Gastroplasty for morbid obesity: effect on morbidity and quality of life

ABSTRACT

54 patients underwent Mason vertical banded gastroplasty over 3 years. 12 patients were superobese, 32 morbidly obese and 10 with medical significant obesity. Operative treatment results in a reduction of 85.5% of ideal weight [38.5% of their original weight and 70.14% of their excess weight] after 2 years in 53.7% of patients. A typical indication is in a patient above 160% of his ideal weight [body mass index more than 35 kg/m2], aged between 18-60 years, has masculine fat distribution and got an obesity related disease with impairment of life quality. The constricting band and pouch size should not be greater than 5 cm and 20 ml respectively. Double staple line with reinforcement is essential to avoid suture line dehiscence. Post- gastroplasty special diet should be followed. No mortality recorded and all complications treated conservatively except 2 and they entail hypoventilation [2 cases], chest infection [4 cases], wound infection [4 cases], wound seroma [4 cases], stomal stenosis [3 cases], nutritional problem [1 case], reflux esophagitis [3 cases] and weight regain [4 cases]. Co-morbid conditions [obesity related disease] entails arthritis [38 cases], hypertension [19 cases], diabetes [12 cases], hyperlipidemia [11 cases], asthmatic bronchitis [9 cases], angina/CHF [4 cases] and sleep apnea [1 case]. The improvement of co- morbidity with surgically induced weight loss is impressive. The percentage of either resolution or improvement is documented. Finally, the effect on the quality of life has been studied using the sickness impact profile, and total dysfunction score has improved from 22.3% preoperatively to 8.7% postoperatively. To date, surgical methods are the only viable method to achieve weight loss in dangerously obese patients and gastroplasty is a safe and effective procedure to achieve this