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leak in bariatric surgery

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https://www.readbyqxmd.com/read/29197192/laparoscopic-gastric-plication-for-the-treatment-of-morbid-obesity-by-using-real-time-imaging-of-the-stomach-pouch
#1
Cristian Borz, Tivadar Jr Bara, Tivadar Bara, Andras Suciu, Marton Denes, Bogdan Borz, Dorin Marian, Simona Muresan, Anca Bacarea, Mircea Muresan, Gabriela Jimborean
BACKGROUND: Bariatric surgery is a continuously evolving field. Laparoscopic greater curvature plication is a new investigational procedure used to treat patients with morbid obesity. The demand for this operation from the obese patients is also rising. The problem is that during gastric plication the exact dimensions and volume of the pouch are not known so frequently it is too large or too tight thus compromising the results. The aim of the study was to identify the parameters that can improve the outcomes after this procedure...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29181746/severe-dehiscence-of-gastrojejunal-anastomosis-after-gastric-bypass-its-cure-by-using-partially-covered-stent-and-avoiding-migration
#2
Helga C A W Alhinho, Flávio C Ferreira, Rodrigo C L Medeiros, Álvaro A B Ferraz, Josemberg M Campos
BACKGROUND: Gastric leak is a severe complication of gastric bypass that is associated with significant morbidity and mortality. Anastomosis dehiscence usually occurs at gastrojejunal anastomosis and can appear simultaneously with gastric leak, for which treatment can be a challenge. Fistula may have several clinical impacts, depending on patient-related factors, fistula characteristics, onset time, and therapy proposal. Abdominal toilet, drainage, gastrostomy, and revisional surgery constitute the traditional approaches to dehiscence and fistula closure, with variable results...
November 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29159552/the-effect-of-helicobacter-pylori-on-postoperative-outcomes-in-patients-undergoing-bariatric-surgery-a-systematic-review-and-meta-analysis
#3
REVIEW
Valentin Mocanu, Jerry T Dang, Noah Switzer, Daniel Skubleny, Xinzhe Shi, Chris de Gara, Daniel W Birch, Shahzeer Karmali
Helicobacter pylori (HP) occurs in 50% of people worldwide with higher rates reported in the bariatric population. HP has been associated with adverse outcomes following bariatric surgery; however, its true impact has not yet been defined. We aimed to systematically review the effect of HP on bariatric surgery outcomes. A comprehensive literature review was conducted yielding seven studies with 255,435 patients. Meta-analysis found comparable rates of bleeding, leak, hospital length of stay, and weight loss between HP-positive and HP-negative patients...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#4
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/29124550/gastrectomy-with-extended-lymphadenectomy-a-north-american-perspective
#5
Alexandre Gosselin-Tardif, Jessica Lie, Ioana Nicolau, Juan Carlos Molina, Jonathan Cools-Lartigue, Liane Feldman, Jonathan Spicer, Carmen Mueller, Lorenzo Ferri
PURPOSE: Despite evidence of oncologic benefits from extended (D2) lymphadenectomy in gastric cancer from many East Asian studies, there is persistent debate over its use in the West, mainly due to perceived high rates of morbidity and mortality. This study evaluates the safety and efficacy of D2 dissection in a high-volume North American center. METHODS: A prospectively entered database of all patients undergoing gastrectomy for cancer at a North American referral center from 2005 to 2016 was reviewed...
November 9, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
#6
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
#7
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
#8
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/28988235/readmissions-and-emergency-department-visits-after-bariatric-surgery-at-saudi-arabian-hospital-the-rates-reasons-and-risk-factors
#9
Anwar Ahmed, Doaa AlBuraikan, Bashayr ALMuqbil, Wijdan AlJohi, Wala Alanazi, Budor AlRasheed
BACKGROUND: Saudi Arabian hospital readmissions and emergency department (ED) visits following bariatric surgery and discharge have never been investigated. This study aimed to evaluate the rates and reasons of hospital readmissions and ED visits related to surgical weight loss interventions at the King Abdulaziz Medical City - Riyadh. METHODS: We conducted a retrospective cohort study on 301 patients who underwent bariatric surgery between January 2011 and July 2016...
October 7, 2017: Obesity Facts
https://www.readbyqxmd.com/read/28975492/sleeve-gastrectomy-outcomes-in-patients-with-bmi-between-30-and-35-3-years-of-follow-up
#10
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
#11
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
#12
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/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/28858079/laparoscopic-vertical-sleeve-gastrectomy-a-5-year-veterans-affairs-review
#14
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/28840455/effects-of-laparoscopic-roux-en-y-gastric-bypass-on-chinese-type-2-diabetes-mellitus-patients-with-different-levels-of-obesity-outcomes-after-3%C3%A2-years-follow-up
#15
Xiao Du, Xiang-Hui Fu, Lei Shi, Jian-Kun Hu, Zong-Guang Zhou, Zhong Cheng
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been proven to be effective on treating type 2 diabetes mellitus (T2DM) in severely obese patients, but whether LRYGB surgery should be performed in obese class I patients is controversial. MATERIALS AND METHODS: A retrospective study of 3-year bariatric and metabolic outcomes in different obese class T2DM patients who underwent LRYGB was conducted to compare the effectiveness of LRYGB in obese class I patients with that in obese class II/III patients in a Chinese T2DM population...
August 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28836135/mandatory-risk-assessment-reduces-venous-thromboembolism-in-bariatric-surgery-patients
#16
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
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
#17
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/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#18
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#19
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/28702740/large-bariatric-specific-stents-and-over-the-scope-clips-in-the-management-of-post-bariatric-surgery-leaks
#20
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
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