach's upper portion. A mesh ring encloses the stomach's middle part so that food must pass through a 5-centimeter opening to reach the stomach's lower portion. Recent studies four years after surgery indicate that 36 percent of patients require repeat surgery either because of an excessive narrowing of the opening or a failure to lose weight. Overall weight loss after vertical banded gastroplasty is 10 to 15 percent less than the loss after gastric bypass surgery. Kuzmak adjustable silastic band The Kuzmak adjustable silastic band is another restrictive technique that uses an inflatable ring around the stomach to reduce the stomach's size and limit food intake. Unlike the other two surgeries, this procedure can be performed with the aid of laparoscopy, a visual/video aid that allows surgeons to see the patient's internal cavity. Laparoscopic surgery is less invasive than other kinds of abdominal surgery. One study showed that 76 percent of patients experienced vomiting after having the procedure. The average weight loss after Kuzmak adjustable silastic band surgery is 10 to 15 percent less than the loss after gastric bypass surgery. Ask your doctor Of the three, no single procedure stands out as significantly better than the others. Your doctor can discuss the pros and cons of each type of surgery. The choice, as with all surgeries, should be based on the patient's individual needs. Copyright 1999 by WebMD, Inc. All rights reserved. live each day like it's your last... love like you've never been hurt... Deb in Hazlet, NJ " Debbie Dancer " distal rny September 3, 2002 386/212/165 BMI 60/31/24 -174 -92.5 " Angel to Bill, Debbie, Ilene, Roy, and Ro Quote Link to comment Share on other sites More sharing options...
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