La chirurgie de l'obésité en France : résultats d'une enquête prospective nationale

Abstract

Aim. – To compare the actual practice of Bairatric surgery in France with the guidelines of scientific societies regarding surgical indications and followup. Methods. – This a prospective descriptive transversal study performed within a two month period (December 2002 – January 2003) in all patients for which a consent demand has been sent to the Medical Insurance Services (examined by an administrative consultant) and/or patients operated on for morbid obesity (with or without administrative sonsent). Results. – One thousand (and) three patients have been examined by an administrative consultant before obesity surgery and 1238 patients have been operated in 263 centres including 79 public (non-profit) centres and 184 private centres. In 16.7 % of the cases, there were wrong indications according to recognized criteria (BMI < 35 kg/m 2 or lack of comorbidities for BMI between 35 and 39) or even contraindications because of other diseases. Patient informed consent was retrieved in only 54 % of medical files and follow up protocol was done in only 47 % of the cases. Because of several missing data, the practice of bariatric surgery followed the guidelines in only 34 % of cases. In hospital morbidity rate was 5 %. Two patients died postoperatively (mortality rate 0.2 %). Conclusions. – This study demonstrates that the practice of bariatric surgery needs to be improved in France.