Laparoscopic gastric bypass provides better results

NEW YORK (Reuters Health) — Performing gastric bypass surgery to reduce the weight of morbidly obese patients using a laparoscopic method, rather than the conventional more invasive "open" abdominal method, reduces postoperative complications, the need for a second operation, and shortens hospital stays, new research shows. Nevertheless, laparoscopic gastric bypass is more expensive.

Obesity surgery, also called bariatric surgery, is growing in popularity and more and more of these operations are being done using a laparoscope, note co-authors Dr. Wendy E. Weller, from the University at Albany in New York, and Dr. Carl Rosati, from Albany Medical Center.

This is done by placing one or more small incisions in the abdomen, through which a hollow tube is inserted.

This allows very small instruments to be inserted to perform the gastric bypass. The entire procedure is visualised on a screen.

In contrast, the more invasive "open" procedure involves making an incision to open the abdomen so the procedure can be performed.

The current study, reported in the Annals of Surgery, involved an analysis of data from 19,156 subjects who underwent gastric bypass surgery in 2005 and were logged in the Nationwide Inpatient Sample, the largest all-payer inpatient database in the US Slightly less than 75 percent of the patients underwent laparoscopic gastric bypass, the report indicates.

Laparoscopic gastric bypass was linked to a reduced risk of several complications.

With open surgery, the risk of pulmonary complications was increased by 92 percent, for cardiovascular complications it was 54 percent, for sepsis, a serious system-wide infection, the risk was more than doubled and the risk of anastomotic leak, leakage from the operative site, 32 percent higher.

On average, performing laparoscopic rather than open gastric bypass reduced the hospital stay by about one day.

The average total charges were similar for the two procedures, but median total charges were significantly higher with laparoscopic gastric bypass: $30,033 vs. $28,107 respectively.

Colon cancer screening rates still low

NEW YORK (Reuters Health) — Just half of Americans who should be screened for colorectal cancer are actually getting tested, and lack of health insurance appears to be a major reason why, new research suggests.

"Colorectal cancer is the second leading cancer killer in the US, but it doesn't have to be," Dr. Jean Shapiro, an epidemiologist at the Centers for Disease Control and Prevention (CDC) in Atlanta and the study's lead researcher, told Reuters Health.

She pointed out that screening can not only identify cancer early, but may also spot precancerous polyps that can be removed before cancer develops.

Regular screening for colorectal cancer is recommended for people 50 and older, but screening rates are known to be low, Shapiro and her colleagues note in the journal Cancer Epidemiology, Biomarkers and Prevention.

To investigate reasons why people might not be getting screened, the researchers analysed data on 13,269 people aged 50 and older who participated in the 2005 National Health Interview Survey.

Exactly half of the survey respondents said they had been screened for colorectal cancer with a faecal occult blood test (FOBT) in the past year, endoscopy within the past ten years, or both.

But just 24.1 percent of people who had no health insurance had gotten tested. Among people who reported having no usual source of health care, 24.7 percent had been screened.

Shapiro and her team also saw sharp differences in colorectal cancer screening rates based on education and income.

Men may need to work harder to cut diabetes risk

NEW YORK (Reuters Health) — Losing weight through diet and exercise lowers diabetes risk in men and women, but men may have to work harder for the same benefit, new research suggests.

In a study of more than 1,100 adults at risk of Type 2 diabetes, researchers found that those who went on an "intensive" regimen of calorie-cutting and exercise lowered their risk of developing diabetes over the next year.

However, despite the fact that men lost more weight and exercised more than women did, that did not translate into a greater reduction in diabetes risk, the researchers report in the journal Diabetes Care.

For the study, researchers led by Dr. Leigh Perreault at the University of Colorado Health Sciences Center in Aurora randomly assigned participants to either an intensive programme of lifestyle changes or standard lifestyle advice.

Those in the former group were given the goal of losing seven percent of their body weight by cutting calories and fat from their diet and exercising for at least 2.5 hours per week.

Overall, men and women in the intensive group were 58 percent less likely to develop diabetes over the next year.

In general, men exercised more and were more successful at losing weight — 47 percent reached the seven-percent goal, versus 37 percent of women.

Weight loss translated into a reduction in triglycerides (a type of blood fat) and better blood sugar control. Once again, men had greater decreases in these two factors as well.

However, men saw no more benefit than women did when it came to diabetes risk.

The rates of return to normal glucose tolerance levels and the development of diabetes did not differ between men and women.

The reason, according to Perrault's team, may have to do with the fact that men had more diabetes risk factors to begin with.

They say that more studies are needed to understand whether and how various diabetes prevention tactics affect men and women differently.