A study recently released by the Duke University Medical Center indicates five characteristics of patients most at risk for developing fatal complications from gastric bypass weight loss surgery, a procedure which reduces the size of a morbidly obese patient's stomach while mildly reducing calorie absorption.
Winchester Hospital Director of Bariatric Surgery Darius Ameri, MD, FACS, agrees with the findings of the study, which revealed that patients' risk factors increase if they: have a body mass index (BMI), or calculation of weight versus height, of 50 or higher (more than double the normal range); are male; currently or previously suffered from hypertension; have had or are at risk for developing pulmonary embolus, or blood clots in the lung; and are over 45 years of age.
The study followed 2,075 bariatric surgery patients treated at Virginia Commonwealth University in Richmond between 1995 and 2004. Of the 31 who died within 90 days of surgery, three were classified as low risk; 19 were medium risk; and nine were high risk.
Follow up:
According to Ameri, one of the causes of the discrepancy is the different distribution of fat between the genders. Women take on a gynecoid, or pear shape, as they gain weight. Men, on the other hand, develop a central, or apple-shaped, distribution of fat that is typically deposited around the upper trunk area - precisely the area in which the surgery is performed.
"Morbidly obese men who also have a history of cardio pulmonary conditions such as sleep apnea, hypertension, and pulmonary embolism have to be well educated about the risks and benefits of the procedure, and how these conditions may predispose them to increased complications," 
said Ameri, who has performed the minimally invasive laparoscopic gastric bypass surgery at Winchester Hospital since 2000.
With patient safety as the main priority, Ameri evaluates patients individually and requires high-risk patients to lose a specified amount of weight prior to their bariatric procedure. An alternative - and less invasive - procedure for high-risk patients is adjustable gastric banding. While weight loss is slower following this operation, long-term results may be comparable.
Regardless of risk level, all Winchester Hospital gastric bypass surgery candidates are required to attend several monthly support group meetings led by Ameri and which often include a registered dietician, psychologist, guest speakers discussing a variety of obesity issues, and former patients who share their own success stories.
"Bariatric surgery is a tool, not a cure," Ameri said, "and we do all we can to help patients cultivate the understanding, motivation, readiness, and commitment required for their surgery and recovery."
Source: The Winchester Star
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