The safety and efficacy of bariatric surgery for obese, wheelchair bound patients.
| Title: | The safety and efficacy of bariatric surgery for obese, wheelchair bound patients. |
|---|---|
| Authors: | Williams GJ; Chelsea and Westminster Hospital NHS Foundation Trust, UK.; Georgiou PA; Cocker DM; Bonanomi G; Smellie J; Efthimiou E |
| Source: | Annals of the Royal College of Surgeons of England [Ann R Coll Surg Engl] 2014 Jul; Vol. 96 (5), pp. 373-6. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Royal College of Surgeons of England Country of Publication: England NLM ID: 7506860 Publication Model: Print Cited Medium: Internet ISSN: 1478-7083 (Electronic) Linking ISSN: 00358843 NLM ISO Abbreviation: Ann R Coll Surg Engl Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : Royal College of Surgeons of England |
| MeSH Terms: | Wheelchairs*; Gastric Bypass/*adverse effects ; Gastroplasty/*adverse effects ; Laparoscopy/*adverse effects ; Movement Disorders/*surgery ; Obesity, Morbid/*surgery; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Patient Safety ; Quality of Life ; Treatment Outcome ; Weight Loss ; Young Adult |
| Abstract: | Introduction: The aim of this study was to evaluate outcomes of bariatric surgery performed in order to improve mobility in patients with severe mobility limitations.; Methods: Patients with severe mobility impairment (wheelchair bound) who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic adjustable gastric banding (LAGB) surgery to improve their mobility were included in this study. Patients were identified between July 2009 and October 2011 using an electronic prospective bariatric database. Mobility was assessed by questionnaire during clinic follow-up appointments.; Results: Fifteen patients (11 female, 4 male) with a mean age of 48 years (range: 26-71 years) and a mean body mass index of 46 kg/m(2) (range: 33-54 kg/m(2)) were included. Seven patients (47%) underwent LAGB and eight (53%) LRYGB. The aetiologies of mobility impairment included advanced osteoarthritis (n=6), spinal conditions (n=4), severe bilateral leg oedema and ulceration (n=2), advanced rheumatoid arthritis (n=2) and traumatic paraplegia (n=1). The mean length of hospital stay was 3.8 days. There was no mortality. One patient was lost to follow-up. Of the remaining 14 patients, the mean excess weight loss percentage at a mean of 18.5 months postoperatively was 48% (68% for LRYGB, 20 months; 29% for LAGB, 17 months). Ten patients reported improved mobility. Reduced pain, improved independence and ability to transfer were most commonly cited. Four patients reported no improvement in mobility (three LAGB patients, one LRYGB patient).; Conclusions: Bariatric surgery can safely improve mobility and quality of life in obese patients with severe mobility impairment. Our paper supports the idea that severe mobility impairment should be considered an indication for bariatric surgery in selected patients. LRYGB demonstrated better weight loss and mobility improvement than LAGB. Larger studies are required to establish robust selection criteria for surgery in this group. |
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| Entry Date(s): | Date Created: 20140704 Date Completed: 20140903 Latest Revision: 20240323 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4473935 |
| DOI: | 10.1308/003588414X13946184901083 |
| PMID: | 24992422 |
| Database: | MEDLINE |
Journal Article