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sleeve gastrectomy leak

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https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#1
Alon Ben Nun, David Simansky, Merav Rokah, Nona Zeitlin, Nir Golan, Ramez Abu Khalil, Michalle Soudack
BACKGROUND: Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3-8%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro-pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29122706/mid-to-long-term-outcomes-of-laparoscopic-sleeve-gastrectomy-in-indian-population-3-7-year-results-a-retrospective-cohort-study
#2
Harshit Garg, Sandeep Aggarwal, Mahesh Chandra Misra, Pratyusha Priyadarshini, Ashish Swami, Lokesh Kashyap, Richa Jaiswal
INTRODUCTION: Few studies have addressed the mid to long term impact of Laparoscopic Sleeve Gastrectomy (LSG) on weight loss and obesity associated co-morbidities, particularly in Indian population. The aim of this study is to assess the efficacy of LSG in morbid obesity over 3-7 years follow up. MATERIALS AND METHODS: Data of all patients who underwent LSG between January 2008 and March 2015 and completed their at least 1 year follow up till March 2016 was retrospectively reviewed using a prospectively collected database...
November 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29099314/outcomes-in-super-obese-patients-undergoing-laparoscopic-sleeve-gastrectomy
#3
Vitish Singla, Sandeep Aggarwal, Harshit Garg, Lokesh Kashyap, Dilip R Shende, Samagra Agarwal
BACKGROUND: Super obese patients remain a challenge for management because of large liver size resulting in decreased work space and associated comorbidities. OBJECTIVES: To study outcomes in super obese patients undergoing Laparoscopic sleeve gastrectomy (LSG). METHODS: Retrospective data of 123 patients undergoing LSG from January 2008 to March 2015 were analyzed prospectively. RESULTS: Mean age and body mass index (BMI) of 123 patients (± 2 standard deviation [SD]) were 39...
November 3, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29091018/seal-or-drain-endoscopic-management-of-leaks-following-sleeve-gastrectomy
#4
Gianfranco Donatelli, David Fuks, Nicolas Tabchouri, Guillaume Pourcher
No abstract text is available yet for this article.
October 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29079385/the-role-of-routine-abdominal-drainage-after-bariatric-surgery-a-metabolic-and-bariatric-surgery-accreditation-and-quality-improvement-program-study
#5
Aristithes G Doumouras, Azusa Maeda, Timothy D Jackson
BACKGROUND: The efficacy of drains has long been debated in bariatric surgery. Drains may provide some theoretical benefits to early detection of anastomotic leaks and potential nonoperative treatment; however, there has never been data to support the practice. OBJECTIVE: The objective of this study was to evaluate the effect of drain placement after bariatric surgery. SETTING: This retrospective cohort study includes all hospitals in the United States that participated in the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program...
August 31, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29071067/the-birmingham-experience-of-high-pressure-methylene-blue-dye-test-during-primary-and-revisional-bariatric-surgery-a-retrospective-cohort-study
#6
G C Kirby, C A W Macano, S M Nyasavajjala, M Sahloul, R Nijjar, M Daskalakis, M Richardson, R Singhal
INTRODUCTION: Leak following bariatric surgery continues to be associated with morbidity and rarely mortality. With improvement in surgical techniques and stapler design, leak rates have reduced drastically. Intra-operative high pressure Methylene blue leak test (HPMB) is one of the techniques employed to confirm integrity of anastomoses and staple lines. Despite this, evidence for its use remains limited. We evaluated the role of HPMB in detecting and preventing leaks. METHODS: A retrospective cohort of consecutive patients who underwent primary or revisional Laparoscopic Sleeve Gastrectomy (SG) or Laparoscopic Roux-en-Y Gastric bypass (RYGB) under the care of five surgeons in three centres across Birmingham, UK, between 2012 and 2016 were assessed...
November 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29052063/endoscopic-treatment-of-leaks-after-laparoscopic-sleeve-gastrectomy-using-mega-esophageal-covered-stents
#7
Tomasz Klimczak, Jerzy Klimczak, Tomasz Szewczyk, Przemysław Janczak, Piotr Jurałowicz
BACKGROUND: Sleeve gastrectomy has become one of the main bariatric procedures over the last few years. This can be explained by the relative simplicity and high effectiveness of this method. Yet, it causes complications as any other method. Staple line leaks are the most frequent ones. According to different sources, this complication may occur with 0-7% frequency. Until 2013, surgery was the only effective treatment method for this complication. However, reoperations considerably increased treatment cost and patient morbidity...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29029355/over-sewing-of-staple-line-in-laparoscopic-sleeve-gastrectomy-initial-experience-of-a-comparative-study
#8
Giorgio Lisi, Roberto Rossini, Irene Gentile, Giacomo Ruffo
INTRODUCTION: The main drawback of laparoscopic sleeve gastrectomy (LSG) is the severity of postoperative complications. Staple line reinforcement (SLR) is strongly advocated. Recently, over-sewing has been proposed as a cost-effective and helpful method for reinforcing the staple line. The purpose of this study was to report our initial experience with LSG comparing over-sewing over the entire staple line with the upper-third staple line. MATERIALS AND METHODS: All obese patients seen at Negrar Sacro Cuore, Don Calabria Hospital were entered into our prospective database and were retrospectively evaluated...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28975492/sleeve-gastrectomy-outcomes-in-patients-with-bmi-between-30-and-35-3-years-of-follow-up
#9
Marcos A Berry, Lionel Urrutia, Patricio Lamoza, Alfredo Molina, Eduardo Luna, Federico Parra, María J Domínguez, Rodrigo Alonso
INTRODUCTION AND PURPOSE: Laparoscopic sleeve gastrectomy (LSG) in patients with a BMI between 30 and 35 kg/m(2) plus comorbidities has shown to be safe and effective. The purpose of this study is to describe our outcomes in this group of patients after 3 years of follow-up. MATERIALS AND METHODS: Retrospective descriptive analysis of patients with initial BMI between 30 and 35 kg/m(2) plus comorbidities were submitted to LSG between 2006 and 2013. We analyzed gender, age, comorbidities, BMI, total weight loss (%TWL), excess weight loss (%EWL), comorbidity resolution, morbidity, and mortality...
October 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28951446/concurrent-bariatric-operations-and-association-with-perioperative-outcomes-registry-based-cohort-study
#10
Jason B Liu, Kristen A Ban, Julia R Berian, Matthew M Hutter, Kristopher M Huffman, Yaoming Liu, David B Hoyt, Bruce L Hall, Clifford Y Ko
Objective To determine whether perioperative outcomes differ between patients undergoing concurrent compared with non-concurrent bariatric operations in the USA.Design Retrospective, propensity score matched cohort study.Setting Hospitals in the US accredited by the American College of Surgeons' metabolic and bariatric surgery accreditation and quality improvement program.Participants 513 167 patients undergoing bariatric operations between 1 January 2014 and 31 December 2016.Main outcome measures The primary outcome measure was a composite of 30 day death, morbidity, readmission, reoperation, anastomotic or staple line leak, and bleeding events...
September 26, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28943213/evaluating-the-feasibility-of-phrenoesophagopexy-during-hiatal-hernia-repair-in-sleeve-gastrectomy-patients
#11
Nathaniel R Ellens, Joshua E Simon, Kimberly D Kemmeter, Tyler W Barreto, Paul R Kemmeter
BACKGROUND: Both hiatal hernias (HH) and morbid obesity significantly contribute to gastroesophageal reflux disease, which increases the risk for esophagitis and esophageal cancer. Therefore, concomitant HH repair is recommended during bariatric surgery procedures. Unfortunately, recurrence of HH after repair is not uncommon and the optimal surgical technique has yet to be established. OBJECTIVE: To evaluate the feasibility of recreating the phrenoesophageal ligaments by adding phrenoesophagopexy to HH repair during sleeve gastrectomy...
August 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28929425/medium-term-outcomes-after-reversal-of-roux-en-y-gastric-bypass
#12
Gustavo Andrés Arman, J Himpens, R Bolckmans, D Van Compernolle, R Vilallonga, G Leman
BACKGROUND: Roux-en-Y gastric bypass (RYGB) can be reversed into normal anatomy (NA) or into sleeve gastrectomy (NASG) to address undesired side effects. Concomitant hiatal hernia repair (HHR) may be required. Before reversal, some patients benefit from placement of a gastrostomy, mostly to predict the result of recreating the native anatomy. METHODS: Retrospective study on mid-term effects of RYGB reversal to NA and NASG, including clinical and weight evolution, surgical complications, and incidence of gastro-esophageal reflux (GERD)...
September 19, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28927340/risk-factors-of-perioperative-morbimortality-after-laparoscopic-sleeve-gastrectomy-a-club-coelio-multicenter-study
#13
B Tulelli, P Loi, E van Vyve, H Johanet, G Fromont, A Dabrowski, A Piquart, T Delaunay, P Ledaguenel, B Navez, F Maisonnette, M Lepere, T Dugué, V Demoor, B Bokobza, Jp Staudt, P Hauters, P Malvaux, J Closset
OBJECTIVES: Postoperative complications after Laparoscopic sleeve gastrectomy (LSG) can dramatically compromise patient's outcome. The aim of this study is to analyze the per- and postoperative short-term outcomes after LSG and to assess predictive risk factors of complications. METHODS: The study group consisted of 790 patients (610 women and 180 men) who underwent LSG In 2014. All interventions were performed by 18 experienced surgeons members of the Club Coelio...
September 19, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28895037/management-of-acute-sleeve-gastrectomy-leaks-by-conversion-to-roux-en-y-gastric-bypass-a-small-case-series
#14
Kutay Saglam, Aydin Aktas, Ersin Gundogan, Ismail Ertugrul, Ali Tardu, Servet Karagul, Serdar Kirmizi, Fatih Sumer, Veysel Ersan, Cuneyt Kayaalp
Management of early sleeve gastrectomy leak remains challenging. The recommended approach is endoscopic stenting and abdominal drainage. Conversion to a Roux-en-Y gastric bypass (RYGB) is a common procedure used for late fistulas with distal obstruction. Here, we have presented three cases of early staple line leaks treated by conversion to RYGB. These patients had uncontrolled abdominal infections despite intensive medical treatments, and surgery was elected for abdominal drainage as well as to control the source of sepsis...
November 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28866827/fistula-following-laparoscopic-sleeve-gastrectomy-a-proposed-classification-and-algorithm-for-optimal-management
#15
G Al Hajj, R Chemaly
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is an accepted restrictive procedure with a hormonal component. There is no definitive course of treatment for post-LSG fistula; it remains a feared complication. We aimed to classify post-LSG fistulas and propose an algorithm to optimize their treatment. METHODS: Following primary and revisional LSG in obese patients, a retrospective observational study of fistulas was undertaken. Radiological studies were performed to identify anatomically distinct types of fistulas...
September 2, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28858079/laparoscopic-vertical-sleeve-gastrectomy-a-5-year-veterans-affairs-review
#16
Rahman G Barry, Farzad A Amiri, Todd W Gress, D Blaine Nease, Timothy D Canterbury
The aim of this study was to evaluate the outcomes after laparoscopic sleeve gastrectomy (SG) in a VA population.SG has recently gained popularity as a definitive bariatric surgery procedure. Data are lacking on long-term outcomes, particularly in a Veterans Affairs population.We retrospectively reviewed 223 patients who underwent SG for morbid obesity between January 2009 and June 2014. Data on length of stay, complications, interval weight loss, comorbidities, and number of therapies preoperatively and at long-term follow-up were collected...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28853595/staple-line-oversewing-during-laparoscopic-sleeve-gastrectomy
#17
REVIEW
H Wang, J Lu, J Feng, Z Wang
Introduction This meta-analysis was performed to assess the possible benefits of staple line oversewing during laparoscopic sleeve gastrectomy. Methods A comprehensive search up to February 2017 was conducted on PubMed, the Web of Science™ and Embase™. All eligible studies were included, and the outcomes of staple line bleeding and leak, overall complications and operative time were pooled. Results A total of 7 randomised controlled trials involving 845 patients (428 cases and 417 controls) were analysed...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28840525/laparoscopic-sleeve-gastrectomy-versus-banded-roux-en-y-gastric-bypass-for-diabetes-and-obesity-a-prospective-randomised-double-blind-trial
#18
Rinki Murphy, Michael G Clarke, Nicholas J Evennett, S John Robinson, M Lee Humphreys, Hisham Hammodat, Bronwen Jones, David D Kim, Richard Cutfield, Malcolm H Johnson, Lindsay D Plank, Michael W C Booth
BACKGROUND: There are very few randomised, blinded trials comparing laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) in achieving remission of type 2 diabetes (T2D), particularly silastic ring (SR)-LRYGB. We compared the effectiveness of (LSG) versus SR-LRYGB among patients with T2D and morbid obesity. METHODS: Prospective, randomised, parallel, 2-arm, blinded clinical trial conducted in a single Auckland (New Zealand) centre...
August 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28840492/proximal-leakage-after-laparoscopic-sleeve-gastrectomy-an-analysis-of-preoperative-and-operative-predictors-on-1738-consecutive-procedures
#19
Giovanni Cesana, Stefano Cioffi, Riccardo Giorgi, Roberta Villa, Matteo Uccelli, Francesca Ciccarese, Giorgio Castello, Bruno Scotto, Stefano Olmi
BACKGROUND: The purpose of this paper was to search for predictive factors for proximal leakage after laparoscopic sleeve gastrectomy (LSG) in a large cohort from a single referral center. MATERIALS AND METHODS: One thousand seven hundred and thirty-eight patients, collected in a prospectively held database from 2008 to 2016, were retrospectively analyzed. The correlation between postoperative leakage and both preoperative (age, gender, height, weight, BMI, and obesity-related morbidities) and operative variables (the distance from pylorus at which the gastric section was started, operative time, experience of surgeons who performed the LSG, and the surgical materials used) was analyzed...
August 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28836135/mandatory-risk-assessment-reduces-venous-thromboembolism-in-bariatric-surgery-patients
#20
Abdelrahman A Nimeri, Jejomar Bautista, Maha Ibrahim, Ruby Philip, Talat Al Shaban, Ahmed Maasher, Ajda Altinoz
INTRODUCTION: Bariatric surgery patients are at high risk for venous thromboembolism (VTE), and chemoprophylaxis is recommended. METHODS: Sheikh Khalifa Medical City (SKMC) is an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) member since 2009. We report the rates of VTE in bariatric surgery patients from 2010 to 2016 compared to ACS NSQIP bariatric surgery programs before and after switching from heparin to low molecular weight heparin (LMWH), initiating mandatory risk assessment using Caprini scoring for VTE and adopting an aggressive strategy for high-risk patients regarding dosage of LMWH and chemoprophylaxis after discharge...
August 23, 2017: Obesity Surgery
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