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https://www.readbyqxmd.com/read/27914029/mid-term-results-and-responsiveness-predictors-after-two-step-single-anastomosis-duodeno-ileal-bypass-with-sleeve-gastrectomy
#1
José M Balibrea, Ramón Vilallonga, Marta Hidalgo, Andreea Ciudin, Óscar González, Enric Caubet, Andrés Sánchez-Pernaute, José M Fort, Manel Armengol-Carrasco
BACKGROUND: In patients with insufficient weight loss after sleeve gastrectomy (SG) or in super obese individuals, among many surgical options available, a single-anastomosis duodeno-ileal bypass (SADI) after SG (SADI-S) could be considered. Due to the limited information available about the use of SADI as a second-step procedure, the objective of this study was to evaluate the mid-term results and responsiveness of SADI after sleeve gastrectomy. METHODS: We present prospective data from 30 consecutive patients with a mean BMI of 40...
December 2, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27913235/laparoscopic-gastric-bypass-versus-laparoscopic-sleeve-gastrectomy-a-retrospective-multicenter-comparison-between-early-and-long-term-post-operative-outcomes
#2
Fabio Rondelli, Walter Bugiantella, Maria Cristina Vedovati, Enrico Mariani, Ruben Carlo Balzarotti Canger, Sara Federici, Adriano Guerra, Marcello Boni
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly performed procedures for morbid obesity. METHODS: We performed a retrospective review of patients undergoing LRYGB or LSG between August 2000 and November 2014. RESULTS: Data from 581 (280 LSG and 301 LRYGB) were gathered. Operating time (77.6 vs 250.5 min; p < 0.001), post-operative complication rate (3.9% vs 11...
November 29, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27912678/the-physiology-and-molecular-underpinnings-of-the-effects-of-bariatric-surgery-on-obesity-and-diabetes
#3
Simon S Evers, Darleen A Sandoval, Randy J Seeley
Bariatric surgeries, such as Roux-en-Y gastric bypass and vertical sleeve gastrectomy, produce significant and durable weight loss in both humans and rodents. Recently, these surgical interventions have also been termed metabolic surgery because they result in profound metabolic improvements that often surpass the expected improvement due to body weight loss alone. In this review we focus on the weight-loss independent effects of bariatric surgery, which encompass energy expenditure and macronutrient preference, the luminal composition of the gut (i...
November 28, 2016: Annual Review of Physiology
https://www.readbyqxmd.com/read/27908263/prevalence-and-predictors-of-overweight-and-obesity-in-patients-with-pituitary-dysfunctions
#4
Birgit Harbeck, Sven Danneberg, Amir Hossein Rahvar, Heiner Mönig, Christian Stefan Haas
BACKGROUND: Patients with hypothalamic-pituitary disorders (HPD) may be of increased risk to develop overweight and obesity, thereby fostering cardiovascular events. However, it remains unclear if patients with pituitary dysfunctions per se have an increased risk of becoming obese. OBJECTIVE: The objective of this study was to evaluate prevalence and to identify possible predictors of overweight and obesity in patients with pituitary dysfunctions. METHODS: A total of 121 out-patients having various causes for HPD were assessed for height and body weight; body mass index (BMI) was calculated and correlated with clinical features...
November 30, 2016: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/27908218/risk-factors-for-dural-tears-a-study-of-elective-spine-surgery
#5
Meghan E Murphy, Panagiotis Kerezoudis, Mohammed Ali Alvi, Brandon A McCutcheon, Patrick R Maloney, Lorenzo Rinaldo, Daniel Shepherd, Daniel S Ubl, William E Krauss, Elizabeth B Habermann, Mohamad Bydon
OBJECTIVE: This study moves beyond previous cohort studies and benchmark data by studying a population of elective spine surgery from a multicenter registry in an effort to validate, disprove, and/or identify novel risk factors for dural tears. METHODS: A retrospective cohort analysis queried a multicenter registry for patients with degenerative spinal diagnoses undergoing elective spinal surgery from 2010-2014. Multivariable logistic regression analysis interrogated for independent risk factors of dural tears...
December 2, 2016: Neurological Research
https://www.readbyqxmd.com/read/27907821/total-small-bowel-herniation-through-the-space-between-the-connecting-tube-of-gastric-band-and-abdominal-wall-a-case-report-of-a-surgical-emergency
#6
Tarek Hashem, Soliman M Soliman, Sherif Wagih
INTRODUCTION: Laparoscopic adjustable gastric banding is one of the most frequently done procedures for morbid obesity. In most reported cases, the band itself is the cause of complications. There are only a few reports of morbidities caused by the connecting tube. This presentation describes a case of acute abdomen due to small bowel herniation between the connecting tube and the abdominal wall. This case report aims to remind clinicians of possible complications caused by the connecting tube of a gastric band...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#7
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906601/association-between-pre-operative-cefazolin-dose-and-surgical-site-infection-in-obese-patients
#8
William J Peppard, David G Eberle, Nathan W Kugler, Danielle M Mabrey, John A Weigelt
BACKGROUND: A fixed dose of cefazolin results in serum concentrations that decrease as body mass increases. Current national guidelines suggest a pre-operative cefazolin dose of two grams may be insufficient for patients ≥120 kg; thus a three gram dose is recommended. These recommendations, however, are based on pharmacokinetic rather than outcome data. We evaluate the efficacy of pre-operative cefazolin two gram and three gram doses as measured by the rate of surgical site infection (SSI)...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27905219/early-24-hour-blood-pressure-response-to-roux-en-y-gastric-bypass-in-obese-patients
#9
Julie S Pedersen, Christian Borup, Morten Damgaard, Vindhya D Yatawara, Andrea K Floyd, Niels Gadsbøll, Peter K Bonfils
Recently, it has been proposed, that the blood pressure (BP) lowering effect of gastric bypass surgery not only is explained by the obtained weight loss, but that the anatomical rearrangement of the gut after 'malabsorptive' surgical techniques, such as the laparoscopic Roux-en-Y gastric bypass (LRYGB), may affect BP through a change in a putative 'entero-renal' axis. If so one could anticipate a reduction in BP even before a noticeable weight loss was obtained. The purpose of the present study was to investigate the very early BP response to LRYGB surgery...
December 1, 2016: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/27903151/how-to-manage-the-obese-patient-with-cancer
#10
Andrew G Renehan, Michelle Harvie, Ramsey I Cutress, Michael Leitzmann, Tobias Pischon, Sacha Howell, Anthony Howell
Purpose Obesity (body mass index [BMI] ≥ 30 kg/m(2)) is common among patients with cancer. We reviewed management issues in the obese patient with cancer, focusing on how obesity influences treatment selection (including chemotherapy dosing), affects chemotherapy toxicity and surgical complications, and might be a treatment effect modifier. Methods The majority of evidence is drawn from observational studies and secondary analyses of trial data, typically analyzed in N × 3 BMI categories (normal weight, overweight, and obese) matrix structures...
December 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#11
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#12
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
November 26, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27896516/the-differential-impact-of-body-mass-index-and-the-feature-of-metabolic-syndrome-on-oncological-outcomes-following-different-surgical-procedures-in-japanese-men-with-prostate-cancer
#13
Masaki Shiota, Ario Takeuchi, Masaaki Sugimoto, Eiji Kashiwagi, Takashi Dejima, Keijiro Kiyoshima, Junichi Inokuchi, Katsunori Tatsugami, Akira Yokomizo, Masatoshi Eto
PURPOSE: This study aimed to examine the differential impact of body mass index and the feature of metabolic syndrome (MetS; obesity, hypertension, diabetes mellitus, and dyslipidemia) on biochemical recurrence (BCR) following radical prostatectomy (RP) treatment for prostate cancer using different surgical procedures. METHODS: This study included 283 Japanese patients with clinically localized prostate cancer who were treated with RP between 2008 and 2012. The prognostic significance of overweight and the feature of MetS were analyzed according to surgical procedures...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27896401/sleeve-gastrectomy-combined-with-the-simplified-hill-repair-in-the-treatment-of-morbid-obesity-and-gastro-esophageal-reflux-disease-preliminary-results-in-14-patients
#14
Daniel Gero, Lara Ribeiro-Parenti, Konstantinos Arapis, Jean-Pierre Marmuse
BACKGROUND: Our aim is to report our initial experience with a novel technique which addresses morbid obesity and gastro-esophageal reflux disease (GERD) simultaneously by combination of laparoscopic sleeve gastrectomy (LSG) and simplified laparoscopic Hill repair (sLHR). METHODS: Retrospective analysis of LSG+sLHR patients >5 months postoperatively includes demographics, GERD status, proton-pump inhibitor (PPI) use, body mass index (BMI), excess BMI loss (EBMIL), complications and GERD-Health Related Quality of Life (GERD-HRQL) questionnaire...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27895368/does-obesity-affects-early-infection-after-total-knee-arthroplasty-a-comparison-of-obese-vs-non-obese-patients
#15
Waseem Ahmed, Riaz Hussain Lakdawala, Yasir Mohib, Aurangzeb Qureshi, Rizwan Haroon Rashid
Surgical site infection (SSI) is a disastrous complication after total knee arthroplasty (TKA) which can cause prosthesis loosening and may end up in septicaemia. The incidence of infection reported to be in the range of 0.3-12.4% for primary TKA. Significantly higher infection rate is found in the morbidly obese patients. The current study compared the immediate rate of post-total knee replacement wound infection in the obese versus non-obese population. The cross-sectional study was conducted at Aga Khan University Hospital (AKUH) and comprised patients undergoing TKA for primary knee osteoarthritis...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27895003/effect-on-nitrogen-balance-thermogenesis-body-composition-satiety-and-circulating-branched-chain-amino-acid-levels-up-to-one-year-after-surgery-protocol-of-a-randomized-controlled-trial-on-dietary-protein-during-surgical-weight-loss
#16
Violeta Moizé, Xavier Pi-Sunyer, Josep Vidal, Patricia Miner, Yves Boirie, Blandine Laferrère
BACKGROUND: Bariatric surgery (BS), the most effective treatment for severe obesity, typically results in 40-50 kg weight loss in the year following the surgery. Beyond its action on protein metabolism, dietary protein intake (PI) affects satiety, thermogenesis, energy efficiency, and body composition (BC). However, the required amount of PI after surgical weight loss is not known. The current daily PI recommendation for diet-induced weight loss is 0.8 g/kg ideal body weight (IBW) per day, but whether this amount is sufficient to preserve fat-free mass during active surgical weight loss is unknown...
November 28, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27891833/metabolomics-guided-insights-on-bariatric-surgery-versus-behavioral-interventions-for-weight-loss
#17
REVIEW
Sara Tulipani, Jules Griffin, Magali Palau-Rodriguez, Ximena Mora-Cubillos, Rosa M Bernal-Lopez, Francisco J Tinahones, Barbara E Corkey, Cristina Andres-Lacueva
OBJECTIVE: To review the metabolomic studies carried out so far to identify metabolic markers associated with surgical and dietary treatments for weight loss in subjects with obesity. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS: Thirty-two studies successfully met the eligibility criteria. The metabolic adaptations shared by surgical and dietary interventions mirrored a state of starvation ketoacidosis (increase of circulating ketone bodies), an increase of acylcarnitines and fatty acid β-oxidation, a decrease of specific amino acids including branched-chain amino acids (BCAA) and (lyso)glycerophospholipids previously associated with obesity, and adipose tissue expansion...
December 2016: Obesity
https://www.readbyqxmd.com/read/27890683/the-effect-of-obesity-on-perioperative-outcomes-for-open-and-minimally-invasive-prostatectomy
#18
Scott C Johnson, Vignesh T Packiam, Shay Golan, Andrew J Cohen, Charles U Nottingham, Norm D Smith
OBJECTIVES: To compare the impact of obesity on perioperative outcomes between open radical prostatectomy (ORP) and minimally invasive prostatectomy (MIP). METHODS: Using the National Surgical Quality Improvement Program (NSQIP) public use files for 2008-2013, we identified patients undergoing prostatectomy using current procedural terminology codes. Those without BMI or comorbidity information were excluded. BMI was treated as a categorical variable according to the World Health Organization classification...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27890184/imaging-of-cerebrospinal-fluid-rhinorrhea-and-otorrhea
#19
REVIEW
Mahati Reddy, Kristen Baugnon
As the obesity epidemic grows in the United States, rhinorrhea and otorrhea from spontaneous cerebrospinal fluid (CSF) leaks secondary to untreated idiopathic intracranial hypertension are increasing in prevalence. CSF rhinorrhea and otorrhea should also be carefully evaluated in posttraumatic and postsurgical settings, because untreated CSF leaks often have serious consequences. The work-up, diagnosis, and characterization of a CSF leak can be complex, often requiring a multimodality approach to optimize surgical planning...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#20
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
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