Weight-loss surgery deaths raise concerns
August 12, 2004
By Linda A. Johnson
An obese Massachusetts woman and her 8-month-old fetus died of complications 18 months after stomach-stapling surgery, an apparent first that doctors say highlights the risks of pregnancy soon after the surgery.
The deaths almost two years ago raise concerns because most of the 110,000 people who have gastric, or stomach, bypass surgery each year in this country are women in their child-bearing years, say doctors at Brigham and Women's Hospital in Boston who tried to save the mother and baby. They reported on the case in a letter in today's New England Journal of Medicine.
Brigham surgeon Dr. Edward E. Whang performed emergency surgery on the 41-year-old woman when she was brought in with pain in her upper stomach. He found most of her small intestine had slid through a tear in an adjacent membrane, a defect sometimes left after the intestines are rearranged in the bypass operation. The hole choked off blood to the intestines, and the tissue turned gangrenous. By then the fetus had died, and though Whang repaired the intestine, the woman died within a few hours. She still weighed 440 pounds.
Dr. Mark Tucker, director of bariatric surgery at the University of Medicine and Dentistry of New Jersey, said such tears are common and can happen up to five years after the surgery.
"You need to look at the overall risk-benefit of the surgery," said Dr. Harvey Sugerman, president of the American Society for Bariatric Surgery. He said studies show extremely obese patients have death rates up to five times lower if they undergo the surgery, compared with those who don't, and lower pregnancy complication rates after the weight-loss surgery.
Source:www.boston.com
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