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Obesity Surgery

Wesley F Kim, Thomas Sonnanstine
BACKGROUND: Despite effectively treating obesity and its comorbidities, only a fraction of the growing obese population is evaluated for bariatric surgery. Aside from barriers including resources and social support, patients report personal experience with friends and relatives suffering poor outcomes after bariatric surgery. Rates of mortality, leaks, and strictures have decreased over the past 20 years, but few instances of gross surgeon error have been reported in the literature. Our objective is to report and demonstrate the revision of a critically shortened Roux limb in a patient with chronic nausea and dysphagia found to have a 15-cm Roux limb and briefly discuss its implications...
March 14, 2018: Obesity Surgery
Rashed Al Amer, Khalid Al Khalifa, Safeyah Ali Alajlan, Ahmed Al Ansari
PURPOSE: The Short Form-36 (SF-36) questionnaire is a valuable and easy-to-use tool for the measurement of quality of life in patients with obesity. To become a widely used tool, the questionnaire must be validated in many different contexts. Thus, the present study aimed to evaluate the construct validity and reliability of the SF-36 questionnaire among patients with obesity in Bahrain. METHODOLOGY: The 36-item questionnaire was administered to a study cohort scheduled to undergo bariatric surgery at the Bahrain Defence Force Hospital in Bahrain...
March 14, 2018: Obesity Surgery
Stefanie R van Mil, L Ulas Biter, Gert-Jan M van de Geijn, Erwin Birnie, Martin Dunkelgrun, Jan N M IJzermans, Noelle van der Meulen, Guido H H Mannaerts, Manuel Castro Cabezas
INTRODUCTION: Type 2 diabetes mellitus (T2DM) and obesity are both related to increased risk of cardiovascular disease and mortality. Early atherosclerotic vascular changes can be detected by non-invasive tests like carotid artery intima-media thickness (cIMT) and pulse wave velocity (PWV). Both cIMT and PWV are significantly impaired in T2DM patients and in obese patients, but the additional effect of T2DM on these vascular measurements in obese subjects has not been evaluated. METHODS: Two hundred morbidly obese patients with or without T2DM were enrolled in a prospective cohort study and underwent extensive laboratory testing, including cIMT and PWV measurements...
March 13, 2018: Obesity Surgery
Tarun Mittal, Ashish Dey, Abhilash Nali, Sheikh Mohammad Taha Mustafa, Vinod K Malik
INTRODUCTION: Ischemia of the tip of the alimentary limb involving the gastrojejunostomy (GJ) is an unusual complication during Roux-en-Y gastric bypass (RYGB). Revision of the GJ may be needed to manage this complication. OBJECTIVES: We present a case of inadvertent perforation of the jejunum by a gastric calibration tube, which was recognized on the table and appropriate measures are then taken. Repair of this enterotomy however then led to ischemia of the tip of alimentary limb extending to a portion of the GJ anastomosis...
March 13, 2018: Obesity Surgery
Ji Yeon Park, Yong Jin Kim
BACKGROUND: Percentage of excess weight loss (%EWL) is the most common metric used after bariatric surgery. However, there has been consistent argument against its use since it varies significantly by initial body mass index (BMI). This study aimed to validate the newly suggested percentage of alterable weight loss (%AWL) metric in Korean patients. METHODS: A retrospective review of the prospectively established database at Soonchunhyang University Seoul Hospital identified 165 patients who underwent primary laparoscopic Roux-en-Y gastric bypass (RYGB) and had at least 2-year follow-up weight loss results after surgery...
March 12, 2018: Obesity Surgery
Silvia Bettini, Emanuel Bordigato, Roberto Fabris, Roberto Serra, Chiara Dal Pra', Anna Belligoli, Marta Sanna, Chiara Compagnin, Mirto Foletto, Luca Prevedello, Paola Fioretto, Roberto Vettor, Luca Busetto
OBJECTIVES: Resting energy expenditure (REE) declines more than what is expected according to body composition changes after caloric restriction. This metabolic adaptation is considered one of the factors favoring weight regain. The aim of this study is to evaluate the changes of REE and calculate the degree of metabolic adaptation occurring after laparoscopic sleeve gastrectomy (LSG). METHODS: REE (by indirect calorimetry) and body composition (fat-free mass or FFM, fat mass or FM by bioelectrical impedance analysis) were determined before and after 12 months in 154 patients with obesity treated with laparoscopic sleeve gastrectomy (LSG)...
March 12, 2018: Obesity Surgery
Sandra Jumbe, Jane Meyrick
BACKGROUND: The superiority of obesity surgery for improving medical and weight outcomes in severely obese patients when compared to other weight loss interventions remains undisputed. However, knowledge about the psychological impact of the procedure on patients' lives is limited. Systematic reviews indicate persisting psychological distress after surgery compared to control groups especially longer term, suggesting the need for postoperative psychological support and assessment. Research literature also infers limited knowledge regarding the postoperative patient experience of obesity surgery...
March 12, 2018: Obesity Surgery
Luciana Teixeira de Siqueira, Marcela Silvestre Outtes Wanderley, Roberto Afonso da Silva, Adriana da Silva Andrade Pereira, José Luiz de Lima Filho, Álvaro Antônio Bandeira Ferraz
BACKGROUND: Obesity has been associated with the development of various types of cancer. Biomarker studies may provide molecular level knowledge of the factors involved in this association, improving clinical practice through new methods of prevention and treatment. PURPOSE: The present study aimed to analyze proteins found in the plasma of obese patients prior to and 6 months after bariatric surgery, using body mass index (BMI) and percentage total weight loss (%TWL) to evaluate, in a prospective manner, the effects of weight loss on the regulation of proteins related to the appearance of tumors...
March 10, 2018: Obesity Surgery
Uri Kaplan, Scott Penner, Forough Farrokhyar, Nicole Andruszkiewicz, Ruth Breau, Scott Gmora, Dennis Hong, Mehran Anvari
PURPOSE: Older age (> 60) has been considered a relative contraindication for bariatric surgery due to increased complication risk. This study examined the risks and benefits of bariatric surgery for patients older than 60 years in Canadian population. METHODS: This was a retrospective cohort study of the Ontario Bariatric Registry: a database recording peri-operative and post-operative outcomes of publicly funded bariatric surgeries across the province. Patients who completed 1 year follow-up, who underwent laparoscopic gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between January 2010 and May 2013, were divided into older (> 60) and younger (> 60) cohorts, and outcomes were compared...
March 10, 2018: Obesity Surgery
Tamasin Taylor, Yijiao Wang, William Rogerson, Lynda Bavin, Cindy Sharon, Grant Beban, Nicholas Evennett, Greg Gamble, Timothy Cundy
BACKGROUND: Factors such as ethnicity, gender, and socioeconomic status may play a role in both access to and attrition from bariatric programs before surgery is undertaken. New Zealand (NZ) has high rates of obesity in its Pacific population and the indigenous Māori. These groups also experience poorer health outcomes and therefore have the greatest need for surgery. METHODOLOGY: A retrospective cross-sectional study of 704 people referred for and accepted onto a publicly funded bariatric surgery from 2007 to 2016...
March 10, 2018: Obesity Surgery
Weijie Chen, Zenan Xia, Wei Liu, Xiaodong He, Weimin Zhang
PURPOSES: Our aim was to investigate the effects of selective celiac branch vagotomy on food intake and glycemic control after ileal transposition (IT) and the possible roles of the vagus on the improvement of diabetes. MATERIALS AND METHODS: Forty non-obese rats with diabetes underwent either IT, IT + celiac branch vagotomy (ITV), sham IT (SI), or sham IT + celiac branch vagotomy (SIV). They were pair fed, and the food intake, body weight, fasting plasma glucose, and glucagon-like peptide 1 (GLP-1) level were monitored...
March 10, 2018: Obesity Surgery
Gianfranco Donatelli, Ludovica Guerriero, Fabrizio Cereatti, Kostantinos Arapis, Carmelisa Dammaro, Jean-Loup Dumont, David Fuks, Silvana Perretta
INTRODUCTION: Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula. MATERIAL AND METHODS: A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6 months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula...
March 9, 2018: Obesity Surgery
Zubaidah Nor Hanipah, Suriya Punchai, Stacy A Brethauer, Philip R Schauer, Ali Aminian
INTRODUCTION: While bariatric surgery leads to significant prevention and improvement of type 2 diabetes, patients may rarely develop diabetes after bariatric surgery. The aim of this study was to determine the incidence and the characteristic of new-onset diabetes after bariatric surgery over a 17-year period at our institution. METHODS: Non-diabetic patients who underwent bariatric surgery at a single academic center (1997-2013) and had a postoperative glycated hemoglobin (HbA1c) ≥ 6...
March 9, 2018: Obesity Surgery
Dimitrios Dardamanis, Julie Navez, Laurent Coubeau, Benoit Navez
AIMS: To compare the perioperative parameters and excess weight loss between patients operated by laporoscopic Roux-en-Y gastric bypass (LRYGB), as a primary operation or a revisional, for insufficient weight loss after vertical banded gastroplasty (VBG) or adjustable gastric banding (AGB). METHODS: A retrospective analysis of all patients who underwent a LRYGB was performed for the period 2004-2011. Demographics, preoperative body mass index (BMI), co-morbidities, operation time, conversion rate, perioperative complications, hospitalization period, and % of excess BMI loss (%EBMIL) were investigated and compared between groups...
March 9, 2018: Obesity Surgery
Golaleh Asghari, Alireza Khalaj, Maryam Ghadimi, Maryam Mahdavi, Hossein Farhadnejad, Majid Valizadeh, Fereidoun Azizi, Maryam Barzin, Farhad Hosseinpanah
BACKGROUND: Micronutrient deficiencies are major concerns after bariatric surgery, although these conditions often go undiagnosed pre-surgery. OBJECTIVE: To assess pre-surgery micronutrient status of an Iranian population of morbidly obese candidates of bariatric surgery in a cross-sectional study. METHODS: A cross-sectional analysis of 2008 candidates for bariatric surgery, aged 15-65 years, with either body mass index (BMI) ≥ 40 kg/m2 or 30 < BMI < 35 kg/m2 with a medical comorbidity was conducted...
March 8, 2018: Obesity Surgery
Salman AlSabah, Eliana Al Haddad, Saud Al-Subaie, Shehab Ekrouf, Khaled Alenezi, Ahmad Almulla, Mohannad Alhaddad
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has become the most performed bariatric procedure as of 2015. However, inadequate weight loss may present the need for revisional procedures. OBJECTIVES: The objective of this study was to analyze the efficacy of single-anastomosis gastric bypass (SAGB) in attaining successful weight loss following an initial LSG. METHODS: A retrospective analysis was performed on all patients who underwent LSG at Amiri Hospital, Kuwait from 2008 to 2017...
March 8, 2018: Obesity Surgery
Ahmed Guirat, Hassan Majed Addossari
The one anastomosis gastric bypass (OAGB) is a recent procedure, which still raises controversies concerning its presumed role in the genesis of biliary reflux and the risk of developing esophageal or gastric cancer. A review of the literature in order to have evidence in favor of or against the risk of cancer after OAGB. We have conducted a review of the English literature using the MEDLINE database. The theoretical risk of asymptomatic chronic biliary reflux after OAGB exists and may be responsible for gastroesophageal cancer...
March 8, 2018: Obesity Surgery
Mario Musella, Valeria Cantoni, Roberta Green, Wanda Acampa, Nunzio Velotti, Paola Maietta, Alberto Cuocolo
BACKGROUND: To demonstrate the lack of utility and efficacy of routine early postoperative upper gastrointestinal study (UGI) in obese patients undergoing bariatric surgery and to show the higher efficacy of CT scan in cases of clinical suspicion of a leakage, a meta-analysis was performed. MATERIALS AND METHODS: A literature search including articles published in last 18 years was performed. For both UGI and CT scan, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated...
March 7, 2018: Obesity Surgery
Piers R Boshier, Matyas Fehervari, Sheraz R Markar, Sanjay Purkayastha, Patrik Spanel, David Smith, George B Hanna
BACKGROUND: Dietary restriction together with alteration of the gastrointestinal tract results in major metabolic changes and significant weight loss in patients undergoing bariatric surgery. Current methods of measuring these changes are often inaccurate and lack a molecular basis. The objective of this study was to determine the role of exhaled ketones as non-invasive markers of nutritional status in patients undergoing surgical treatment of obesity. METHODS: Patients at different stages of treatment for obesity were recruited to this single-centre cross-sectional study...
March 7, 2018: Obesity Surgery
Laurent Bailly, Luigi Schiavo, Lionel Sebastianelli, Roxane Fabre, Christian Pradier, Antonio Iannelli
BACKGROUND: Bariatric surgery (BS) has grown exponentially in France, and long-term anemia due to micronutrient deficiencies has become common. OBJECTIVES: The objective of this study was to assess the long-term risk of anemia after BS and to investigate the factors associated with the occurrence of this complication. MATERIALS AND METHODS: Data from the French National Health Service database on patients who had undergone gastric bypass (GB), sleeve gastrectomy (SG), or adjustable gastric banding (AGB), between 2008 and 2016 were extracted...
March 7, 2018: Obesity Surgery
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