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Checkup: Study backs safety, effectiveness of weightloss surgery

New scientific studies show weightloss or bariatric surgery is more effective and is safer than earlier suggested.

Bariatric procedures most commonly cover gastric bypasses, adjustable gastric banding and sleeve gastrectomy. All are aimed at restricting the amount of food a person can consume or process in the stomach.

Demand for such procedures in New Zealand is high and they mainly performed in private hospitals. But the public health system is also under pressure to approve more procedures as a means of combatting morbid obesity.

In the new study, researchers at Washington University in St Louis looked at 164 randomised clinical trials and observational studies that included, but were not limited to, the three most common bariatric procedures.

In addition to weight loss, people who had the surgery saw improvements in related conditions such as diabetes, high blood pressure and sleep apnea.

“We found that death rates were lower than those reported in previous meta-analyses,” study lead author Su-Hsin Chang says.

“Possibly, this is because we only included more recent studies published from 2003 to 2012, capturing the fact that the technology of bariatric surgery and the experience of surgeons have advanced.”

Outcomes of bariatric surgery have not been systematically evaluated in a large number of trials since 2003.

Across all procedures, the mortality was eight deaths out of 10,000 patients within 30 days of surgery. This mortality increased to 31 deaths out of 10,000 patients after 30 days, based on the data from the randomised clinical trials.

The rate of any type of complication ranged from 10-17%, with gastric bypass having more complications but also more effective weight loss.

Patients who underwent adjustable gastric banding lost comparatively less weight and were more likely to require another operation to fix problems such as band erosion. Despite requiring more follow-up operations, gastric banding had lower death and complication rates.

Sleeve gastrectomy appeared comparable to gastric bypass in terms of weight loss and therefore was more effective than adjustable gastric banding.

Journal of the American Medical Association

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