By Serena Gordon
TUESDAY, October 30, 2018 (HealthDay News) – The decision to have weight loss surgery is quite difficult, but then you have to choose between several procedures, each with different risks and potential weight loss.
So how do you decide which one is best for you?
A new study comparing three types of weight loss surgeries in more than 46,000 patients may help. Three types of surgery included gastric bypass, gastrectomy, and adjusted gastric banding (also known as lap).
The study found that gastric bypass surgery boasts the greatest weight loss, both short-term and long-term. But that procedure also had the highest rates of complications within a month of surgery.
“There are compromises. Bypassing is more effective for weight loss, but there is a greater risk of short-term complications. People need to consider, “What do I value most?” “Is safety your biggest concern, or is it the amount of weight loss?” said lead author of the study, Dr. David Arterbern. He is a senior fellow at the Kaiser Permanente Washington Health Research Institute in Seattle.
Arterbern added that other weight loss treatments, such as medication, may be considered.
Nearly 25,000 people in the study underwent Roux-en-Y gastric bypass. This procedure involves shrinking the stomach and bypassing part of the small intestine, according to the US National Institute of Diabetes and Digestive Kidney Diseases (NIDDK). After this surgery, people eat much less, և the body does not absorb as many calories.
Nearly 19,000 people in the study underwent a gastrectomy, which involved removing a portion of the stomach to get full faster.
Eventually, more than 2,500 people underwent surgery in the area. The surgeon places an inflatable bandage over your stomach, leaving only a small bag that can be filled with food. The rest of your stomach is filled with a balloon containing saline solution attached to the layer, NIDDK reports. Arterbern said the procedure has become obsolete in recent years.
The study found that bypassing the stomach seems to be the most effective for weight loss.
- Stomach bypass surgery resulted in an average loss of 31% of total body weight in the first year and 25% of total weight in five years.
- T-gastrectomy resulted in 25 percent of total body weight loss in the first year and 19 percent of total body weight five years later.
- Adjustable gastric banding resulted in 14% of total weight loss after one year and 12% after five years.
For the average person in this study, there was a 19-pound difference in weight loss between the bypass procedures after five years. The average person in this study weighed 277 pounds before surgery, scientists say.
But the 30-day rate of serious gastric bypass complications was almost twice as high as the risk of surgery. In the 30 days after surgery, the complication rate was 5% for gastric bypass and 2.6% for gastrectomy and 2.9% for gastric banding.
Complications measured during the study included death, surgery / rehabilitation procedures, blood clots, or discharge from the hospital within 30 days.
According to Arterbern, gastric bypass’s gastrectomy are similar in cost. He estimates that each procedure costs an average of $ 20,000 to $ 30,000. He noted that the adjustable stomach belt is cheaper և can average $ 15,000. The insurance coverage for these procedures varies considerably բոլորը not all will include weight loss surgery.
Dr. Mitchell Roslin, director of bariatric surgery at North Westchester Hospital in North Kisco, New York, said people should not focus solely on total weight loss when trying to choose a procedure.
“There is no perfect way. The more we change the body, the greater the weight loss, but the complications can be greater. “There is not a single operation for weight loss,” said Roslin, who was not involved in the study.
“The decision really requires a detailed conversation and education. You need to understand your individual medical issues and problems, ”he said.
Arterbern added that people should look for a surgeon who has experience in many weight loss procedures.
“Not all surgeons are equally comfortable with all procedures. “Have a conversation with the surgeon who performs all the surgeries, so the conversation is about what is right for you,” he said.
The findings were published on October 29 Chronicle of Internal Medicine.