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Roux en Y Gastric Bypass

John Melissas, Konstantinos Stavroulakis, Vassilis Tzikoulis, Angeliki Peristeri, John A Papadakis, Abdolreza Pazouki, Alireza Khalaj, Ali Kabir
BACKGROUND: The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program. METHODS: Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared. RESULTS: There were steadily increasing numbers of patients underwent SG from 2010 to 2015...
October 20, 2016: Obesity Surgery
Gisele Farias, Rubia D Thieme, Laila M Teixeira, Maria Emilia V D Heyde, Solange C Bettini, Rosana B Radominski
BACKGROUND: Bariatric surgery is one of the main treatments for severity obesity, but weight regain after surgery is an important issue. OBJECTIVES: To compare the clinical and nutritional profiles of good and poor weight loss responders in the late postoperative period after bariatric surgery. METHODS: A cross-sectional study with patients undergoing Roux-en-Y gastric bypass in a University Hospital. Patients were divided into good weight loss responders (GWLR) and poor weight loss responders (PWLR) defined as ≥ 50% or < 50% excess weight loss (EWL), respectively, at least 2 years post-surgery...
September 20, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Jaime Ruiz-Tovar, Pablo Royo, José L Muñoz, Manuel Duran, Elisabeth Redondo, Jose M Ramirez
INTRODUCTION: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery. PATIENTS AND METHODS: A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery...
October 7, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Lava Y Patel, Brittany Lapin, Craig S Brown, Thomas Stringer, Matthew E Gitelis, John G Linn, Woody E Denham, Elizabeth Farwell, Stephen Haggerty, Michael B Ujiki
BACKGROUND: Approximately 20-30 % of morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) will experience significant weight regain in the years following surgery. Endoscopic gastrojejunal revision (EGJR) has been shown to be a safe, effective and less invasive alternative to revisional surgery, with promising weight loss outcomes. However, minimal data exist regarding how to perform the procedure most effectively and what factors may predict good outcomes. We compared weight loss outcomes between patients undergoing endoscopic stoma revision by one of two full-thickness suturing techniques...
October 17, 2016: Surgical Endoscopy
Ryan E R Reid, Ekaterina Oparina, Hugues Plourde, Ross E Andersen
We explored differences in dietary behaviours, energy, and macronutrient intake among individuals who had regained or maintained weight loss 5 or more years after Roux-en-Y gastric bypass (RYGB). This study assessed 27 adults who underwent RYGB an average of 12.1 ± 3.7 years before this study was conducted. Dietary assessment was performed using 3-day food records. Daily energy intake (kcal), protein (g), carbohydrate (g), fat (g), and alcohol intake (g) were computed using the ESHA's Food Processor(®). Participants were classified by percent weight loss, maintainers (≥38 %), and regainers (≤30 %)...
July 19, 2016: Canadian Journal of Dietetic Practice and Research
Carolina F Nicoletti, Ana Paula R P de Oliveira, Maria José F Brochado, Marcela A S Pinhel, Bruno A P de Oliveira, Julio S Marchini, José E Dos Santos, Wilson Salgado, Nathalia Moreno Cury, Luiza Ferreira de Araújo, Wilson A Silva, Carla B Nonino
OBJECTIVE: The aim of this study was to investigate whether the Ala55Val and -866G>A polymorphisms of the UCP2 gene are related to weight loss and changes in body composition after bariatric surgery performed by Roux-en-Y gastric bypass (RYGB). METHODS: This longitudinal study enrolled obese patients submitted to RYGB. Data regarding weight (kg), body mass index (kg/m(2)), fat-free mass (FFM; kg), fat mass (kg), weight loss (kg and %), and percent excess weight loss were collected from both preoperative and 1-y postoperative medical records...
August 9, 2016: Nutrition
Matthew Da Silva, Michelle C Cleghorn, Ahmad Elnahas, Timothy D Jackson, Allan Okrainec, Fayez A Quereshy
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is a marker that reflects systemic inflammation and organ dysfunction. Its use as a prognostic marker to predict complications following surgery has been recently described in the literature. OBJECTIVES: The objective of our study was to evaluate the use of postoperative day one (POD1) NLR as a predictor of 30-day outcomes in patients undergoing bariatric surgery. SETTING: University Hospital...
October 14, 2016: Surgical Endoscopy
Rinki Murphy, Peter Tsai, Mia Jüllig, Amy Liu, Lindsay Plank, Michael Booth
BACKGROUND: It is unclear whether specific gut microbiota is associated with remission of type 2 diabetes (T2D) after distinct types of bariatric surgery. AIMS: The aim of this study is to examine gut microbiota changes after laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery in obese patients with T2D. METHODS: Whole-metagenome shotgun sequencing of DNA fragments using Illumina HiSeq2000 was obtained from stool samples collected from 14 obese T2D patients pre-operatively (while on very low calorie diet) and 1 year after randomisation to laparoscopic SG (n = 7) or RYGB (n = 7)...
October 13, 2016: Obesity Surgery
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
Deanna J M Isaman, Amy E Rothberg, William H Herman
OBJECTIVE: Bariatric surgery may induce remission of type 2 diabetes in obese patients. However, estimates of remission rates reported in the literature range from 25 to 81%, contributing to the uncertainty patients and physicians both face as they assess treatment options. This analysis attempts to reconcile the seemingly disparate rates of diabetes remission reported in studies of Roux-en-Y gastric bypass (RYGB) surgery. It examines variation in the methodologies used to derive the estimates and proposes outcomes that should be reported by all studies...
October 13, 2016: Diabetes Care
Siva T Gounder, Delendra Rasith Wijayanayaka, Rinki Murphy, Delwyn Armstrong, Richard G Cutfield, David Dw Kim, Michael Graham Clarke, Nicholas J Evennett, Martyn Lee Humphreys, Steven John Robinson, Michael Wc Booth
AIM: To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand. METHODS: The Waitemata District Health Board costing system was used to calculate costs in New Zealand Dollars (NZD) associated with all pre- and post-operative hospital clinic visits, peri-operative care, hospitalisations and medication costs up to one year after bariatric surgery...
October 14, 2016: New Zealand Medical Journal
Mirjam A Lips, Jan Bert van Klinken, Hanno Pijl, Ignace Janssen, Ko Willems van Dijk, Frits Koning, Vanessa van Harmelen
INTRODUCTION: Weight loss interventions such as Roux-en-Y gastric bypass (RYGB) and very low calorie diets (VLCD) lead to improvement of glucose metabolism in obese individuals with type-2 diabetes. Weight loss can also positively influence the unfavorable inflammatory profile associated with obesity. However, a direct comparison of the effect of VLCD and RYGB on systemic inflammation is lacking. METHODS: Systemic inflammation was investigated in age- and BMI-matched morbidly obese T2DM women by determining the number and activation- or memory status of peripheral blood leukocytes by flow cytometry, in addition to measuring circulating levels of cytokines and CRP...
November 2016: Metabolism: Clinical and Experimental
Abdelrahman A Nimeri, Ahmed Maasher, Talat Al Shaban, Elnazeer Salim, Maha Ibrahim
BACKGROUND: Conversion of laparoscopic adjustable gastric banding (LAGB) to other operations is commonly done for significant weight recidivism and complications. METHODS: This is a consecutive series of LAGB converted to RYGB done at the Bariatric and Metabolic Institute (BMI) Abu Dhabi from 2009 to 2013 for weight recidivism. Our preferred approach is to convert LAGB to LRYGB in one stage. All patients undergo upper endoscopy (EGD) and upper gastrointestinal series and are started on clears liquids 2 h after surgery without performing UGI studies...
October 12, 2016: Obesity Surgery
Asad J Choudhry, Nadeem N Haddad, Matthew Martin, Cornelius A Thiels, Elizabeth B Habermann, Martin D Zielinski
OBJECTIVE: Given the current rate of obesity in the USA, it has been estimated that close to half of the US adult population could be obese by 2030, resulting in greater demand for bariatric procedures. Our objective was to analyze malpractice litigation related to bariatric surgery. METHODS: We conducted a retrospective review of Westlaw (Thompson Reuters) of all bariatric operations that resulted in the filing of a malpractice claim. Each case was reviewed for pertinent medicolegal information related to the procedure, claim, and trial...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Fady Saleh, Aristithes G Doumouras, Scott Gmora, Mehran Anvari, Dennis Hong
BACKGROUND: Bariatric surgery centres of excellence are relatively new in Canada and were first started in Ontario in 2009. This study presents short-term outcomes of Canada's largest bariatric collaborative, from Ontario, during its first 3 years. METHODS: We performed a population-based cohort study that included all patients (age ≥ 18) who received a Roux-en-Y gastric bypass or sleeve gastrectomy for the purpose of weight loss from March 2009 to April 2012 within Ontario...
July 2016: CMAJ Open
Ri-Xing Bai, Wen-Mao Yan, You-Guo Li, Jun Xu, Zhi-Qiang Zhong, Ming Yan
AIM: To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed. RESULTS: All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum...
October 7, 2016: World Journal of Gastroenterology: WJG
Xiao Du, Si-Qin Zhang, Hong-Xu Zhou, Xue Li, Xiao-Juan Zhang, Zong-Guang Zhou, Zhong Cheng
OBJECTIVES: This 1:1 matched cohort study with 3-year follow-up aimed to compare the safety and efficacy of LSG with LRYGB for morbid obesity patients. METHODS: From 2009 to 2013, patients undergoing LRYGB (n = 63) were matched with LSG (n = 63) by gender, age, and body mass index (BMI). Major complications, BMI, percentage of excess weight loss (%EWL), and obesity-related comorbidities after 6, 12, 24, and 36 months were compared. RESULTS: Hospital stay and major complication rates were comparable, but operative time in LSG was significantly shorter (83...
October 8, 2016: Oncotarget
Patchaya Boonchaya-Anant, Nitchakarn Laichuthai, Preaw Suwannasrisuk, Natnicha Houngngam, Suthep Udomsawaengsup, Thiti Snabboon
Objective. Obesity is a risk factor for hypogonadotropic hypogonadism in men. Weight loss has been shown to improve hypogonadism in obese men. This study evaluated the early changes in sex hormones profile after bariatric surgery. Methods. This is a prospective study including 29 morbidly obese men. Main outcomes were changes in serum levels of total testosterone (TT), free testosterone (cFT), SHBG, estradiol, adiponectin, and leptin at 1 and 6 months after surgery. Results. The mean age of patients was 31 ± 8 years and the mean BMI was 56...
2016: International Journal of Endocrinology
María Díaz-Tobarra, Norberto Cassinello Fernández, Pablo Jordá Gómez, Mohammad Nebih Nofal, Raquel Alfonso Ballester, Joaquín Ortega Serrano
BACKGROUND: Surgical strategies in patients with BMI > 55 kg/m(2) are not well established. OBJECTIVES: The objective of this study is to compare the long term results and complications of 1- vs. 2-stage laparoscopic "Roux-en-Y″ gastric bypass (LRYGB) for patients with BMI > 55 kg/m(2). METHODS: Retrospective review of the complications and outcomes, between January 2007 and January 2010, for patients with a BMI > 55 kg/m(2) who underwent directly a LRYGB (1-stage) or a LRYGB as a 2nd stage of a laparoscopic sleeve gastrectomy (LSG)...
October 9, 2016: Obesity Surgery
Xiao Du, Hong-Xu Zhou, Si-Qin Zhang, Hao-Ming Tian, Zong-Guang Zhou, Zhong Cheng
BACKGROUND: The metabolic effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes (T2D) patients who do not meet National Institutes of Health indications has not been well studied. OBJECTIVES: To compare the effectiveness of LSG and LRYGB in Chinese T2D patients with body mass index (BMI)<35 kg/m(2). SETTING: University hospital, China. METHODS: A nonrandomized cohort of patients who underwent LRYGB (n = 64) and LSG (n = 19) were followed up for 3 years and the outcomes (weight loss and remission of diabetes and other metabolic parameters) were compared...
August 31, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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