The second study, which looked at a broader population, found a much lower one-year mortality rate: 0.91 percent. It looked at 60,077 California residents, with an average age of 42.2 years, who underwent surgery for obesity from 1995 through 2004.
But that study also found that the hospitalization rate of patients up to three years after bypass surgery was twice as high as the rate during the three years before the operation.
Surgical complications were the main reasons for hospital re-admissions, followed by cosmetic surgery to remove sagging skin after patients lost weight, said Dr. David S. Zingmond of the University of California, Los Angeles, who headed the study.
"The risks of gastric bypass surgery may be similar to those of other types of abdominal surgery, but in this case it's an elective procedure," he said. "They have a choice about whether or not they want to undertake that risk."
When Madalyn "Midge" Ruhl of Indian Head Park, Ill., had her gastric bypass surgery at Rush University Medical Center 21 months ago, she was aware of the risk of dying but felt it was small.
Ruhl, who saw her weight drop from 304 pounds to 180, said she was home from the hospital in a day and a half and had no medical complications. "It was life-changing for me. Stairs are not a threat. Parking lots are not a threat. I'm doing the day-to-day things that I was shying away from before."
Previous studies have shown that people undergoing gastric bypass procedures lost an average of 61 percent of their excess weight and saw other weight-related conditions, such as diabetes and high blood pressure, either disappear or improve.
The studies appear at a time when Medicare is considering whether to provide blanket coverage for obesity surgery. Cases are now considered individually. Private medical insurance covers more than 80 percent of non-Medicare patients undergoing the surgery, which is estimated to cost between $25,000 and $50,000.
"These studies have to be taken with a grain of salt," said Dr. Edward Livingston, chief of gastrointestinal surgery at the University of Texas Southwestern Medical Center, who frequently performs gastric bypass surgery. "My concern is that policy people are going to react to them without considering the whole picture for these operations.
"If [patients'] diabetes goes away, which it usually does, and if their hypertension gets better or their sleep apnea goes away, that won't be captured in those kinds of studies," he said. "These patients have a huge improvement in their quality of life."
The studies furthermore do not include the results of the newer, less invasive laparoscopic surgery in which a surgeon partitions the stomach through a series of small holes in the abdomen, Flum said. These patients often are released from the hospital within 24 hours and have fewer complications, he said.
This is cache, read story here
