Gastric restrictive surgery for morbid obesity

Institute for Clinical Systems Improvement
Record ID 32003000550
Authors' objectives:

This review aims to assess the available evidence on the effectiveness of gastric restrictive surgery for morbid obesity.

Authors' recommendations: Based in a review of the recent evidence, the ICSI Technology Assessment Committee concludes the following: Gastric surgery may be considered for patients 18 years of age or older, with a body mass index (BMI) >= 40 kg/m2 or a BMI >= 35 kg/m2 with comorbid conditions, and who have failed maximal medical therapy. Vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB) are the surgeries currently being done in the United States. Both are generally safe (mortality <1.5% in experienced centers). There is evidence in the literature that both procedures result in weight loss that may be sustained for seven years or longer. (Conclusion Grade II) While many of the studies are case series, there are also prospective cohort studies. There are clinical trials showing improvements in glucose tolerance, forms of hyperlipidemia, hypertension, and arthritis. (Conclusion Grade I) There remains a need for long-term trials to demonstrate long-term survival benefit and long-term maintenance of both weight loss and reversal of comorbidities. Although some reports suggest that RYGB may be more durable than VBG in terms of maintenance of weight loss and reversal of comorbidities, there is insufficient data, to date, to strongly support that suggestion. Patients who have VBG or RYGB should be followed by a multidisciplinary team with lifelong medical surveillance for nutrient deficiencies and medical complications.
Authors' methods: Review
Project Status: Completed
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Gastric Bypass
  • Gastroplasty
  • Obesity, Morbid
Organisation Name: Institute for Clinical Systems Improvement
Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
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Copyright: Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.