Obesity surgery up tenfold in england

Obesity surgery up tenfold in england

The number of NHS operations for bariatric or weight loss surgery has increased tenfold in England since 2000 say researchers, who suggest the main reason is because obese patients are more aware of it as a viable treatment option.

Researchers at Imperial College London conducted their observational population cohort study, which covered all the people who had a first elective bariatric procedure under the NHS in England between April 2000 and March 2008, and published their findings in the 26 August online issue of the British Medical Journal, BMJ.

There are three main types of bariatric procedure: primary gastric bypass, where the surgeon re-routes the small intestines to a small stomach pouch; gastric banding, where the surgeon reduces the size of the stomach with a surgical band; and sleeve gastrectomy which involves removing a part of the stomach.

More and more of these procedures are now being done laparoscopically, that is via "keyhole".

Using the Hospital Episode Statistics database, the researchers found a total of 6,953 bariatric procedures were carried out under the NHS in England between April 2000 and March 2008. The number rose more than ten-fold from 238 in 2000 to 2,543 in 2007.

The researchers also looked at outcomes, such as deaths recorded 30 days and one year after surgery, and how long patients stayed in hospital and if there were any unplanned further hospital stays.

They found fewer deaths among patients who had gastric banding and also shorter hospital stays and fewer unplanned readmissions compared to those who had gastric bypass.

People who already had other complications also fared less well than those who did not.

The proportion of procedures performed laparoscopically went up from 28 per cent in 2000 to 75 per cent in 2007, suggesting, said the researchers, that laparoscopy has been introduced in a safe manner into the NHS.

Bariatric procedures are usually performed on people who are dangerously obese. The aim is to help them reduce weight by reducing the size of the stomach so they eat less.

The operation has received much publicity in the UK in recent years, much of it because of celebrities like Fern Britton, who revealed in 2008 that she had shed more than five stones after having gastric band surgery in 2006.

Research shows that bariatric surgery reduces the risk of death, hospital admission and long term cost to the health service.

NICE (the National Institute for Health and Clinical Excellence) recommends it for people who are morbidly obese, that is with a body mass index (BMI) of 40 and higher (or 35, if they also have a medical condition that could be improved if they lost weight), for whom all non-surgical ways of losing weight have failed.

"Introduction of laparoscopic bariatric surgery in England: observational population cohort study."

Elaine M Burns, Haris Naseem, Alex Bottle, Antonio Ivan Lazzarino, Paul Aylin, Ara Darzi, Krishna Moorthy, and Omar Faiz.

BMJ 2010; 341:c4296

Published online 26 August 2010

DOI: 10.1136/bmj.c4296

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