Stomach-shrinking has high risk of early death

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Stomach-shrinking has high risk of early death

BY PAUL H.B. SHIN

NEW YORK DAILY NEWS

November 15, 2005

The number of stomach-shrinking operations for severely obese people

has skyrocketed in recent years, partly fueled by extreme makeovers

of once-portly celebrities such as weatherman Al Roker, singer

Carnie and " American Idol " judge Randy .

But these surgeries are riskier than previously thought --

especially for elderly people and those suffering from heart

disease -- with nearly 1 in 20 Medicare patients dying within the

first year after the surgery, a new study shows.

Previous reports from a limited number of surgeons have suggested

the risk of death was about 1 in 100 to 1 in 500.

But the new study looked at more than 16,000 patients who received

procedures while on Medicare -- federal insurance for elderly and

disabled people.

" Patients aged 65 or older face a nearly threefold increase in the

risk of early mortality, " says lead researcher Dr. Flum of the

University of Washington.

Flum also found that men are nearly twice as likely to die following

such procedures -- known as bariatric surgery -- as opposed to

women. And the surgeon's experience dramatically affects survival,

according to research in today's Journal of the American Medical

Association.

The study also found that more than 5% of men and nearly 3% of women

ages 35 to 44 were dead within a year.

And slightly higher rates were found in patients 45 to 54.

" This is very valuable information, " says Dr. Ren,

director of the Program for Surgical Weight Loss at NYU Medical

Center. " All the numbers that we've known before were from selected

surgeons or institutions with good results. "

Ren's center performs the largest number of gastric banding

operations in the United States.

(Banding is a reversible procedure in which a band is placed around

the stomach to reduce its size.)

In Washington state, for example, patients whose surgeons had

performed fewer than 20 procedures were nearly five times as likely

to die within 30 days after the operation.

" It is clear that this is complicated surgery. It's also clear that

with any complicated surgery the experience of the surgeon is key, "

says U.S. Rep. Jerrold Nadler, D-N.Y., who has lost 103 pounds since

his high-profile gastric bypass in August 2002.

Despite the greater risk than previously thought, both Ren and Flum

agreed that bariatric surgery can be a safe and effective tool for

morbidly obese people, who face serious health problems if they

don't lose weight.

A separate study in the same journal showed that the number of

bariatric surgeries in the U.S. has ballooned from 13,365 in 1998 to

72,177 in 2002.

The study, led by Dr. Heena Santry of the University of Chicago,

projected the number would skyrocket to 218,000 by 2010.

Copyright © 2005 Detroit Free Press Inc.