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Morbid obesity perioperative care

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https://www.readbyqxmd.com/read/29691174/ten-year-mortality-and-revision-after-total-knee-arthroplasty-in-morbidly-obese-patients
#1
Mina Tohidi, Susan B Brogly, Katherine Lajkosz, Heather J Grant, Elizabeth G VanDenKerkhof, Aaron R Campbell
BACKGROUND: Although morbid obesity has been associated with early surgical complications after total knee arthroplasty (TKA), evidence of long-term outcomes is limited. We conducted a population-based study to determine the association between morbid obesity and 10-year survival and revision surgery in patients undergoing primary TKA. METHODS: A cohort study of 9817 patients aged 18-60 years treated with primary TKA from April 1, 2002 to March 31, 2007 was conducted using Ontario administrative health-care databases of universal health-care coverage...
April 4, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29643964/more-stapler-firings-increase-the-risk-of-perioperative-morbidity-after-laparoscopic-sleeve-gastrectomy
#2
Piotr Major, Michał Wysocki, Michał Pędziwiatr, Magdalena Pisarska, Piotr Małczak, Mateusz Wierdak, Marcin Dembiński, Marcin Migaczewski, Mateusz Rubinkiewicz, Andrzej Budzyński
Introduction: Staple-line bleeding and leakage are the most common serious complications of laparoscopic sleeve gastrectomy. The relationship between multiple stapler firings and higher risk of postoperative complications is well defined in colorectal surgery but has not been addressed in bariatric procedures so far. Identification of new factors such as "the numbers of stapler firings used during laparoscopic sleeve gastrectomy (LSG)" as a predictor for complications can lead to optimization of the patient care at bariatric centers...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29525941/peri-and-postoperative-management-and-outcomes-of-morbidly-obese-patients-bmi-40-kg-m-2-with-gynaecological-disease
#3
Sudip Kundu, Hatun Karakas, Hermann Hertel, Peter Hillemanns, Ismini Staboulidou, Cordula Schippert, Philipp Soergel
INTRODUCTION: For the last two decades, obesity rates have been increasing in both developed and developing countries, with the number of obese women roughly doubling during this period (Stevens et al. in Popul Health Metr 10(1):33, 2012). Obesity represents one of the biggest epidemics of the 21st century. The aim of this retrospective study is to characterise the outcomes of gynaecologic surgeries in cases of extremely obese women with a body mass index (BMI) over 40 kg/m2 . METHODS: This study is a retrospective case control study in a single-centre setting...
March 10, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29397618/-the-consensus-on-nutritional-and-multi-disciplinary-management-for-bariatric-surgery
#4
(no author information available yet)
Obesity is associated with many chronic diseases and has become a major public health problem all over the world. Although weight loss includes lifestyle modification, psychological and medical treatment, bariatric surgery remains an effective treatment for morbidly obese patients. Due to the lack of multidisciplinary management and long-term nutrition monitoring, some patients are suffering from malnutrition, functional impairment and other issues after bariatric surgery. This consensus is commissioned by the Nutrition and Metabolism Cooperation Group of Chinese Society for Parenteral and Enteral Nutrition and Bariatric Multidisciplinary Team of Peking Union Medical College Hospital...
February 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29358013/perioperative-care-of-the-obese-cardiac-surgical-patient
#5
REVIEW
M Megan Chacon, Sreekanth R Cheruku, Peter J Neuburger, Laeben Lester, Sasha K Shillcutt
Morbid obesity is associated with impairment of cardiovascular, pulmonary, gastrointestinal, and renal physiology with significant perioperative consequences and has been linked with higher morbidity and mortality after cardiac surgery. Cardiac surgery patients have a higher incidence of difficult airway and difficult laryngoscopy than general surgery patients do, and obesity is associated with difficult mask ventilation and direct laryngoscopy. Positioning injuries occur more frequently because obese patients are at greater risk of pressure injury, such as rhabdomyolysis and compartment syndrome...
December 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29239152/the-safety-and-efficiency-of-a-fast-track-protocol-for-sleeve-gastrectomy-a-team-approach
#6
Sebastiaan J Vreeswijk, Pim W van Rutte, Simon W Nienhuijs, R Arthur Bouwman, J Frans Smulders, Marc P Buise
BACKGROUND: Increasing numbers of morbid obese patients has led to increased numbers of bariatric procedures. Fast-track protocols are being developed to enhance the available resources, while maintaining a safe procedure. Reported results on safety merely apply to a mixed bariatric population. The objective was to evaluate safety and efficiency of the fast-track principles in patients undergoing sleeve gastrectomy. METHODS: Retrospective observational study including patients undergoing primary sleeve gastrectomy at the Obesity Centre of the Catharina Hospital Eindhoven, the Netherlands...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29232296/morbid-obesity-does-not-increase-morbidity-or-mortality-in-robotic-cardiac-surgery
#7
Hiroto Kitahara, Brooke Patel, Mackenzie McCrorey, Sarah Nisivaco, Husam H Balkhy
OBJECTIVE: Morbid obesity (body mass index ≥ 35 kg/m) usually confers a higher perioperative risk in cardiac surgery. Robotic cardiac surgery may have many advantages for these high-risk patients. METHODS: We retrospectively reviewed patients undergoing robotic cardiac surgery from July 2013 to April 2017 at our institution. We compared the outcomes of morbidly obese patients versus nonobese patients. RESULTS: A total of 486 patients underwent robotic cardiac surgery (322 men, median age = 65 years)...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29212336/-new-directions-in-bariatric-and-metabolic-surgery
#8
Martin Fried
Czech Republic may be counted among the leading European Countries in regards of the level of delivered high quality multidisciplinary care in treatment of obesity and obesity related metabolic diseases. The 1st Faculty of Medicine (Charles University) and the Faculty General Hospital in Prague played the most important role in the development of bariatric and metabolic surgery in the Czech Republic. pCzech bariatric surgery achieves great successes both on national and international levels. Just to mention some of them: M...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29195738/a-perioperative-care-map-improves-outcomes-in-patients-with-morbid-obesity-undergoing-major-surgery
#9
Benjamin D Boodaie, Anthony H Bui, David L Feldman, Michael Brodman, Peter Shamamian, Ronald Kaleya, Meg Rosenblatt, Donna Somerville, Patricia Kischak, I Michael Leitman
BACKGROUND: The surgical management of patients with morbid obesity (body mass index ≥ 40) is notable for a relatively high risk of complications. To address this problem, a perioperative care map was developed using precautions and best practices commonly employed in bariatric surgery. It requires additional medical assessments, sleep apnea surveillance, more stringent guidelines for anesthetic management, and readily available bariatric operating room equipment, among other items...
February 2018: Surgery
https://www.readbyqxmd.com/read/29114413/perioperative-factors-affecting-ambulatory-outcomes-following-laparoscopic-adjustable-gastric-banding
#10
Mirsad Dupanovic, Ron Krebill, Iris Dupanovic, John Nachtigal, Melissa Rockford, Walter Orr
Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29077813/death-or-near-death-in-patients-with-obstructive-sleep-apnoea-a-compendium-of-case-reports-of-critical-complications
#11
Y Subramani, M Nagappa, J Wong, J Patra, F Chung
The care of surgical patients with obstructive sleep apnoea (OSA) invokes concerns with safety and liability because of the risk that exists for perioperative death or near-death. The purpose of this review is to analyse the available literature to identify risk factors for perioperative critical complications in patients with OSA. Literature reports were screened for life threatening complications and deaths in surgical patients with OSA. The critical complications were sub-grouped as death/near-death events (death and anoxic brain damage) vs critical respiratory events (CRE)/other events and analysed for various risk factors...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29064879/the-successful-implementation-of-a-modified-enhanced-recovery-after-surgery-eras-program-for-bariatric-surgery-in-a-south-african-teaching-hospital
#12
Emil Loots, Benn Sartorius, Imran M Paruk, Damian L Clarke
BACKGROUND: This study assessed the impact of strict adherence to perioperative pathways incorporating an enhanced recovery after surgery protocol on the outcomes of bariatric surgery at our center. METHODS: Prospective data were collected on 62 patients undergoing bariatric surgery between January 2011 and March 2016. Outcomes were compared between those who adhered to the perioperative pathway and those who did not. RESULTS: Fifty-three patients underwent laparoscopic sleeve gastrectomy, and 9 patients underwent Laparoscopic Roux-en-Y Gastric Bypass...
October 23, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29062439/problems-in-bariatric-patient-care-challenges-for-dieticians
#13
REVIEW
Małgorzata Kostecka, Monika Bojanowska
Obesity management options include a low-calorie diet, behavioral therapy, regular physical activity and pharmacological therapy. However, treatment failure is frequently encountered, most of these methods are ineffective, and a positive outcome is rarely maintained in the long term. In morbidly obese patients, bariatric surgery is considered the most effective treatment for obesity as well as the accompanying diseases. Bariatric surgery promotes much greater weight loss than conservative treatment, regardless of the applied surgical technique...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29049219/risk-assessment-of-morbidly-obese-parturient-in-cesarean-section-delivery-a-prospective-cohort-single-center-study
#14
Xiaohu An, Yanhong Zhao, Ying Zhang, Qiling Yang, Yilong Wang, Weiwei Cheng, Zeyong Yang
BACKGROUND: Up to 40% of women gain excessive weight during pregnancy. Obesity complications and risks in parturient women undergoing cesarean section (CS) with different anesthetic methods remain unknown. This study aimed to assess the safety and risk of obese women undergoing CS delivery with various perioperative anesthetic methods. METHODS: Seven hundred ninety parturient women underwent CS under general anesthesia (GA), intraspinal anesthesia including epidural anesthesia (EA) and combined spinal-epidural anesthesia (CSEA)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28951657/sleeve-gastrectomy-and-left-ventricular-assist-device-for-heart-transplant
#15
Joseph Greene, Tung Tran, Timothy Shope
BACKGROUND AND OBJECTIVES: Heart failure (HF) is a severe obesity-related comorbidity. Many patients with end-stage HF eventually require cardiac transplantation for long-term survival. These patients may be precluded from enrollment in heart transplant programs secondary to morbid obesity. We propose a pathway involving sleeve gastrectomy (SG) for patients with morbid obesity and HF to afford cardiac transplantation eligibility. METHODS: Three patients with HF and morbid obesity underwent implantation of a left ventricular assist device (LVAD) and SG at an academic tertiary care institution in Washington, DC...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#16
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
February 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28866313/impact-of-super-obesity-on-perioperative-outcomes-after-hepatectomy-the-weight-of-the-risk
#17
Luis F Acosta, Catherine R Garcia, Adam Dugan, Francesc Marti, Daniel Davenport, Roberto Gedaly
BACKGROUND: We evaluated perioperative outcomes in super obese patients (body mass index >50 kg/m2 ) undergoing liver resection using the American College of Surgeons National Surgical Quality Improvement Program. METHODS: Patients undergoing hepatectomy recorded in the American College of Surgeons National Surgical Quality Improvement Program dataset from 2005 to 2015 were analyzed. Out of 21,228 hepatectomies in the National Surgical Quality Improvement Program dataset, 146 were performed on super obese patients...
November 2017: Surgery
https://www.readbyqxmd.com/read/28833518/post-sternotomy-mediastinitis-in-the-modern-era
#18
Siew S C Goh
BACKGROUND: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. METHODS: This review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery...
September 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28817167/body-mass-index-50-kg-m2-and-beyond-perioperative-care-of-pregnant-women-with-superobesity-undergoing-cesarean-delivery
#19
Marcela Carolina Smid, Sarah K Dotters-Katz, Robert M Silver, Jeffrey A Kuller
Importance: Superobesity, defined as body mass index 50 kg/m2 or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. Objective: To review evidence of perioperative care during cesarean delivery among superobese women. Evidence Acquisition: We performed an evidence-based review of maternal and neonatal risks of cesarean delivery and of intraoperative management and immediate postpartum care of superobese pregnant women...
August 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28767803/perioperative-care-in-bariatric-surgery-in-the-context-of-the-acerto-project-reality-versus-surgeons-assumptions-in-a-cuiab%C3%A3-hospital
#20
Jacqueline Jéssica De-Marchi, Mardem Machado De-Souza, Alberto Bicudo Salomão, José Eduardo de Aguilar Nascimento, Anyelle Almada Selleti, Erik de-Albuquerque, Katia Bezerra Veloso Mendes
Objective: to assess the level of knowledge among bariatric surgeons, about the recommendations of the ACERTO Project, correlating their assumptions on their perioperative prescriptions and the reality, according to the patients charts. Method: we conducted a prospective, longitudinal, observational study comparing the assumptions of bariatric surgeons obtained through responses on a specific questionnaire with the reality found in clinical data from the hospital records...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
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