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Staying Healthy

Doctors Weigh Stomach Reduction Surgery Risks

Procedure Carries 1 Percent Risk Of Death

UPDATED: 8:14 pm EST November 9, 2003

Stomach reduction surgery is becoming increasingly popular, increasing 60 percent in the last year alone.

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But it is serious surgery with major risks, as indicated by a recent death that prompted officials to temporarily halt the procedure at Brigham and Women's Hospital in Boston.

About 100,000 people over the next year will have stomach reduction surgery. It carries with it about a 1 percent risk of death, and about a 5 percent risk of other serious complications.

Experts say those risks as well as the benefits must be weighed carefully before going into the operating room.

Caritas St. Elizabeth's Medical Center in Boston started offering gastric bypass surgery to their patients last April. Patients must be more than 100 pounds over their ideal body weight to even be considered.

"Before any one of these patients can get into this type of program, they have to show evidence they have failed medically supervised diets," said Dr. Kevin O'Donnell, of St. Elizabeth's Medical Center.

Many surgeons now perform a laparoscopic technique, involving smaller incisions. Studies suggest it may lower the chance of infection and speed recovery. But the technique takes a skilled surgeon to perform, and there are still risks, especially because the patients are obese and more prone to heart disease and diabetes.

"Complications with anesthesia, complications with pneumonia, wound infections, hernias, so it isn't something that we or the patient takes lightly," O'Donnell said.

The risks also must be weighed against the benefits, experts say. While an estimated 1,000 people may die in the next year as a result of gastric bypass surgery, 300,000 are expected to die from their obesity.

"We know that many of those who lose substantial amounts of weight after surgery come off their hypertensive medications, many of them are no longer diabetic and it's those long-term benefits that we see as the real benefits," O'Donnell said.

Before patients are able to undergo this surgery, there's a rigorous screening process that includes tests to rule out underlying medical reasons for weight gain, along with psychological and nutritional testing.

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