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A University Experience

Joe A. Cates, MD; Ernst J. Drenick, MD; Mohammed Z. Abedin, PhD; Jeff E. Doty, MD; Kimberly D. Saunders, MD; Joel J. Roslyn, MD

Arch Surg. 1990;125(10):1400-1404.

Abstract
• Patients who undergo surgery for morbid obesity are often subjected to reoperation for a wide array of indications. To evaluate outcome following revisional procedures, we reviewed the records of 32 such patients treated at UCLA between April 1986 and May 1989. Twenty-five women (78%) and 7 men (22%) with a mean age of 44 years underwent 76 reoperations (2.4 per patient) for complications of prior obesity surgery. Indications for initial surgical revision consisted primarily of metabolic derangements (12 patients) and weight-related problems (11 patients). In contrast, indications for the patients' final surgical procedure were commonly for bowel obstruction (41%), intra-abdominal sepsis (12%), and gastrointestinal bleeding (6%). Following initial revision, 23 patients (71.8%) required further surgery for major complications and four patients died (12.5%). While initial revisions are frequently indicated for metabolic problems, final reoperations are more frequently undertaken for urgent, life-threatening complications. Revisional procedures for morbid obesity should be carefully considered, and the potential for major complications and/or death should be weighed heavily against proposed benefits.

(Arch Surg. 1990;125:1400-1404)

Author Affiliations
From the Departments of Surgery (Drs Cates, Abedin, Doty, Saunders, and Roslyn) and Medicine (Dr Drenick), UCLA School of Medicine.

Footnotes
Accepted for publication May 23, 1990.

Read before the 61st Annual Meeting of the Pacific Coast Surgical Association, Laguna Niguel, Calif, February 21, 1990.

Reprint requests to Division of General Surgery, UCLA School of Medicine, Los Angeles, CA 90024 (Dr Roslyn).

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