Long-term analysis of Risk for Anemia in Laparoscopic Roux-en-Y Gastric Bypass Patients with at Least 5-year Follow Up

Piotr J Gorecki, MD2, Christine M Najjar, MS1, Krystyna Kabata, PA2, Anthony Tortolani, MD2. 2New York Methodist Hospital, 1St. George’s University School of Medicine

BACKGROUND: Short-term benefits of laparoscopic Roux-en-Y gastric bypass (LRYGB) are well known and it remains the treatment of choice for morbid obesity. Prevalence of anemia in bariatric surgery candidates has been reported in 10% to 40% of patients. Few long-term studies evaluate the prevalence of anemia after LRYGB. Our study analyzes the incidence of anemia in LRYGB patients with at least 5-year follow up.

METHODS: Fifty-five patients operated on between August 2001 and August 2004 in a single institution by a single surgeon utilizing the same technique were analysed. All data was collected prospectively. Patients with at least one charted hemoglobin (Hb) level 5 or more years after surgery were included. Females and males were considered anemic with Hb levels of <12g/dL and <13.5g/dL, respectively. Incidence of anemia and follow-up Hb levels were compared to pre-operative Hb levels using a paired two-sample t-test.

RESULTS: There were no conversions to open surgery and no perioperative mortalities.  Average preoperative patient age and BMI were 35.6 years and 48.2kg/m2, respectively. Females represented 89% of patients. See tables.

Follow-up Periodn = Patients (M) Mean Hb ± SD (M)Pvalue (M)n = Patients (F)Mean Hb ± SD (F)Pvalue (F)

A worsening anemia becomes statistically significant at the 24-month period (p=0.0038). Mean decrease in Hb for females becomes significant at 24-months and continues to decrease in all follow-up periods. 21.7% of females are anemic in the pre-operative period and 69.4% (p=0.001) are anemic 10 years after LRYGB.

CONCULSION: Patients undergoing LRYGB are at risk of developing anemia at long-term follow. This risk is greater for females and increases each year after LRYGB. 

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