Evaluation of Surgical Outcomes in Patients Undergoing Bariatric Surgery for Obesity Treatment: A Comprehensive Review of the First Decade of Practice at Tikrit Teaching Hospital

Mohammed Saleh Qadoori; Faisal Hassan  Ehmaid; Rabah Ali  Husein; Ihsan Mohammed  Khalaf; Thaer Jasim  Mohammed

doi:10.51699/cajmns.v7i4.3359

Authors

Mohammed Saleh Qadoori Department of Surgery, College of Medicine, Tikrit University, Tikrit, Iraq
Faisal Hassan Ehmaid Department of Surgery, Tikrit Teaching Hospital, Salah Al-Din Health Directorate, Tikrit, Iraq
Rabah Ali Husein Department of Surgery, Tikrit Teaching Hospital, Salah Al-Din Health Directorate, Tikrit, Iraq
Ihsan Mohammed Khalaf Department of Surgery, Tikrit Teaching Hospital, Salah Al-Din Health Directorate, Tikrit, Iraq
Thaer Jasim Mohammed Department of Surgery, College of Medicine, Tikrit University, Tikrit, Iraq

DOI:

https://doi.org/10.51699/cajmns.v7i4.3359

Keywords:

Bariatric Surgery, Obesity, Surgical Outcomes, Weight Loss, Postoperative Complications

Abstract

Background: Obesity is a chronic relapsing condition with a strong association to a variety of cardiometabolic, respiratory, hepatic and gastrointestinal comorbidities. Although bariatric surgery is an effective treatment, there is limited local outcome data from Iraqi centers. The aim: To assess early and late outcomes as well as complications, nutritional deficiencies and weight loss effectiveness following bariatric surgery in Tikrit Teaching Hospital. Patients and Methods: This was a descriptive study, analytical, retrospective, hospital-based study which included all patients undergoing bariatric surgery between 1st of October 2024 and 31st July 2025 at Tikrit Teaching Hospital. Sixty-eight patients with complete perioperative and follow-up data that fulfilled the strict criteria for bariatric surgery were enrolled. Information was collected in the operating room, inpatient records, bariatric clinic notes, and laboratory information systems. Demographic, preoperative comorbidities, type of procedure, intraoperative events, early complications (≤72 hours), readmission, late complications (up to 6 months), infections, nutritional deficiencies, gastrointestinal symptoms and indices of weight loss (ΔBMI, total weight loss, %TBWL, %EWL) were included. Results: The mean age was 39.2 ± 9.1 years; most patients were female 47 (69.12%). Mean preoperative BMI was 47.0 ± 5.9 kg/m² and mean weight 127.1 ± 18.9 kg. Common comorbidities included NAFLD 38 (55.88%), hypertension 30 (44.12%), type 2 diabetes mellitus 25 (36.76%), dyslipidemia 23 (33.82%), GERD 17 (25.00%), obstructive sleep apnea 9 (13.24%), and smoking 13 (19.12%). Laparoscopic sleeve gastrectomy was performed in 58 (85.29 %) patients and Roux-en-Y gastric bypass in 10 (14.71 %). Most early complications were mild, with 21 (30.88%) having nausea/vomiting, 7 (10.29%) having tachycardia, suspected leak in 2 (2.94%) and confirmed leak in 1 (1.47%). 2 (2.94%) patients required intervention for bleeding, 2 (2.94%) were admitted to the ICU, 1 (1.47%) was re-operated and 3 (4.41%) were readmitted early, mostly for dehydration. Late complications were GERD, which was worsened in 7 (10.29%) children, gallstones in 5 (7.35%) children, and any nutritional deficiency in 8 (11.76%). Specific deficiencies were vitamin D in 15 (22.06%), iron in 9 (13.24%), and vitamin B12 in 6 (8.82%). There were no intra-abdominal infection or sepsis reported, and only 3 (4.41%) wound/port-site infections were noted. The most common gastrointestinal side effects were constipation (17.65%) and reflux/heartburn (14.71%). At follow-up, mean BMI decreased to 37.0 ± 5.0 kg/m², with a mean total weight loss of 26.0 ± 9.2 kg, %TBWL of 20.9 ± 6.3, and %EWL of 53.3 ± 15.6. Conclusion: This high-risk group of obese patients had an impressive initial weight loss from bariatric surgery at Tikrit Teaching Hospital and very low occurrence of serious complications, leaks and infection. Some nutritional deficits and functional gastrointestinal symptoms were present, but the majority of these were mild and treatable. The results not only confirm the safety and effectiveness of the bariatric program but also stress the need for proper perioperative care and long-term nutritional follow-up.

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