Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 May 1;110(5):2577-2582.
doi: 10.1097/JS9.0000000000001108.

The current status and challenges of perioperative management of patients with a BMI of greater than or equal to 50 kg/m 2 undergoing bariatric surgery in China: a multicenter cross-sectional study

Ningli Yang  1 , Hongxia Hua  1 , Shaozhuang Liu  2 , Songhai Zhang  3 , Xiangwen Zhao  4 , Peng Zhang  5 , Pin Zhang  6 , Yong Wang  7 , Jiajia Shen  1 , Shibo Lin  1 , Wei Guan  1 , Hui Liang  1
Affiliations
Multicenter Study

The current status and challenges of perioperative management of patients with a BMI of greater than or equal to 50 kg/m 2 undergoing bariatric surgery in China: a multicenter cross-sectional study

Ningli Yang et al. Int J Surg. .

Abstract

Background: Performing bariatric surgery on patients with a BMI of over 50 kg/m 2 is challenging. This study aimed to explore the status and challenges related to the perioperative management of such patients in China.

Materials and methods: A prospective survey was designed to investigate the perioperative management of patients with a BMI of greater than or equal to 50 kg/m 2 undergoing bariatric surgery in China. The questionnaire of our survey included general information, preoperative management measures, surgical procedures performed, technical details regarding anaesthesia, and postoperative management measures. A response from only one attending physician per bariatric centre was accepted.

Results: Physicians from a total of 101 hospitals responded to the questionnaire, and the questionnaire data from 98 hospitals were complete. These centres had completed a total of 44 702 bariatric surgeries since the launch of such surgery to December 2021. A total of 3280 patients had a BMI exceeding 50 kg/m 2 . The preferred surgical procedures for patients with super obesity were sleeve gastrectomy by 62 centres, Roux-en-Y gastric bypass by 11 centres, sleeve gastrectomy plus jejunojejunal bypass by 19 centres, one anastomosis gastric bypass by 1 centre, and duodenal switch by 1 centre. The most worrying issues were cardiopulmonary failure and difficulty in extubation. 91 centres believed that preoperative weight loss was beneficial. A low-calorie diet was the specific measure mainly implemented, only three centres considered using intragastric balloon placement. Postoperative management measures varied greatly.

Conclusion: Bariatric surgery has seen rapid development. Chinese physicians show significant differences regarding the perioperative management for patients with a BMI of over 50 kg/m 2 . The perioperative risks of these patients remain relatively high, making further development of clinical pathways is necessary.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
The anatomical diagram of sleeve gastrectomy plus jejunojejunal bypass.
See this image and copyright information in PMC

References

    1. Chen K, Shen Z, Gu W, et al. . Prevalence of obesity and associated complications in China: a cross-sectional, real-world study in 15.8 million adults. Diabetes Obes Metab 2023;25:3390–3399. - PubMed
    1. Recalde M, Davila-Batista V, Díaz Y, et al. . Body mass index and waist circumference in relation to the risk of 26 types of cancer: a prospective cohort study of 3.5 million adults in Spain. BMC Med 2021;19:10. - PMC - PubMed
    1. Hruby A, Manson JE, Qi L, et al. . Determinants and consequences of obesity. Am J Public Health 2016;106:1656–1662. - PMC - PubMed
    1. Hanipah ZN, Rubino F, Schauer PR. Remission with an intervention: is metabolic surgery the ultimate solution? Endocrinol Metab Clin North Am 2023;52:65–88. - PubMed
    1. Liang H, Li C. Bariatric and metabolic surgery and medical insurance payment in China. Curr Obes Rep 2023;12:365–370. - PubMed

Publication types