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https://www.readbyqxmd.com/read/28815402/covered-esophageal-stenting-is-effective-for-symptomatic-gastric-lumen-narrowing-and-related-complications-following-laparoscopic-sleeve-gastrectomy
#1
Murad A Aburajab, Joshua B Max, Mel A Ona, Kapil Gupta, Miguel Burch, F Michael Feiz, Simon K Lo, Laith H Jamil
BACKGROUND AND STUDY AIMS: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity in treating morbid obesity. Prior studies showed a 3.5% risk of gastric sleeve stenosis (GSS). There is no consensus on how to treat these patients, and the role of endoscopic therapy has been addressed in only a few studies. We aim to assess the efficacy and safety of endoscopic stenting in the management of GSS following LSG. PATIENTS AND METHODS: Retrospective data were reviewed from July 2009 to November 2013...
August 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28815383/a-5-year-follow-up-study-of-laparoscopic-sleeve-gastrectomy-among-morbidly-obese-adolescents-does-it-improve-body-image-and-prevent-and-treat-diabetes
#2
Moamena Ahmed El-Matbouly, Nesreen Khidir, Hussien Aly Touny, Walid El Ansari, Mohammed Al-Kuwari, Moataz Bashah
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is widely used, and it is important to examine its physiologic and psychological efficacy among adolescents. We assessed LSG's efficacy for weight loss, its short- and long-term effects on resolving and improving obesity-related comorbidities, and its psychological outcomes among morbidly obese adolescents. METHODS: We retrospectively analyzed the medical records of 91 morbidly obese adolescents in Qatar who underwent LSG (2011-2014), with 1- and 5-year follow-ups...
August 17, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28807556/long-term-weight-loss-in-laparoscopic-sleeve-gastrectomy
#3
Matías Sepúlveda, Munir Alamo, Jorge Saba, Cristián Astorga, Raúl Lynch, Hernán Guzmán
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has become an option as a bariatric surgical technique. There is a lack of long-term results of this procedure in the literature. The aim of this study is to present weight loss results of LSG for up to 7 years of follow-up. METHODS: A retrospective series of patients who underwent LSG between 2008 and 2011 was examined. The primary endpoint was weight loss: percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and body mass index (BMI) were reported...
July 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28803707/patients-reasons-for-and-against-undergoing-roux-en-y-gastric-bypass-adjustable-gastric-banding-and-vertical-sleeve-gastrectomy
#4
Melissa Opozda, Gary Wittert, Anna Chur-Hansen
BACKGROUND: The most common bariatric procedures, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (LAGB), and sleeve gastrectomy (SG), generally induce significant weight loss and health improvements. However, little is known about how patients decide which procedure to undergo. OBJECTIVE: Investigate patients' reasons for and against undergoing RYGB, LAGB, and SG. SETTING: Online questionnaire. METHODS: Data were analyzed from 236 Australian adults with current RYGB (15...
July 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28761766/technical-details-of-laparoscopic-sleeve-gastrectomy-leading-to-lowered-leak-rate-discussion-of-1070-consecutive-cases
#5
David L Warner, Kent C Sasse
INTRODUCTION: Laparoscopic sleeve gastrectomy is a widely utilized and effective surgical procedure for dramatic weight loss in obese patients. Leak at the sleeve staple line is the most serious complication of this procedure, occurring in 1-3% of cases. Techniques to minimize the risk of sleeve gastrectomy leaks have been published although no universally agreed upon set of techniques exists. This report describes a single-surgeon experience with an approach to sleeve leak prevention resulting in a progressive decrease in leak rate over 5 years...
2017: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/28742012/the-usefulness-and-costs-of-routine-contrast-studies-after-laparoscopic-sleeve-gastrectomy-for-detecting-staple-line-leaks
#6
Dimitry Terterov, Philemon Ho-Yan Leung, Laurie K Twells, Deborah M Gregory, Chris Smith, Darrell Boone, David Pace
BACKGROUND: Although laparoscopic sleeve gastrectomy (LSG) has been shown to be a safe and effective treatment for severe obesity (body mass index ≥ 35), staple line leaks remain a major complication and account for a substantial portion of the procedure's morbidity and mortality. Many centres performing LSG routinely obtain contrast studies on postoperative day 1 for early detection of staple line leaks. We examined the usefulness of Gastrografin swallow as an early detection test for staple line leaks on postoperative day 1 after LSG as well as the associated costs...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28741238/a-randomized-comparison-between-staple-line-oversewing-versus-no-reinforcement-during-laparoscopic-vertical-sleeve-gastrectomy
#7
Osama Taha, Mahmoud Abdelaal, Mohamed Talaat, Mohamed Abozeid
BACKGROUND: Varieties of intraoperative methods such as oversewing of staple lines or other reinforcement products are used for preventing the laparoscopic vertical sleeve gastrectomy (LSG) complications. The aim of this study is to evaluate the complication rates of the gastric stapling alone versus stapling with oversewing invagination of the staple line in the LSG. METHODS: This is a single-center randomized study, Patients were randomized to two groups, 200 patients underwent LSG without reinforcement of the staple line and 200 patients underwent LSG with oversewing of the staple line...
July 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#8
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#9
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28709560/an-alternative-view-on-the-necessity-of-egd-before-sleeve-gastrectomy
#10
Kivanc Derya Peker, Nuri Alper Sahbaz, Hakan Seyit, Osman Kones, Alpen Yahya Gumusoglu, Halil Alis
BACKGROUND: Esophagogastroduodenoscopy (EGD) is particularly recommended for choosing a surgical method to be used with asymptomatic patients and for the assessment of symptomatic patients prior to sleeve gastrectomy. The presence of hiatal hernia, for instance, is a relative contraindication. EGD is used for malignancy scanning as well as surgical planning, but seems inefficient in determining postoperative complications. OBJECTIVE: Our aim was to investigate the effectiveness of the pathological evaluation of endoscopic biopsies obtained with esophagogastroduodenoscopy (EGD) according to Sydney classification prior to sleeve gastrectomy in identifying the risk of staple line leak, independently of clinical diagnosis...
June 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28702740/large-bariatric-specific-stents-and-over-the-scope-clips-in-the-management-of-post-bariatric-surgery-leaks
#11
Hany Shehab, Emad Abdallah, Khaled Gawdat, Inas Elattar
BACKGROUND: Endoscopic stents are successful in the management of surgical leaks; however, stent migration remains a significant problem. In this study, we present our approach depending on a large bariatrics-specific stent (Mega stent) and over-the-scope clips in the management of post-bariatric surgery leaks. METHODS: A retrospective analysis of all patients with post-bariatric surgery leaks treated at our institution using an approach reliant on Mega stents and over-the-scope clips was conducted...
July 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695460/inversion-technique-for-the-removal-of-partially-covered-self-expandable-metallic-stents
#12
Christine Hill, Bassem K Khalil, Sindhu Barola, Abhishek Agnihotri, Robert A Moran, Yen-I Chen, Saowanee Ngamruengphong, Vikesh K Singh, Leigh A Frame, Michael A Schweitzer, Thomas H Magnuson, Mouen A Khashab, Patrick I Okolo, Vivek Kumbhari
BACKGROUND AND AIMS: Partially covered self-expandable metallic stents (PCSEMS), although an effective treatment for anastomotic/staple line leaks and strictures, can be difficult to remove. This study examines the effectiveness of the inversion technique for the removal of PCSEMS in the treatment of leaks and strictures that occurred post-sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). METHODS: Consecutive patients who underwent PCSEMS removal for a leak and/or stricture post-SG or RYGB between July 2013 and December 2016 at the Johns Hopkins Medical Institutions were reviewed...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695459/endoscopic-vacuum-therapy-evt-a-new-concept-for-complication-management-in-bariatric-surgery
#13
Fabian Schmidt, Rudolf Mennigen, Thorsten Vowinkel, Philipp A Neumann, Norbert Senninger, Daniel Palmes, Mike G Laukoetter
BACKGROUND: Bariatric surgery is the most efficient therapy for morbid obesity. Staple line and anastomotic leakage are the most feared postoperative complications after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy (LSG). Traditional treatment options like revisional surgery and endoscopic stent placement are associated with high morbidity and mortality as well as variable success rates. Endoscopic vacuum therapy (EVT) has shown to be a new successful and feasible treatment option for leaks of different etiology after major gastro-esophageal surgery...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28690770/utility-of-the-balloon-overtube-assisted-modified-over-the-wire-stenting-technique-to-treat-post-sleeve-gastrectomy-complications
#14
Ana Ponte, Rolando Pinho, Luísa Proença, Joana Silva, Jaime Rodrigues, Mafalda Sousa, João Carlos Silva, João Carvalho
AIM: To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications. METHODS: Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described...
June 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28689733/long-term-outcome-of-laparoscopic-sleeve-gastrectomy-from-a-single-center-in-mainland-china
#15
Pankaj Kumar Hans, Wei Guan, Shibo Lin, Hui Liang
BACKGROUND/OBJECTIVE: Laparoscopic sleeve gastrectomy (LSG) is at present the most popular bariatric procedure due to its significant weight loss, remission of co-morbidities, and acceptable morbidity. But, there are not many studies showing its long term efficacy and safety in Chinese patients. The aim of this study is to give five results of LSG in terms of weight loss, co-morbidity (Type 2 diabetes mellitus) resolution and possible complications from a single center in mainland China...
July 7, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28681283/the-visualization-of-gastro-esophageal-junction-vascular-supply-during-a-laparoscopic-sleeve-gastrectomy-role-of-a-new-device
#16
Mario Musella, Marco Milone, Paolo Bianco, Francesco Milone
Leaks arising at the level of gastro-esophageal junction remain a major complication in patients who undergo a laparoscopic sleeve gastrectomy. Besides technical pitfalls, these fistulas are mainly attributable to tissue ischemia following the preparation of the gastric sleeve, explained by the irregular vascularization often present in the area of the gastro-esophageal junction. This video presentation shows how, the utilization of a new model of bougie can be of help in preventing a leak, allowing a better visualization of the particular vascular anatomy present at the level of the gastro-esophageal junction area...
July 5, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28681256/one-anastomosis-gastric-bypass-versus-sleeve-gastrectomy-for-morbid-obesity-a-systematic-review-and-meta-analysis
#17
REVIEW
Dimitrios E Magouliotis, Vasiliki S Tasiopoulou, Alexis A Svokos, Konstantina A Svokos, Eleni Sioka, Dimitrios Zacharoulis
We aim to review the available literature on obese patients treated with one-anastomosis gastric bypass (OAGB) or laparoscopic sleeve gastrectomy (LSG), in order to compare the clinical outcomes and intraoperative parameters of the two methods. A systematic literature search was performed in PubMed, Cochrane Library, and Scopus databases, in accordance with the PRISMA guidelines. Seventeen studies met the inclusion criteria incorporating 6761 patients. This study reveals increased weight loss, remission of comorbidities, shorter mean hospital stay, and lower mortality in the OAGB group...
July 5, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28647931/correct-evaluation-of-gastric-wall-thickness-may-support-a-change-in-staplers-size-when-performing-sleeve-gastrectomy
#18
Sergio Susmallian, David Goitein, Royi Barnea, Asnat Raziel
BACKGROUND: Leakage from the staple line is the most serious complication encountered after sleeve gastrectomy, occurring in 2.4% of surgeries. The use of inappropriately sized staplers, because of variability in stomach wall thickness, is a major cause of leakage. OBJECTIVES: To measure stomach wall thickness across different stomach zones to identify variables correlating with thickness. METHODS: The study comprised 100 patients (52 females)...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28629729/a-multicenter-study-of-routine-versus-selective-intraoperative-leak-testing-for-sleeve-gastrectomy
#19
Jason Bingham, Jedediah Kaufman, Kai Hata, James Dickerson, Alec Beekley, Gordon Wisbach, Jacob Swann, Eric Ahnfeldt, Devon Hawkins, Yong Choi, Robert Lim, Matthew Martin
BACKGROUND: Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. OBJECTIVES: To determine the efficacy of IOLT and if routine use has any benefit over selective use. SETTING: Eight teaching hospitals, including private, university, and military facilities. METHODS: A multicenter, retrospective analysis over a 5-year period...
May 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28623446/laparoscopic-sleeve-gastrectomy-investigation-of-fundus-wall-thickness-and-staple-height-an-observational-cohort-study-fundus-wall-thickness-and-leaks
#20
Clara Boeker, Julian Mall, Christian Reetz, Kamil Yamac, Ludwig Wilkens, Christine Stroh, Hinrich Koehler
BACKGROUND: Staple line leakage is a well-known complication after laparoscopic sleeve gastrectomy (LSG). Gastric wall thickness and the staple height may be determining factors for the occurrence of insufficiencies. To investigate this problem, an observational cohort study was carried out. Investigation concentrated on the gastroesophageal junction close to the angle of His, since this area is at highest risk for a leakage. METHODS: Fundus wall thickness of 141 specimens after LSG was measured by light microscopy at a predetermined location by a blinded pathologist...
June 16, 2017: Obesity Surgery
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