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Sánchez et al. Mini-invasive Surg 2024;8:36 https://dx.doi.org/10.20517/2574-1225.2024.72 Page 5 of 9

Table 1. Reported surgical complications between LATAM and Mexico according to the two most common MBS procedures
RYGB SG
Mexico (n = 1,554) LATAM (n = 1,828) P Mexico (n = 514) LATAM (n = 2,419) P
30 days
**
Leaks, % 1.6 0.6 0.003 0.6 0.3 0.30
Bowel obstruction, % 0.4 0.4 0.96 0.0 0.04 0.83
DVT, % 0.1 0.1 0.59 0.0 0.1 0.54
PE, % 0.1 0.1 0.98 0.0 0.1 0.54
90 days
Leaks, % 0.0 0.1 0.34 0.0 0.1 0.62
DVT, % 0.0 0.1 0.58 0.3 0.1 0.49
PE, % - - - 0.0 0.04 0.85
Death, % 0.1 0.0 0.42 0.0 0.04 0.85
**
Statistically significant values using the Fisher exact test are highlighted with asterisks ( ) after Bonferroni adjustment for multiple comparisons.
No statistical significance was found using the chi-square test. LATAM: Latin America; MBS: metabolic and bariatric surgery; RYGB: Roux-en-Y
gastric bypass; SG: sleeve gastrectomy; DVT: deep venous thrombosis; PE: pulmonary embolism.

in Figure 3. The most common comorbid condition was HBP, followed by T2D. Figure 4 shows the
evolution of T2D, HBP, and dyslipidemia in the total group included in the database divided by the two
most common surgical procedures (RYGB and SG).

DISCUSSION
The current analysis of 13,727 patients who underwent bariatric/metabolic surgery in five countries of
LATAM during five years has allowed the identification of some similarities and differences in the practice
of MBS between Mexico and the other analyzed countries. For practicality, we will divide the discussion
into three different areas. The first important area for analysis relates to patient characteristics. Our data
show that age and gender distributions at the time of surgery were very similar in Mexican patients and
those from other LATAM countries. However, BMI was higher in comorbid conditions such as sleep apnea
and dyslipidemia were present in a higher number of Mexican patients, whereas GERD was more frequently
identified in LATAM.

Concerning the presence of comorbidities before surgery, the incidence of T2D was similar in Mexico to
that in LATAM, whereas HBP and dyslipidemia had a different prevalence. In the absence of a standard
algorithm for the evaluation of comorbid conditions, differences may be real or related to the clinical
accuracy and diagnostic methodology of each center. Differences in the prevalence of comorbidities may
also be related to ethnicity. In the USA, for example, the frequency of T2D is higher in American Indians/
Alaska Natives (14.7%), people of Hispanic origin (12.5%), and non-Hispanic blacks (11.7%) than in
Caucasians [9-11] . This suggests that obesity is strongly influenced by factors such as gender, age, ethnic group,
geographic area, and socioeconomic stratum. Differences in the prevalence of T2D have been noted even in
people with similar ethnic ancestry but from different countries, and in the same way, some authors have
suggested that the genetic/ethnic background may have a significant impact on weight loss and metabolic
improvement even when using the same surgical technique in patients with the same ancestry .
[12]
The second area corresponds to the surgical practice. The distribution of surgical procedures was different
in Mexico than in LATAM. RYGB was performed in 69% of the Mexican patients and 40.2% of patients
from LATAM. This higher frequency of RYGB in the Mexican group may be related to a higher BMI at the
time of surgery, compared to the LATAM group, since in the Mexican group, 63% of the patients were