scholarly journals A safety study of laparoscopic single-anastomosis duodeno-ileal bypass with gastric plication (SADI-GP) in the management of morbid obesity

2021 ◽  
Author(s):  
Istvan Bence Balint ◽  
Ferenc Csaszar ◽  
Lajos Orban ◽  
Peter Radics ◽  
Akos Farics ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Personality Inventory ◽  
Gastric Plication ◽  
Safety Study ◽  
Single Anastomosis ◽  
Weight Loss Outcomes ◽  
Ileal Bypass

Abstract Background Bariatric surgery is more effective in the management of morbid obesity and related comorbidities than is conservative therapy. Pylorus-preserving single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-SG) is a modified duodenal switch technique. Gastric plication (GP) is an alternate to SG. Methods Morbidly obese (BMI of > 40, or > 35 in the presence of diabetes or prediabetes) patients were recruited and operated on to perform SADI with GP. Complications related to surgery were recorded to assess the feasibility of the procedure. Weight-loss outcomes were analysed to determine efficacy. Minnesota Multiphasic Personality Inventory 2 (MMPI-2) was recorded after 1 year of follow-up, and test scales were used to describe physiological phenomena. Results Seventeen middle-aged (mean: 40 years) patients were involved in our study; 15 of them were females. The mean duration of surgery was 205 min. There were no complications of conversion, death, bleeding, VTE or 30-day readmission to hospital. We did experience CD4a (pulmonary insufficiency due to chronic lung disease) and a CD3b (anastomosis leakage treated laparoscopically) complications. Vomiting occurred in three cases (CD1). Obesity-related comorbidities showed favourable resolution rates (77.8% for hypertension, 81.2% for dyslipidaemia, 100% for diabetes at the 1-year follow-up). Weight-loss outcomes were favourable (53.20 EWL%, and 35.58 TWL% at 1-year follow-up). Greater weight loss caused significantly higher levels of Depression (t(13.958) =  − 2.373; p = 0.00; p < 0.05) and Low Positive Emotions (t(13.301) =  − 2.954; p = 0.00; p < 0.05) and Introversion/Low Positive Emotionality (t(13.408) =  − 1.914; p = 0.02; p < 0.05) in MMPI-2 data. Conclusion According to our safety study, SADI-GP is a promising malabsorptive procedure, but a long-term high-volume case series or a randomised controlled trial is necessary to evaluate complication rates and weight-loss outcomes. Emotional dysregulation is common among bariatric surgery patients according to personality inventory data; therefore, psychological follow-up and psychotherapeutic support are necessary for weight-loss maintenance.

scholarly journals Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

2021 ◽  
Author(s):  
Henry K. Karlsson ◽  
Lauri Tuominen ◽  
Semi Helin ◽  
Paulina Salminen ◽  
Pirjo Nuutila ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Opioid Receptor ◽  
Weight Regain ◽  
Postoperative Weight Loss ◽  
Weight Loss Outcomes ◽  
Preoperative Weight

AbstractBackgroundBariatric surgery is the most effective method for weight loss in morbid obesity. There is significant individual variability in the weight loss outcomes, yet factors leading to postoperative weight loss or weight regain remain elusive. Alterations in the µ-opioid receptor (MOR) and dopamine D2 receptor (D2R) systems are associated with obesity, appetite control, and reward processing. The magnitude of initial brain receptor system perturbation is a plausible predictor of long-term surgical weight loss outcomes. The aim was to test this hypothesis by measuring obese subjects’ MOR and D2R availability with positron emission tomography (PET) preoperatively before bariatric surgery and then assessing their weight development association with regional MOR and D2R availabilities at 2-year follow-up.MethodsWe studied 19 morbidly obese women (mean BMI 40, mean age 43) scheduled to undergo bariatric surgery, i.e. Roux-en-Y gastric bypass or sleeve gastrectomy, according to their standard clinical treatment. Preoperative MOR and D2R availabilities were measured using PET with [11C]carfentanil and [11C]raclopride, respectively. Subject weight was recorded at 3, 6, 12, and 24 months after surgery. Radiotracer binding potentials (BPND) were extracted and correlated with patient weight at different time points. ROIs were delineated in the striatum and in limbic and paralimbic components of the emotion and reward networks.ResultsMOR availabilities were not correlated with preoperative weight. MOR availabilities in the amygdala (r = −0.54), insula (r = −0.46), ventral striatum (r = −0.48) and putamen (r = −0.49) were associated with subject weight at 3 months. Significant association was found in the amygdala at 6 months (r = −0.53), 12 (r = −0.49), and 24 months (r = −0.50). D2R availabilities were associated with neither preoperative weight nor weight loss at any follow-up time point.ConclusionsTo our knowledge, this is the first study to demonstrate that neuroreceptor markers prior to bariatric surgery in patients with morbid obesity are associated with the postoperative weight loss. Preoperative MOR availability in the amygdala was associated with long-term postoperative weight development after surgery suggesting that postoperative weight regain may derive from dysfunction in the opioid system. Postoperative weight loss outcomes after bariatric surgery may be partially predicted based on preoperative receptor availability opening up new potential for treatment possibilities.Clinical Trials RegistrationSleevePET2, NCT01373892, http://www.clinicaltrials.gov

scholarly journals Comparative study between Single Anastomosis Duodeno–Ileal Bypass with Sleeve Gastrectomy and Mini-Gastric Bypass Surgery for the Treatment of Morbid Obesity

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A Abdelhamid ◽  
S Albalkiny ◽  
K Abdel-Samee ◽  
A Mustafa
Keyword(s):  
Morbid Obesity ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Mini Gastric Bypass ◽  
Morbidly Obese ◽  
Single Anastomosis ◽  
Gastric Bypass Operation ◽  
One Year ◽  
Ileal Bypass

Abstract Background Metabolic and bariatric surgery is a proven therapy for the treatment of obesity and its related comorbidities. Malabsorptive operations usually offer a higher rate of metabolic improvement, despite higher rate of complications and secondary effects. Objectives To compare Single Anastomosis Duodeno–Ileal bypass with Sleeve gastrectomy (SADIS) and Mini-Gastric Bypass operation as two types of bariatric surgeries with regard to weight loss, metabolic outcome and nutritional deficiencies within one year of post-operative follow up. Methods We performed a prospective comparison of 40 morbidly obese patients submitted to SADIS (n. = 20) and MGB (n. = 20) between July 2016 to July 2017 with one year of postoperative follow up. Results The groups were nearly similar in terms of age and sex. The SADI-S group had BMI of (47.4 vs 46.1) with 100% prevalence of DM in both groups, hypertension in SADIS 70% vs 65% in MGB and almost equal incidence of dyslipidemia. The SADI-S group presented markedly higher percentage of EWL of 91.4% vs 71.6% after one year. Control of DM, with HbA1c below 6%, was obtained in 85% in both groups with more decrease in mean HbA1c of SADIS being 5.44 vs 5.815 in MGB after one year. Most patients abandoned antidiabetic therapy or at least were controlled by less medications and lower doses. The SADI-S group presented remission of hypertension by 90% of patients as those of MGB but with far less medications. Lipid profile improvement was noticed in both groups with slightly higher resolution in SADIS group by 95% vs 90% for total cholesterol, 85% in both groups for T.G, 80% vs 85% for LDL, 65% vs 70% for HDL in SADIS and MGB patients respectively. Although the nutritional deficiency is still a considerable concern after SADIS, ours study didn’t show intense difference from MGB provided that proper vitamin supplementation and patient compliance are maintained postoperatively. Conclusion When compared to gastric bypass, SADI-S appears to be an effective and safe therapeutic technique with excellent short-term results for treating morbid obesity and its associated comorbidities with a low rate of nutritional complications. Proving its safety and efficacy by further studies will grant it more popularity in the future.

scholarly journals Developed foot drop as a complication of bariatric surgery: case reports

2010 ◽  
Vol 8 (2) ◽  
pp. 232-234 ◽  
Author(s):  
Marcelo Pires Prado
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Muscle Strength ◽  
Literature Review ◽  
Physical Examination ◽  
Case Reports ◽  
Ankle Dorsiflexion ◽  
Foot Drop

ABSTRACT Two cases of patients with morbid obesity submitted to bariatric surgery and with considerable weight loss are presented. During follow-up, they complained of weakness in the legs and the physical examination showed reduction of ankle dorsiflexion muscle strength (foot drop). In these cases, the symptoms subsided spontaneously. A literature review is presented.

scholarly journals Place Work on a Scale: What Do We Know About the Association Between Employment Status and Weight Loss Outcomes After Bariatric Surgery?

2021 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Marlies Bongers ◽  
Daniëlle D.B. Holthuijsen ◽  
Loes Janssen ◽  
François M.H. van Dielen ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Employment Status ◽  
Weight Regain ◽  
Weight Loss Outcomes ◽  
Working Status ◽  
Successful Weight Loss ◽  
Patients Experience ◽  
The Impact

AbstractDespite the initial successful weight loss after bariatric surgery, a significant amount of patients experience weight loss failure and weight regain. Several factors are known to contribute to this, though the impact of employment status is unknown. The objective of this systematic review was to examine the impact of employment status on post-surgical weight loss outcomes. Eight studies were included with a follow-up ranging between 2 and 10 years. Employed patients seemed to present more weight loss (9.0–11.0% EWL, 1.3–1.6% BMI loss) compared to unemployed patients, but none of these numbers were statistically significant. Moreover, there were contrasting findings in terms of weight regain. This review may highlight the importance of working status after bariatric surgery and warrants further investigation on this topic. Graphical abstract

scholarly journals Laparoscopic Greater Curvature Plication for Morbid Obesity: Indications, Results, Perspectives

2015 ◽  
Vol 61 (2) ◽  
pp. 142-144 ◽  
Author(s):  
T Bara ◽  
C Borz ◽  
A Suciu ◽  
M Denes ◽  
A Torok ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Weight Loss Surgery ◽  
The United States ◽  
Lifestyle Changes ◽  
Long Term Results ◽  
Gastric Plication ◽  
Important Health ◽  
Complications Rate

Abstract Morbid obesity is an important health problem of our century. It is managed by diet, lifestyle changes and medication and surgery. Weight-loss surgery is the most effective treatment for morbid obesity, producing durable weight loss, improvement or remission of comorbid conditions and longer life. Bariatric surgery provides the best results in up to 75% of cases of severe obesity and obesity comorbidities. In the United States, over 200 000 patients benefit every year from bariatric procedures. That means there is a continuous evolving of the bariatric surgery. Bariatric surgery is metabolic surgery because it resolves or alleviates Type2 Diabetes, hyperlipidemia and hypertension. The most employed bariatric operations are Roux -en- Y gastric by-pass, adjustable gastric banding, biliopancreatic diversion and sleeve gastrectomy, each of them having shortage of long term results and safety. In the last eight years was introduced a new bariatric procedure, the gastric plication, in an effort to obtain similar weight loss with lesser complications and costs. We present our initial experience with 30 morbid obese patients who undergone laparoscopic gastric plication in our institution. The mean % Excess Weight Loss was 50% at 6 month and 65% at 12 month with important alleviation of comorbidities. The complications rate was 6.6% for major complications (but only in the first 6 cases) and 10% for minor complications.

scholarly journals Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

2021 ◽  
Author(s):  
Arnaud Liagre ◽  
Francesco Martini ◽  
Yves Anduze ◽  
Hubert Boudrie ◽  
Olivier Van Haverbeke ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Weight Regain ◽  
Postoperative Mortality ◽  
Short Term ◽  
Postoperative Complication Rate ◽  
Single Anastomosis ◽  
Biochemical Assessment ◽  
Ileal Bypass

Abstract Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

Su1982 Compliance With Bariatric Surgery Follow-Up and Weight Loss Outcomes

2016 ◽  
Vol 150 (4) ◽  
pp. S1224
Author(s):  
Britney Corey ◽  
Lauren Goss ◽  
Allison A. Gullick ◽  
David Breland ◽  
Joshua Richman ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Loss Outcomes

scholarly journals Are the Results of a Combined Behavioural and Surgical Treatment of Morbid Obesity Satisfactory and Predictable?

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1997
Author(s):  
Per G Farup
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Weight Reduction ◽  
Treatment Success ◽  
Behavioural Therapy ◽  
Behavioural Treatment ◽  
Alternative Interventions ◽  
Clinically Significant

Treatment of subjects with morbid obesity (Body Mass Index (BMI) > 40 kg/m2 or > 35 kg/m2 with obesity-related complications) often fails. This study explored the biopsychosocial predictors of dropout and weight loss during a combined behavioural and surgical weight-reduction program. Behavioural treatment for six months was followed by bariatric surgery and a visit six months after surgery. The success criterion was the loss of ≥50% of excess BMI above 25 kg/m2 (%EBMIL). Thirty-one men and 113 women with BMI 43.5 kg/m2 (SD 4.3) and 41.8 kg/m2 (SD 3.6), respectively, were included; 115 underwent bariatric surgery (Gastric sleeve: 23; Roux-en-Y gastric bypass: 92), and 98 had a follow-up visit six months after surgery. The mean %EBMIL at follow-up was 71.2% (SD 18.5). Treatment success was achieved in 86 subjects. Assuming success in 17 subjects who did not attend the follow-up visit (best possible outcome), 103 out of 144 subjects (72%) achieved successful weight reduction. Cohabitation was the only predictor of accomplishing surgery. Neither weight loss during behavioural therapy nor biopsychosocial factors were found to be clinically significant predictors of weight loss after surgery. The success rate of less than three in four subjects was unsatisfactory. There is a need to improve the regimen and to determine effective alternative interventions.

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