Bariatric surgery, which reduces the risk of death, hospital admissions and long term NHS costs, is recommended by the National Institute for Health and Clinical Excellence (NICE) for people with morbid obesity for whom all non-surgical weight loss therapies failed. But little is known about who is actually having bariatric surgery in England.
Thus researchers led by Omar Faiz, Senior Lecturer and Honorary Consultant Gastrointestinal Surgeon at Imperial College, St Mary’s Hospital, London, set out to analyse national outcomes after surgery for obesity in the NHS in England. Using the Hospital Episode Statistics database, the team identified all adult patients who had a first elective bariatric procedure (gastric bypass, gastric banding or sleeve gastrectomy) between April 2000 and March 2008.
Mortality rates 30 days and one year after surgery were recorded, with hospital stay duration and unplanned re-admissions. 6,953 bariatric procedures were carried out in the study period. Procedures rose more than ten-fold from 238 in 2000 to 2,543 in 2007.
Patients selected for gastric banding had lower post-surgery mortality and readmissions and a shorter length of stay than those selected for gastric bypass. Patients with comorbidities showed poorer post-surgery outcomes than other patients.
The percentage of laparoscopic procedures also increased from 28% in 2000 to 75% in 2007. However, no significant increase in mortality or unplanned re-admission was seen over the study period, suggesting that laparoscopy has been introduced in a safe manner into the NHS, the researchers observed.