Re: DS vs. RNY: Percentage of excess weight lost/maintained long-term

[Guest guest]

,

The best results on the RNY that I cuold find was published by Dr.

Witgrove. The study is a 5 year study on laprascopic RNY's only. You

can find it at:

http://www.gastricbypass.com/images/LapGBP%20-%20500%20Patients.pdf

Dr. Witgrove basically claims comparable results to the DS (77% EWL).

Other studies have shown poorer results for the RNY (typically 60%

EWL). Dr. Wittgrove reports very rapid weight loss (60% EWL @ 6

monts, compared to 50% EWL @ 6 months for Hess).

Hull

>

> > I have been told that you don't loose as much weight with a

> > DS as with an RNY. Is that true?

>

> I have never seen any evidence that this is true. Some people say

that

> RNY folks lose faster initially, which wouldn't surprise me given

the

> extreme restriction of the pouch. But I've seen DS patients lose

darn

> quick too. The initial rapid weight loss is such an individual

thing,

> and of course those who start out heavier will lose a greater

amount of

> weight in a shorter time initially, so that could skew our

perception in

> some way as well if we're looking at anecdotal data.

>

> The real question is not how fast one loses how much, but how long

how

> much stays off. We have clinical data to show that the DS is

unmatched

> in percentage of excess weight kept off over the long term (5+

years).

>

> Here are some cites on the issue of weight regain following DS:

>

> ---

> 1.) From Dr. Baltasar, a surgeon with many years of experience in

all

> forms of WLS, reporting on 125 patients at the five-year mark:

>

> http://www.duodenalswitch.com/Procedure/baltasar.pdf

> " Duodenal Switch: an Effective Therapy for Morbid Obesity —

> Intermediate Results. " Obes Surg. 2001 Feb;11:54-59

>

> " BPD-DS is the most effective operation to lose weight. Hess had

> a %EWL of 80 at 2 years and 70 at 8 years. Marceau had a 73% EWL

> at 4.5 years, and 87% of his patients had a %EWL >50; 81% of his

> patients had a BMI <35 and only 6% had a BMI >40. In our

intermediate

> experience, %EWL exceeded the 70% throughout the years, and only

3

> patients did not reach 50% EWL. Comparing morbid and super

obesity,

> %EWL was superior in the morbidly obese but the fall in BMI was

> greater in the super obese. The mean fall in BMI was 37% in the

> morbidly obese and 43% in the super obese. Marceau found the

nadir

> of weight loss at 53 ± 20 kg, and the weight gain was 7 kg after

> several years. We have had no conversions in our patients thus

> far due to poor weight loss.

>

> 2.) From Dr. Hess, reporting on his first 440 DS patients at the

> eight-year mark.

>

> (See the second " RESULTS " link in the index on the page referenced

below

> for more details):

>

> http://www.duodenalswitch.com/Procedure/1998Hess/1998hess.html

> Hess, et al.: Biliopancreatic Diversion with a Duodenal Switch,

> Obesity Surgery, 8, 1998; 267-282.

>

> " Of the long term results, there is a only small amount of regain

> and we have never had a patient regain weight up to their

original

> weight. "

>

> 3.) Rabkin reported a mean %EWL in his DS patients of 73% at the

> four-year mark. At the two-year mark, these patients had been at 78%

> EWL. If we extrapolate those numbers to assume a 5% regain from the

> nadir, these numbers are consistent with the other DS studies which

show

> only a small amount of regain after the " opportunity window " closes.

>

> (If this link breaks to two lines, you'll need to cut and paste to

get

> the entire URL into your browser's address field):

>

>

http://www.pacificsurgery.com/For_Physicans/Clinical_Data/clinical_dat

a.

> html

> (Rabkin RA. " Distal gastric bypass/duodenal switch procedure, Roux-

en-Y

> gastric bypass and biliopancreatic diversion in a community

practice. "

> Obes Surg. 1998 Feb;8(1):53-9.44).

>

> ---

>

> I don't know of any RNY studies that report results out to four

years

> and beyond that are comparable to the DS with regard to %EWL and

> maintained. Shorter-term RNY studies have shown comparable results

to

> the DS, but the numbers get more dissimilar the further post-op

they get

> -- which presumably means that RNY patients are regaining at a

greater

> rate than DS patients.

>

> It has been awhile since I've been involved in any lengthy " DS vs.

RNY "

> debate, but last time I was in such a debate, we couldn't find any

RNY

> studies that reported results further out than the 2-year point.

There

> was one study that was a far out as 4 years, but that showed

mediocre

> results for the RNY.

>

> M.

>

> ---

> in Valrico, FL, age 38

> Starting weight 299, now 156

> Starting BMI 49.7, now 26.0

> Lap DGB/DS by Dr. Rabkin 10-19-99

> http://www.duodenalswitch.com

>

> Direct replies: mailto:melanie@t...

>

>

> _________________________________________________________

>

[Guest guest]

> ,

>

> The best results on the RNY that I could find was published by Dr.

> Witgrove. The study is a 5 year study on laprascopic RNY's only. You

> can find it at:

>

> http://www.gastricbypass.com/images/LapGBP%20-%20500%20Patients.pdf

>

> Dr. Witgrove basically claims comparable results to the DS (77% EWL).

> Other studies have shown poorer results for the RNY (typically 60%

> EWL). Dr. Wittgrove reports very rapid weight loss (60% EWL @ 6

> monts, compared to 50% EWL @ 6 months for Hess).

Yes, this study has the best RNY results I could find too. In this

study, only 4 patients were followed for a 60-month period, and only 16

patients out to 54 months. The rest of the studied patients (185 people)

were 36-48 months post-op. The overall results overall are a testament

to the skill of the surgeons at Alvarado and the overall program there,

I think. (Check out Table 1 in the .pdf file referenced above to see the

detailed results grouped time post-op.)

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

[Guest guest]

Thank you for the information. This artical really helps me with

informing my family about this surgery.

Pass on any more that you think may be helpful.

karon

> The best results on the RNY that I cuold find was published by Dr.

> Witgrove. The study is a 5 year study on laprascopic RNY's only.

You

> can find it at:

>

> http://www.gastricbypass.com/images/LapGBP%20-%20500%20Patients.pdf

>

[Guest guest]

> Yes, this study has the best RNY results I could find too. In this

> study, only 4 patients were followed for a 60-month period, and

> only 16 patients out to 54 months. ://mail.yahoo.com

And insturance companies and Dr. Poires have the nerve to call the DS

investigational while considering the Lap/RNY to be established!

Hull

[Guest guest]

> Yes, this study has the best RNY results I could find too. In this

> study, only 4 patients were followed for a 60-month period, and

> only 16 patients out to 54 months. ://mail.yahoo.com

And insturance companies and Dr. Poires have the nerve to call the DS

investigational while considering the Lap/RNY to be established!

Hull