scholarly journals Bariatric surgery in elderly patients. A comparison between gastric banding and sleeve gastrectomy with five years of follow up

2014 ◽  
Vol 12 ◽  
pp. S69-S72 ◽  
Author(s):  
Mario Musella ◽  
Marco Milone ◽  
Paola Maietta ◽  
Paolo Bianco ◽  
Guido Coretti ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Elderly Patients ◽  
Gastric Banding ◽  
Surgery In Elderly

Outcomes of bariatric surgery in elderly patients: a registry-based cohort study with 3-year follow-up

2021 ◽  
Author(s):  
Pouya Iranmanesh ◽  
Vanessa Boudreau ◽  
Karim Ramji ◽  
Karen Barlow ◽  
Olivia Lovrics ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Cohort Study ◽  
Elderly Patients ◽  
Surgery In Elderly

scholarly journals A Very Rare Cause of Dilated Cardiomyopathy after Bariatric Surgery: Selenium Deficiency

2021 ◽  
pp. 1-3
Author(s):  
Gulay Kocak ◽  
Munevver Gul Avsar ◽  
Cansu Yazar ◽  
Aylia Yesilova ◽  
Gulcagri Yildiz ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Trace Elements ◽  
Sleeve Gastrectomy ◽  
Dilated Cardiomyopathy ◽  
Selenium Deficiency ◽  
Water Soluble ◽  
Nutritional Deficiencies ◽  
Reduced Ejection Fraction ◽  
Long Term Follow Up

Background: Sleeve gastrectomy for weight loss has increased significantly nowadays. Various complications may develop after this surgery that requires long-term follow-up of these patients. Nutrition is the most important aspect of the follow-up. The deficiency of trace elements, fat-soluble and water-soluble vitamins following bariatric surgeries have been well-described complications. Although nutritional supplementations are often initiated after bariatric surgery, the clinical outcomes related to the deficiency of trace elements have not been well known yet. Case Presentation: A 27-year-old woman who underwent a laparoscopic sleeve gastrectomy for surgical treatment of obesity 9 months ago presented to the emergency department with a signs of heart failure. Transthoracic echocardiography revealed dilated, poorly functioning left ventricle with reduced ejection fraction (28.9%) consistent with dilated cardiomyopathy. We assumed nutritional deficiencies secondary to sleeve gastrectomy as a cause of dilated cardiomyopathy, as the patient had inappropriate nutritional supplements after surgery. Laboratory tests revealed selenium and zinc deficiency that supported our hypothesis. Our patient completely recovered with adequate supplementation of selenium, zinc and thiamine. Conclusion: We highlighted that the early diagnosis of dilated cardiomyopathy due to selenium deficiency following bariatric surgery is of great importance since selenium deficiency is a cause of reversible cardiomyopathy.

scholarly journals MON-657 The Long-Term Effects of Sleeve Gastrectomy in Veterans with Type 2 Diabetes Mellitus (8-Year Follow-Up Analysis)

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Johane Simelane ◽  
Amelia Tisi ◽  
Irma Husain ◽  
Pietra Dale Greenberg
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Friedman Test ◽  
The Mean ◽  
Mental Health Diagnoses

Abstract We previously reported a nonrandomized case control study that showed significant improvements in BMI, HbA1c and HDL levels in 30 diabetic veterans who underwent sleeve gastrectomy (SG) through 2 yrs, compared to 23 controls receiving medical management. BMI decreased from 46 to 34 over two yrs and HbA1c from 7.3 to 5.9% in the SG group. We now report the 8 yr follow up. Since then, bariatric surgery has increasingly become an option for the management of not only obesity but also type 2 diabetes. More data is needed on long term outcomes of bariatric surgery compared to medical care. Our cohort is mainly men with more comorbidities and higher average age than typically included in other cohorts that usually include more women. Objectives: The main objective was to compare long term changes in weight, HbA1C, lipids and creatinine in SG group vs. controls. Secondary objectives analyzed were cardiovascular (CV) and mental health outcomes in SG cases and controls. Methods: Charts for diabetic veterans 18 to 80 yrs were reviewed over an 8 yr period. Data was analyzed using Friedman Test, Wilcoxon Signed Rank test with 2-tailed significance level set at p<05. Results: 23 cases and 22 controls were included in the 8-year data analysis. Mean age was 56 and 96% were male. The mean BMI and HbA1C at baseline were 45 and 7.3 in SG group with 41% on insulin and 42 and 8.4 for controls with 59% on insulin. A Friedman test found significant differences in mean changes in weight for BMI, HbA1C and HDL between SG cases and controls over the 8 yrs. (chi-square = 327.48; df = 4; p<0.000001). Follow up pairwise comparisons used a Wilcoxon test. HDL was higher in the SG group (p<.05) in each yr. Mean change in weight and BMI was significantly better for the SG group in the first 6 yrs after SG (p< .01). Nonetheless, the mean weight and BMI of SG group remained below their mean baseline weight and BMI for the full 8 year-period. The mean change in HbA1C was significantly better for the SG group in only the first 2 yrs (p<0.05). LDL change was significantly worse in SG group but not in all years. There were no significant differences in creatinine. Patients who had SG had fewer CV events 8 yrs after SG (baseline OR: 4.17, yr 8 OR:0.77). However, they also had more mental health diagnoses (yr 8 OR: 1.61). Conclusion:The weight loss in the SG group, as compared to controls, lessened over time remaining statistically significant until yr 6. However, the SG group mean BMI and weight remained below baseline at 8 years. HbA1C change remained significantly better in the SG group compared to controls only during the first 2 yrs. Follow up diabetes management in SG group was less consistent than controls. HDL remained significantly higher among the SG group which may be explain the lower CV events in this group. Awareness of more mental health diagnoses among bariatric surgery patients may lead to improved management and better adherence to a healthy lifestyle.

scholarly journals Bariatric Surgery in Elderly Patients

2021 ◽  
Vol 11 (1) ◽  
pp. 23-26
Author(s):  
Fatih Çiftçi ◽  
Turgut Anuk
Keyword(s):  
Bariatric Surgery ◽  
Elderly Patients ◽  
Surgery In Elderly

scholarly journals New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The “Time-Within-Remission Range”

2020 ◽  
Vol 9 (4) ◽  
pp. 1070
Author(s):  
Ana de Hollanda ◽  
Albert Lecube ◽  
Miguel Angel Rubio ◽  
Enric Sánchez ◽  
Núria Vilarrasa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Diabetes Remission ◽  
Dynamic Responses ◽  
Type 2 Diabetes Remission

Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the “time-within-remission range” as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 ± 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, “time-within-remission range” and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 ± 9.2 years old, body mass index (BMI) 46.3 ± 6.9 kg/m2) underwent primary bariatric procedures. “Time-within-remission range” were 83.3% (33.3–91.6) after gastric bypass, 68.7% (7.1–87.5) after sleeve gastrectomy and 90% (83.3–92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the “time-within-remission range”. The association of bariatric techniques with “time-within-remission range”, using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34–5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40–0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The “time-within-remission range” unveils a superiority of gastric bypass compared to sleeve gastrectomy.

Comparative Effectiveness of Gastric Bypass and Vertical Sleeve Gastrectomy for Hypertension Remission and Relapse: The ENGAGE CVD Study

Hypertension ◽  
2021 ◽  
Author(s):  
Kristi Reynolds ◽  
Lee J. Barton ◽  
Anirban Basu ◽  
Heidi Fischer ◽  
David E. Arterburn ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Vertical Sleeve Gastrectomy ◽  
Variable Approach ◽  
Study Population ◽  
Instrumental Variable Approach

Weight loss is an effective strategy for the management of hypertension, and bariatric surgery is the most effective weight loss and maintenance strategy for obesity. The importance of bariatric surgery in the long-term management of hypertension and which operation is most effective is less clear. We compared the effectiveness of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) for remission and relapse of hypertension after surgery in the ENGAGE CVD cohort study (Effectiveness of Gastric Bypass Versus Gastric Sleeve for Cardiovascular Disease). Operations were done by 23 surgeons across 9 surgical practices. Hypertension remission and relapse were assessed in each year of follow-up beginning 30 days and up to 5 years postsurgery. We used a local instrumental variable approach to account for selection bias in the choice of VSG or RYGB. The study population included 4964 patients with hypertension at the time of surgery (n=3186 VSG and n=1778 RYGB). At 1 year, 27% of patients with RYGB and 28% of patients with VSG achieved remission. After 5 years, without accounting for relapse, 42% of RYGB and 43% of VSG patients had experienced hypertension remission. After accounting for relapse, only 17% of RYGB and 18% of VSG patients remained in remission 5 years after surgery. There were no statistically significant differences between VSG and RYGB for hypertension remission, relapse, or mean systolic and diastolic blood pressure at any time during follow-up.

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