by Edward E. Mason, MD, PhD, FACS; and Kathleen E. Renquist, BS

Dr. Mason and Ms. Renquist are from The Roy J. and Lucille A. Carver College of Medicine, Department of Surgery; The University of Iowa, Iowa City, Iowa.

Correspondence address: Kathleen Renquist, BS; University of Iowa, Department of Surgery, 4125 Westlawn, Iowa City, Iowa 52242-1178. Telephone: (319) 335-8917. Fax: (319) 356-8378. Email: kathleen-renquist@uiowa.edu.

Abstract

Objective: To report the 20-year experience of a large data repository for surgical treatment of obesity with emphasis on development, problems, and outcomes. Design: Standardized data collection and analysis of voluntarily collected preoperative, operative, and postoperative information following surgical treatment for obesity. Setting: This represents the first outcome research facility organized for bariatric surgery in the United States involving multiple data collection sites using standardized software (1986 to the present). Participants: The 85 data collection sites include 148 surgeons. Information represents 45,294 patients from seven international sites and 28 sites in the US. Measurements: NBSR and IBSR data collection software, SAS analyses, and National Death Index searches to study longevity and cause of death. Results: Early publications and COE requests have concentrated on early outcomes. From 1986 to 2005, changes occurred in operative selection from predominately open, simple procedures (63% to 6%) to complex, bypass operations (36.9% to 94.0%) with an increase in the laparoscopic technique (0% to 22%). In addition, mean days of postoperative hospital stay declined from 4.9 to 3.3, while major 30-day complications increased (2.6% to 4.1%). Conclusion: In 2007, reporting results for surgical treatment of obesity must focus more on long-term mortality and cause of death. The IBSR can obtain this information if sufficient financial support is attained.

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