Gender differences in early outcomes following hand-assisted laparoscopic Roux-en-Y gastric bypass surgery : gender differences in bariatric surgery

Abstract

Background: Male gender has been associated with a higher morbidity and mortality rate after bariatric surgery including laparoscopic and open procedures. This study focused on hand-assisted laparoscopic Roux-en-Y gastric bypass and morbidity and mortality among genders.

Methods: Hand-assisted laparoscopic Roux-en-Y gastric bypass operations (N = 319) were evaluated from October 2003 to March 2006. Comparison between males (N = 54) and females (N = 265) were conducted using t test or Fishers exact test and chi-square analysis.

Results: Patients' average age was 42.3 +/- 10.3 and the average body mass index (BMI) was 49.2 +/- 7.9. There was no significant difference between males and females in age or BMI. Males had a significantly greater average weight than females (p < 0.001) and were significantly more likely to experience sleep apnea (p = 0.006) and have heart disease (p = 0.017). For operative risk factors, males had a significantly longer anesthesia time (p = 0.003), operative time (p = 0.027), and length of roux limb (p = 0.038). At 6 and 12 months postsurgery, there was no significant difference between males and females with complications. Although BMI did not differ significantly, males continued to weigh significantly more than females and lost significantly more pounds than did females at both 6 and 12 months postoperation.

Conclusion: Given their larger size and tendency to accumulate fat in the abdominal compartment that increases the technical difficulty of the procedure, males are historically associated with a higher morbidity and mortality following bariatric surgery. Based on the current study, however, there is no difference in outcome among genders following hand-assisted laparoscopic Roux-en-Y gastric bypass.