Long-term outcomes of laparoscopic Roux-en-Y gastric bypass in US veterans.

Background: The objective of this study is to evaluate the long-term outcomes following laparoscopic Roux-en-Y gastric bypass (LREYGB) in veteran patients. The VA bariatric population differs from its counterpart in the private sector by the predominance of a male population, a higher percentage of patients from a lower socioeconomic background, a higher mean age, and a higher rate of obesity-related comorbidities.

Methods: A retrospective review with prospectively collected data was used to analyze postoperative changes of comorbidities and percent of excess weight loss (% EWL) in consecutive patients who underwent LREYGB between August 2003 and September 2006.

Results: Among 70 patients, 73% were men with a mean age of 52 years (29-66 years). Average preoperative weight and body mass index were 310 lbs (224-397 lbs) and 46 kg/m(2) (36-60 kg/m(2)), respectively. The incidence of major and minor complications was 1.4% and 15.7%, respectively. There were no mortalities. Follow-up (f/u) was possible in all patients. At a mean f/u rate of 39 months, % EWL was 56%. At 1, 3, and 5 years, % EWL was 61%, 53%, and 59%, respectively. Thirty-five patients (50%) had type 2 diabetes mellitus (T2DM). Glycosylated hemoglobin concentrations returned to normal levels in 91% of patients and improved in an additional 6% of T2DM cases. Only 7% of patients are still maintained on antidiabetic medications. In patients with more than 1 year f/u, most other comorbidities were improved or resolved.

Conclusions: Long-term f/u of LREYGB in veteran patients demonstrated significant and durable weight loss (56% EWL) with marked improvements in comorbidities especially T2DM.