2005 SAGES Abstracts

POSTER ABSTRACTS
SAGES 2005
i.e. 23%, 52%, and 68% for Groups 1, 2, and 3, respectively.
Conclusion. Age is not a significant determinant of post-surgical
vitamin and mineral deficiencies for gastric bypass surgery
patients, particularly for individuals taking dietary supplements.
P074–Bariatric Surgery
IS RESOLUTION OF HYPERTENSION FOLLOWING LAPARO-
SCOPIC GASTRIC BYPASS RELATED TO INSULIN RESIS-
TANCE?, Patrick McEnaney MD, Richard Perugini MD,Andras
Sandor MD,Liam Haveran DO,Donald R Czerniach
MD,Demetrius Litwin MD,John J Kelly MD, Department of
Surgery, UMASS Memorial Medical Center
INTRODUCTION: Laparoscopic Roux-en-Y Gastric Bypass
(LRGB) has become one of the major treatment options for
individuals with morbid obesity, a proportion of which have
insulin resistance. Insulin may act to increase sympathetic tone
as well as sodium reabsorption with resultant impact on
hypertension. Based on some data from our institution, individuals
with insulin resistance have significantly improved
insulin sensitivity 12 days postoperatively where as those with
lesser insulin resistance have early worsening of their insulin
sensitivity. The purpose of our study was to determine if individuals
undergoing LGB with insulin resistance would have
better resolution of their hypertension as compared to those
undergoing the same procedure with less perturbations in
insulin glucose metabolism.
METHODS: We retrospectively reviewed the medical records of
patients with hypertension who had preoperative fasting
insulin and glucose levels to determine their metabolic profile.
Patients were categorized as insulin resistant if their preoperative
HOMA-IR level was greater than 3.8. Patients were defined
as being hypertensive if they were taking one or more medications
for blood pressure control. The records were subsequently
reviewed to evaluate for resolution of their hypertension
while not requiring antihypertensives.
RESULTS: Of the 72 patients who underwent LGB between
June 2003 and June 2004, 24 of these were hypertensive preoperatively
and 11 of these were insulin resistant. Of the six
patients with six month follow up postoperatively, three were
cured of their hypertension, where as one of the eleven
patients who had not yet reached the 6-month follow up visit
was cured of hypertension. Of the thirteen patients with hypertension
and HOMA-IR levels0.05).
CONCLUSION Short-term follow-up suggests that bariatric surgery
is safe and effective in patients over 50. Older patients
had higher preoperative co-morbidities, but that did not negatively
affect their outcome. Longer-term follow-up data are
necessary to validate these preliminary results.
P076–Bariatric Surgery
QUALITY OF LIFE PRIOR TO LAPAROSCOPIC ROUX-EN-Y
GASTRIC BYPASS DOES NOT VARY WITH BODY MASS
INDEX, Jason G Murphy MD, Ruth R Leeth MPH,Teresa D
Leath RN,Ronald H Clements MD, Department of Surgery,
Section of Gastrointestinal Surgery, The University of Alabama
at Birmingham, Birmingham, AL
Introduction - Quality of life (QOL) has been shown to be
markedly diminished due to morbid obesity. However, there is
little data comparing the effects of morbid obesity (MO), super
morbid obesity (SMO) and super, super morbid obesity
(SSMO) on QOL.
Methods - 370 patients seeking laparoscopic Roux-en-Y gastric
bypass for morbid obesity between 8/01 and 8/04 were included
in this study to assess preoperative quality of life, measured
by the SF-36 Health Survey version 2. Participants were
grouped into 3 categories according to body mass index (BMI):
MO (BMI between 35 with severe co-morbidities and 50,
n=226), SMO (BMI 50-59, n=114), and SSMO (BMI >60, n=30).
Demographic information was collected in regards to gender
(n=322 women and n=48 men), race/ethnicity (n=316 White,
n=53 Black, and n=1 Hispanic), and pre-existing co-morbidities,
including HTN (n=211), sleep apnea (n=201), DM (n=135) and
GERD (n=113). Two-tailed Student?s t-test were used to compare
the mean values of the 8 SF-36 scales for the 3 BMI categories
to each other and to national normal values for women
and men ages 35-44. Multiple linear regression analysis
(MLRA) of the full model including both demographic and comorbidity
patient variables was performed to test for the
impact of BMI on QOL at each of the 8 SF-36 measures.
Results - All patients had significantly worse QOL score in all 8
scales compared to national normal values for women and
men age 35-44. There were significant differences in the mean
QOL among patients in the 3 BMI categories, specifically on
physical function (PF) scale. In the full model using MLRA,
QOL scores for the PF and role of physical scales were significantly
lower for patients with a BMI>60 compared to patients
with a BMI