There was no mortality in this series The mortality rate from a

There was no mortality in this series. The mortality rate from a meta-analysis of 85, 048 patients was 0.28% at 30 days after surgery and 0.35% between NSC 683864 30 days and 2 years [17]. The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium, a 10 center prospective trial involving 4776 patients undergoing bariatric surgery, reported a 30-day postoperative mortality of 0.3% [18]. Major complications in this series were hemorrhage, intestinal obstruction, deep vein thrombosis, band erosions, band slippage, and delayed gastric emptying (Table 2). In the multicenter LABS study of 4776 patients a major (90 day) complication rate of 4.3% was reported [18]. In our series the overall major complication rate for bariatric surgery was 16/197 (8.1%). The 90-day complication rate was 9/197 (4.6%).

There was no conversion to open and the majority of operative complications were performed laparoscopically. Resolution of comorbidities in the present study was comparable to international data published in meta-analyses [19, 20]. Diabetes Mellitus, Hypertension and Sleep Apnea resolved in most patients in the present study (Table 1). In a recent systematic review and meta-analysis by Buchwald et al., which included 135, 246 patients, they demonstrated a 78.1% complete resolution of diabetes and diabetes was improved or resolved in 86.6% of patients [20]. In this study, diabetes mellitus resolved in 85% of patients, while the remaining 15% have excellent control on reduced medication. Bariatric surgery decreases the prevalence of hypertension by 50% while another 25% of patients have a reduction in the number of medications or their dosage [21].

Buchwald et al. demonstrated a resolution of hypertension in 61.7% of patients [19]. In the Swedish obese subjects trial, the prevalence of hypertension decreased by 50% at 2 years (22). Therefore, a significant proportion of bariatric surgical patients show resolution of hypertension. In this study, hypertension resolved in 70/87 (80%) of patients. Seventy percent of patients undergoing bariatric surgery has sleep apnea syndrome [22]. Bariatric surgery is effective in decreasing the severity in 100% patients with 80% of patients using CPAP able to stop treatment [23]. Sugerman et al. demonstrated in patients undergoing gastric bypass a reduction of sleep apnea syndrome from 44% to 8% between 3 to 12 months postoperatively [24].

In this study sleep apnea was improved in 95% of patients with 100% of patients weaned off CPAP machines. Surgery is considered successful if more than 50% of the excess weight is lost and maintained and if the comorbidities resolve. In this study excess weight loss after surgery was greater than 50%, 88.4% of gastric bypass patients, 55.4% gastric Dacomitinib sleeve, and 33% band with followup of 3.4, 0.9, and 6.4 years, respectively. In a meta-analysis by Buchwald et al. excess weight loss after gastric bypass was 68.2% and gastric banding was 61.6% [19].

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