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leak in bariatric surgery

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https://www.readbyqxmd.com/read/28629729/a-multicenter-study-of-routine-versus-selective-intraoperative-leak-testing-for-sleeve-gastrectomy
#1
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/28593411/c-reactive-protein-fibrinogen-and-procalcitonin-levels-as-early-markers-of-staple-line-leak-after-laparoscopic-sleeve-gastrectomy-in-morbidly-obese-patients-within-an-enhanced-recovery-after-surgery-eras-program
#2
Jaime Ruiz-Tovar, Jose Luis Muñoz, Juan Gonzalez, Alejandro Garcia, Carlos Ferrigni, Montiel Jimenez, Manuel Duran
INTRODUCTION: The performance of most bariatric procedures within an Enhanced Recovery After Surgery program has resulted in significant advantages, including a reduction in the length of hospital stay to 2-3 days. However, some postoperative complications may appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 h after a laparoscopic sleeve gastrectomy for predicting staple line leak in the postoperative course...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28527155/status-of-laparoscopic-sleeve-gastrectomy-in-china-a-national-survey
#3
Shibo Lin, Wei Guan, Pankaj Hans, Hui Liang
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a favorable bariatric procedure. This study evaluated the status of LSG in China. METHODS: During the 4(th) International Forum of Bariatric and Metabolic Surgery in May 2016, Nanjing China, an on-the-spot questionnaire was filled out by 105 attending surgeons with experience of LSG. The feedback data was collected and analyzed. RESULTS: For preoperative preparations, surgeons preferred blood glucose control with insulin (61...
May 19, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28477245/systematic-review-and-meta-analysis-of-outcomes-after-revisional-bariatric-surgery-following-a-failed-adjustable-gastric-band
#4
Alistair J Sharples, Vasileios Charalampakis, Markos Daskalakis, Abd A Tahrani, Rishi Singhal
INTRODUCTION: Laparoscopic adjustable gastric band (LAGB)-related complications have been reported in significant numbers of patients often leading to band removal. Increasingly revisional bariatric surgery (RBS) is offered, most commonly either band to Roux-en-Y gastric bypass (B-RYGB) or band to sleeve gastrectomy (B-SG). OBJECTIVES: We conducted a systematic review and meta-analysis of studies to evaluate the efficacy of RBS following failed LAGB. METHODS: Medline, Embase, The Cochrane Library and NHS Evidence were searched for English language studies assessing patients who had undergone LAGB and who subsequently underwent either B-RYGB or B-SG...
May 6, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28472844/-roux-y-gastric-bypass-for-morbid-obesity-in-adolescents-is-it-as-safe-and-effective-as-in-obese-adults
#5
Frank Benedix, Marek Kusibab, Daniela Adolf, Eric Lorenz, Stefanie Wolff, Hans Lippert, Thomas Manger, Christine Stroh
Background Obesity is one of the major challenges of the 21st century. There is also an increasing incidence of obesity in adolescents. Bariatric surgery has been proven safe and effective in obese adults. In adolescents, these operations are still subject to controversy. Current evidence is limited regarding its safety and outcome in this age group. Methods Within the German Bariatric Surgery Registry, data from obese patients that underwent bariatric procedures in Germany are prospectively registered. The current analysis includes all adolescent and adult subjects that underwent primary Roux-Y-gastric bypass (RYGB) surgery from 2005 to 2014...
May 4, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28456510/high-acuity-sleeve-gastrectomy-patients-in-a-free-standing-ambulatory-surgical-center
#6
Peter Billing, Josiah Billing, Jedediah Kaufman, Kurt Stewart, Eric Harris, Rob Landerholm
BACKGROUND: Procedures performed in ambulatory surgical centers (ASC) can provide several advantages over hospital-based surgery. Understandably, concerns have been raised regarding "high acuity" cases in the ASC setting. Recently the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) presented protocols for ASCs to follow, requiring them to perform only "low acuity" cases to be compliant with accreditation. OBJECTIVE: Assess the safety and efficacy of outpatient sleeve gastrectomy (SG) on the "high acuity patient" in a free-standing ASC...
March 27, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28372953/noninvasive-positive-pressure-ventilation-in-the-immediate-post-bariatric-surgery-care-of-patients-with-obstructive-sleep-apnea-a-systematic-review
#7
REVIEW
Solomon Tong, Jonathan Gower, Austin Morgan, Kyle Gadbois, Gordon Wisbach
BACKGROUND: Obstructive sleep apnea is common in morbidly obese patients, and noninvasive positive pressure ventilation (NIPPV) is the standard treatment. Postoperatively, NIPPV is highly effective in preventing hypoxia and apneic episodes; however, the concern of gastric distention leading to increased risk of an anastomotic dehiscence limits universal acceptance. OBJECTIVE: To perform a systematic review of the literature to determine if the use of NIPPV during immediate post-bariatric surgery care is safe...
February 20, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28363345/advanced-laparoscopic-bariatric-surgery-is-safe-in-general-surgery-training
#8
John Kuckelman, Jason Bingham, Morgan Barron, Michael Lallemand, Matthew Martin, Vance Sohn
BACKGROUND: Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. METHODS: Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon...
May 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28360973/endoluminal-solutions-to-bariatric-surgery-complications-a-review-with-a-focus-on-technical-aspects-and-results
#9
REVIEW
Raquel Souto-Rodríguez, María-Victoria Alvarez-Sánchez
Obesity is a growing problem in developed countries, and surgery is the most effective treatment in terms of weight loss and improving medical comorbidity in a high proportion of obese patients. Despite the advances in surgical techniques, some patients still develop acute and late postoperative complications, and an endoscopic evaluation is often required for diagnosis. Moreover, the high morbidity related to surgical reintervention, the important enhancement of endoscopic procedures and technological innovations introduced in endoscopic equipment have made the endoscopic approach a minimally-invasive alternative to surgery, and, in many cases, a suitable first-line treatment of bariatric surgery complications...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28353180/efficacy-and-safety-of-the-over-the-scope-clip-otsc-system-in-the-management-of-leak-and-fistula-after-laparoscopic-sleeve-gastrectomy-a-systematic-review
#10
Saeed Shoar, Lauren Poliakin, Zhamak Khorgami, Rebecca Rubenstein, Moamena El-Matbouly, Jun L Levin, Alan A Saber
BACKGROUND: Endoscopic management of leaks/fistulas after laparoscopic sleeve gastrectomy (LSG) is gaining popularity in the bariatric surgery. OBJECTIVES: This study aimed to review the efficacy and safety of over-the-scope-clip (OTSC) system in endoscopic closure of post-LSG leak/fistula. METHODS: PubMed/Medline and major journals of the field were systematically reviewed for studies on endoscopic closure of post-LSG leaks/fistula by means of the OTSC system...
March 28, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28349296/roux-en-y-fistulojejunostomy-a-new-therapeutic-option-for-complicated-post-sleeve-gastric-fistulas-video-report
#11
Theodoros Thomopoulos, Maximilien Thoma, Benoit Navez
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become during the last few years the most frequent procedure in bariatric surgery. However, complications related to the gastric staple line can be even more serious. The incidence of gastric fistula after LSG varies from 1 to 7%. Its management can be very challenging and long. In case of chronic fistula and failure of the previous treatment, total gastrectomy or Roux-en-Y fistulo-jejunostomy (RYFJ) might be considered. RYFJ has been described very rarely as a salvage procedure of gastric leaks after LSG...
March 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28349295/endoscopic-drainage-of-intra-abdominal-collection-after-bariatric-surgery
#12
Gianfranco Donatelli, Renaud Chiche, Fabrizio Cereatti, Guillaume Pourcher, David Fuks, Bertrand Vergeau, Jean-Loup Dumont, Bruno Meduri
INTRODUCTION: Symptomatic intra-abdominal collection after bariatric surgery occurs in up to 5% of cases. Surgical, percutaneous, or endoscopic drainage are the feasible approaches. MATERIALS AND METHODS: In this video, we show the case report of a 50-year-old woman who underwent to gastric omega bypass on a previous sleeve gastrectomy. After 3 weeks, she presented a well-organized liquid collection just behind the longitudinal staple line of the gastric pouch...
March 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28261497/integrated-approaches-for-the-management-of-staple-line-leaks-following-sleeve-gastrectomy
#13
Mauro Montuori, Domenico Benavoli, Stefano D'Ugo, Luca Di Benedetto, Emanuela Bianciardi, Achille L Gaspari, Paolo Gentileschi
Introduction. Aim of the study was trying to draw a final flow chart for the management of gastric leaks after laparoscopic sleeve gastrectomy, based on the review of our cases over 10 years' experience. Material and Methods. We retrospectively reviewed all patients who underwent LSG as a primary operation at the Bariatric Unit of Tor Vergata University Hospital in Rome from 2007 to 2015. Results. Patients included in the study were 418. There were 6 staple line leaks (1.44%). All patients with diagnosis of a leak were initially discharged home in good clinical conditions and then returned to A&E because of the complication...
2017: Journal of Obesity
https://www.readbyqxmd.com/read/28223086/long-term-10-year-outcomes-after-laparoscopic-roux-en-y-gastric-bypass
#14
Shanu N Kothari, Andrew J Borgert, Kara J Kallies, Matthew T Baker, Brandon T Grover
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult. OBJECTIVE: Evaluate long-term LRYGB outcomes using standard outcome reporting definitions. SETTING: Integrated multispecialty health system...
December 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089439/evaluating-the-effect-of-operative-technique-on-leaks-after-laparoscopic-sleeve-gastrectomy-a-case-control-study
#15
Oliver A Varban, Kyle H Sheetz, Ruth B Cassidy, Amanda Stricklen, Arthur M Carlin, Justin B Dimick, Jonathan F Finks
OBJECTIVE: To assess the effect of operative technique on staple line leaks after laparoscopic sleeve gastrectomy (LSG). BACKGROUND: Staple-line leaks after LSG are a major source of morbidity and mortality. Variations in operative technique exist; however, their effect on leaks is poorly understood. METHODS: We analyzed data from the Michigan Bariatric Surgery Collaborative (MBSC) to perform a case-control study comparing patients who had a clinically significant leak after undergoing a primary LSG to those who did not...
April 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28079244/preoperative-multidisciplinary-program-for-bariatric-surgery-a-proposal-for-the-brazilian-public-health-system
#16
Elinton Adami Chaim, José Carlos Pareja, Martinho Antonio Gestic, Murillo Pimentel Utrini, Everton Cazzo
BACKGROUND: - Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE: - To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS: - A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078641/staple-line-leak-after-primary-sleeve-gastrectomy-risk-factors-and-mid-term-results-do-patients-still-benefit-from-the-weight-loss-procedure
#17
Frank Benedix, Oliver Poranzke, Daniele Adolf, Stephanie Wolff, Hans Lippert, Jörg Arend, Thomas Manger, Christine Stroh
BACKGROUND: Staple line leak after laparoscopic sleeve gastrectomy (LSG) still represents the most feared complication. The purpose of this study was to investigate whether there are factors that increase the risk for a leakage. Furthermore, we aimed to analyze the impact of a leak on weight change and resolution of comorbidities. METHODS: Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered. For the current analysis, all adult subjects that had undergone primary LSG from 2005 to 2014 were considered...
January 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28054296/staple-line-reinforcement-in-laparoscopic-sleevegastrectomy-experience-in-1023-consecutive-cases
#18
Matías Sepúlveda, Cristián Astorga, Juan P Hermosilla, Munir Alamo
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric procedures performed worldwide. However, staple line-related complications have become a major challenge for bariatric surgeons. The aim of this study was to evaluate the morbidity in a cohort of patients who underwent LSG with imbricated oversewing of the staple line at a single high-volume center. MATERIALS AND METHODS: We retrospectively reviewed prospectively collected data for all patients who underwent LSG to treat obesity at our institution from January 2010 to September 2016...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28017845/endoscopic-sleeve-gastroplasty-significantly-reduces-body-mass-index-and-metabolic-complications-in-obese-patients
#19
Reem Z Sharaiha, Nikhil A Kumta, Monica Saumoy, Amit P Desai, Alex M Sarkisian, Andrea Benevenuto, Amy Tyberg, Rekha Kumar, Leon Igel, Elizabeth C Verna, Robert Schwartz, Christina Frissora, Alpana Shukla, Louis J Aronne, Michel Kahaleh
BACKGROUND & AIMS: Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure that reduces the length and width of the gastric cavity to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss and obesity-related comorbidities. METHODS: We collected data from 91 consecutive patients (mean age, 43.86 ± 11.26 years; 68% female) undergoing ESG from August 2013 through March 2016...
December 23, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28008162/endoscopic-approach-for-major-complications-of-bariatric-surgery
#20
Moon Kyung Joo
As lifestyle and diet patterns have become westernized in East Asia, the prevalence of obesity has rapidly increased. Bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB), are considered the first-line treatment option in patients with severe obesity. However, postoperative complications have increased and the proper management of these complications, including the use of endoscopic procedures, has become important. The most serious complications, such as leaks and fistulas, can be treated with endoscopic stent placement and injection of fibrin glue, and a novel full-thickness closure over-the-scope clip (OTSC) has been used for treatment of postoperative leaks...
January 2017: Clinical Endoscopy
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