Comparing the Effectiveness of Laparoscopic Gastric Plication in Younger and Older Patients: a 3-Year Prospective Longitudinal Evaluation

Abstract Background Approximately 10% of older adults are annually admitted to a hospital. Hospitalization is associated with a higher risk of falls and mortality after discharge. This study aimed to identify predictors at admission for falls and mortality 3 months post-discharge in hospitalized older patients. Methods The Evaluation of Muscle parameters in a Prospective cohort of Older patients at clinical Wards Exploring Relations with bed rest and malnutrition (EMPOWER) study is an observational, prospective longitudinal inception cohort of 378 patients aged 70 years and older who were subsequently admitted to a tertiary hospital (the Netherlands). Potential predictors for falls and mortality 3 months post-discharge were tested using univariate and multivariate logistic regression analyses and included the following domains: demographic (age, sex, living independently), lifestyle (alcohol, smoking), nutrition (SNAQ score), muscle mass (absolute, relative), physical function (handgrip strength, Katz ADL score), cognition (six-item cognitive impairment test score), and disease (medications, diseases). Results The mean age was 79.6 years (standard deviation 6.23) and 50% were male. Within 3 months post-discharge, 19% reported a fall and 13% deceased. Univariate predictors for falls were higher age, lower absolute muscle mass and higher six-item cognitive impairment test score. Lower absolute muscle mass independently predicted falls post-discharge (multivariate). Univariate predictors for mortality were higher age, male sex, no current alcohol use, higher SNAQ score, lower absolute and higher relative muscle mass, higher Katz ADL score and higher number of diseases. Male sex, higher SNAQ score, and lower absolute muscle mass independently predicted mortality post-discharge (multivariate). Conclusions In hospitalized older adults, muscle mass should be measured to predict future outcome. Future intervention studies should investigate if increasing muscle mass prevent short-term falls and mortality.

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Laparoscopic gastric plication: towards standardization

International Surgery Journal ◽

10.18203/2349-2902.isj20175899 ◽

2017 ◽

Vol 5 (1) ◽

pp. 221

Author(s):

Ahmed Abdel Monem Ibrahim ◽

Ahmed Elgeidie ◽

Nabil Gadelhak

Keyword(s):

Weight Regain ◽

Excess Weight Loss ◽

Mini Gastric Bypass ◽

Morbidly Obese ◽

Gastric Plication ◽

Obese Patients ◽

Future Studies ◽

Laparoscopic Gastric Plication ◽

Good Reputation

Background: Laparoscopic gastric plication (LGP) is a restrictive bariatric procedure which was found to be safe, effective and economic as well. However, it hasn't a good reputation among some bariatric surgeons due to some reasons; the most important of them is lack of standardization. Objective of the present stud was to study propose a standardized technique for LGP aiming at a better outcome. Setting. Settings: University-affiliated hospital.Methods: This is a retrospective analysis of patients who underwent LGP by the proposed technique., using seromuscular bites with non-absorbable thread, adoption of the four-bite technique, and calibration using bougie.Results: Eighty-eight consecutive morbidly obese patients had been operated by the proposed standardized technique of LGP between March 2010 and September 2014. There were 19 men and 69 women, with a mean age of 30.3 years and a mean BMI of 36.7kg/m2 (range 32-51kg/m2). The most frequently reported complication was prolonged early postoperative nausea/vomiting occurred in 5 of 88 (5.7%) patients. Weight regain was reported in one patient who was treated with conversion of LGP to laparoscopic mini-gastric bypass. Hospital stay was prolonged for a mean of 6.0 (3 -10 days). Postoperative follow-up period ranged from 2 to 38 months with a mean of 15 months. Percentage of excess weight loss was 38.2%, 52.0%, and 63.1% at 3, 6, and 12 months, respectively.Conclusions: The proposed technique of LGP would help in standardization of the procedure in order to improve the outcome; however, the clinical application of this proposed standardized technique should be tested by future studies.

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Laparoscopic Gastric Plication versus Laparoscopic Sleeve Gastrectomy: An Up-to-Date Systematic Review and Meta-Analysis

Journal of Obesity ◽

10.1155/2018/3617458 ◽

2018 ◽

Vol 2018 ◽

pp. 1-14 ◽

Cited By ~ 4

Author(s):

Konstantinos Perivoliotis ◽

Eleni Sioka ◽

Georgia Katsogridaki ◽

Dimitrios Zacharoulis

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Fixed Effects ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Reoperation Rate ◽

Quality Level ◽

Gastric Plication ◽

Laparoscopic Gastric Plication ◽

Larger Sample

Introduction. A meta-analysis was conducted in order to provide an up-to-date comparison of laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric plication (LGP) for morbid obesity.Materials and Methods. The PRISMA guidelines andthe Cochrane Handbook for Systematic Reviews of Interventionswere used for the conduction of this study. A systematic literature search was performed in the electronic databases (MEDLINE, CENTRAL, and Web of Science and Scopus). The fixed effects or random effects model was used according to the Cochran Q test.Results. Totally, 12 eligible studies were extracted. LSG displayed a statistically significant lower rate of overall complications (OR: 0.35; 95% CI: 0.17, 0.68;p=0.002) and a sustainable higher %EWL through all time endpoints (OR: 4.86,p=0.04; OR: 7.57,p<0.00001; and OR: 13.74;p<0.00001). There was no difference between the two techniques in terms of length of hospital stay (p=0.16), operative duration (p=0.81), reoperation rate (p=0.51), and cost (p=0.06).Conclusions. LSG was demonstrated to have a lower overall complications and a higher weight loss rate, when compared to LGP. Further RCTs of a higher methodological quality level, with a larger sample size, are required in order to validate these findings.

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