The database, however, has its advantages, said another discussant, Dr. William O. Richards, chair of the department of surgery and director of the surgical weight loss center at the University of South Alabama, Mobile. “This paper is important because it's another one of the studies emanating from prospective [collections of data across the United States] from hundreds of surgeons, and convinces me we are ever more confident in reporting results not just from a single surgeon but from actual practice,” said Dr. Richards.
He questioned whether the low mortality rate was a reflection of surgeons' opting to avoid procedures in high-risk, older obese patients, or whether it was a reflection of the success of the centers of excellence system.
Dr. Inabnet said that there were 200 patients older than age 75, and although the data are currently too young to allow the measurement of any trends, it does not seem that older patients are being operated on less often than are younger patients.
“What is the best operation? That really is the million dollar question,” he said. The data show that the Roux-en-Y procedure provides the best overall risk profile, but he added that the sleeve gastrectomy is increasing in prevalence and may eventually prove to be a good choice.
Dr. Inabnet, Dr. Schirmer, and Dr. Richards reported no conflicts.
Roux-en-Y has the best risk profile, but sleeve gastrectomy may prove to be a good choice.
Source DR. INABNET