Bariatric surgery in 2006

2006 ◽  
Vol 259 ◽  
pp. 1-3

In a nutshellBariatric surgery continues to prove superior to diet/medical approaches in weight loss and metabolic improvements, even for moderate obesity.However, the complication rate of surgery is greater than has been suggested by previous case review series. Nutritional impacts need to be carefully monitored long-term, particularly with bypass surgical techniques and in vulnerable patients, such as pregnancy, teenagers, and the elderly.

2020 ◽  
Vol 13 (1) ◽  
pp. 19-27
Author(s):  
Toni I. Stoyanov ◽  
Pedro Cascales-Sanchez ◽  
Kaloyan T. Ivanov ◽  
Agustina Martinez-Moreno ◽  
Servando Usero-Rebollo ◽  
...  

Summary Introduction: Bariatric surgery has amply demonstrated its benefit in the treatment of morbidly obese patients. After surgery, there is a progressive and significant decrease in weight in a high percentage of patients. Most comorbidities resolve, improving quality of life and increasing life expectancy. Methods and Objective: The literature review is based on a 10-year or longer follow-up of patients who underwent various bariatric surgery procedures. The long-term weight loss results and the clinical impact were evaluated. Results: The applied surgical techniques, including Rouxen-Y gastric Bypass (RYBG), Biliopancreatic Diversion, Scopinaro type (BPD), and Duodenal Switch (DS), have contributed to achieving very satisfactory long-term and sustainable weight loss results. According to the reviewed literature, the percentage of excessive BMI Loss (%EBMIL) for the various techniques was 67.9%, 70.7%, and 71.5% for RYGB, BPD, and DS, respectively. Patients undergoing BGYR have lost much more weight than non-surgical patients and can maintain long-term weight loss, reaching a Percentage of Excessive Weight Loss (%EWL) as high as 56.4% in 10 years. Patients who underwent Adjustable Gastric Band (AGB) presented with a %EWL of 45.9% in 10 years, but with very high re-operation rate range (8-78%). There are few studies in the literature on Laparoscopic Sleeve Gastrectomy, reporting weight loss results over ten years. According to the study carried out by Arman G. A., Himpens J., et al. isolated Laparoscopic Sleeve Gastrectomy (LGS) produced a satisfactory weight loss over ten years, reachingEBMIL of 62.5%. Amending LSG with a new surgical design with malabsorbtive component (in 25% of patients) increased the weight loss, achieving %EBMIL of 81.7%.The Vertical Band Gastroplasty technique resulted in EWL of 38.1 ± 28.8%, as shown by a mean follow-up of 17.3 years, with a high rate of re-operations and conversions.


2018 ◽  
Vol 24 ◽  
pp. 49
Author(s):  
Keren Zhou ◽  
Kathy Wolski ◽  
Ali Aminian ◽  
Steven Malin ◽  
Philip Schauer ◽  
...  

2012 ◽  
Author(s):  
Leslie M. Schuh ◽  
David B. Creel ◽  
Joseph Stote ◽  
Katharine Hudson ◽  
Karen K. Saules ◽  
...  

Author(s):  
Mauro Lombardo ◽  
Arianna Franchi ◽  
Roberto Biolcati Rinaldi ◽  
Gianluca Rizzo ◽  
Monica D’Adamo ◽  
...  

There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1 ± 10.6 y, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients had sleeve gastrectomy (SG) and 11 subjects had adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: the average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight, was 60.6% ± 32.3. Despite good adherence to prescribed supplements, 80.7% of subjects (72.7%, AGB; 76.7%, SG; 93.8 %, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Long-term nutritional deficiencies were greater than the general population among men for iron and among women for vitamin B12.


2021 ◽  
Author(s):  
Larissa Cristina Lins Berber ◽  
Mariana Silva Melendez-Araújo ◽  
Eduardo Yoshio Nakano ◽  
Kênia Mara Baiocchi de Carvalho ◽  
Eliane Said Dutra

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Miral Subhani ◽  
Kaleem Rizvon ◽  
Paul Mustacchia

Obesity is an epidemic in our society, and rates continue to rise, along with comorbid conditions associated with obesity. Unfortunately, obesity remains refractory to behavioral and drug therapy but has shown response to bariatric surgery. Not only can long-term weight loss be achieved, but a majority of patients have also shown improvement of the comorbid conditions associated with obesity. A rise in the use of surgical therapy for management of obesity presents a challenge with an increased number of patients with problems after bariatric surgery. It is important to be familiar with symptoms following bariatric surgery, such as nausea/vomiting, abdominal pain, dysphagia, and upper gastrointestinal bleeding and to utilize appropriate available tests for upper gastrointestinal tract pathology in the postoperative period.


HPB Surgery ◽  
1997 ◽  
Vol 10 (4) ◽  
pp. 259-261 ◽  
Author(s):  
O. J. Garden

Background: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and. mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly patients, and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes.Methods: Five hundred seventy-seven liver resections (July 1985–July 1994) performed for metastatic colorectal cancer and 488 pancreatic resections (October 1983–July 1994) performed for pancreatic malignancies were identified in departmental data bases. Outcomes of patients younger than age 70 years were compared with those of patients age 70 years or older.Results: Liver resection for 128 patients age 70 years or older resulted in a 4% perioperative. mortality rate and a 42% complication rate. Median hospital stay was 13 days, and 8% of the patients required admission to the intensive care unit (ICU). Median survival was 40 months, and the 5-year survival rate was 35%. No difference were found between results for the elderly and those for younger patients who had undergone liver resection, except for a minimally shorter hospital stay fortheyoungerpatients (median, 12 days vs. 13 days p=0.003). Pancreatic resection for 138 elderly patients resulted in a mortality rate of 6% and a complication rate of 45%. Median stay was 20 days, and 19% of the patients required ICU admission, results identical to those for the younger cohort. Long-term survival was poorer for the elderly patients, with a 5-year survival rate of 21% compared with 29% for the younger cohort (p=0.03).Conclusions: Major liver or pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronologic age alone is not a contraindication to liver or pancreatic resection for malignancy.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Erin Takemoto ◽  
Bruce Wolfe ◽  
Corey Nagel ◽  
Janne Boone-Heinonen

In the general population, bariatric surgery facilitates sustained weight loss and remission of comorbidities (e.g., CVD). The effectiveness among Medicaid beneficiaries, a population with a disproportionately high burden of obesity, remains unclear. We sought to determine if patterns of weight change following bariatric surgery differed in patients with Medicaid compared to commercial insurance. Data were obtained from the Longitudinal Assessment of Bariatric Surgery, an observational cohort study of adults undergoing bariatric surgery (2006-2009) at one of 6 geographically diverse centers. We used group-based trajectory models (PROC TRAJ, SAS) to identify discrete groups of individuals with similar weight trajectories over 5-years; we considered cubic trajectory models with between 1 and 6 groups. We selected the 6-group model based on Bayesian Information Criteria, visual fit and statistical significance of parameter estimates. We tested demographic predictors against trajectory group membership; Medicaid (n=174) vs. Commercial (n=991) was our primary predictor of interest. Medicaid participants had higher mean weight at baseline compared to the commercially insured (307.9 vs. 291.2 lbs), but lost a similar amount of weight over time (74.8 vs 85.0 lbs). All groups experienced the most weight loss in year 1 (Figure). Group 6 was the heaviest at baseline and began to regain weight after year 1; groups 1-5 continued to lose weight through year 2. Group’s 1 & 2 weight remained stable over 5 years while groups 3-6 began to slowly regain weight. Medicaid beneficiaries were more likely to be in group 4 (OR 3.2, 95% CI: 1.2, 8.6), group 5 (OR 5.7, 95% CI: 2.0, 16.1) and group 6 (OR 7.9, 95% CI: 2.5, 25.1) compared to group 1. Medicaid beneficiaries experience substantial long term weight loss. However, they had higher baseline weight and tended to be in groups with less long-term weight loss compared to the commercially insured. Focusing on tailored interventions to specific patient groups could help maintain weight loss.


Author(s):  
Manish Khaitan ◽  
Riddhish Gadani ◽  
Koshish Nandan Pokharel

<b><i>Objectives:</i></b> The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. <b><i>Methods:</i></b> Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s <i>t</i> test and ANOVA and McNemar’s test were applied. <b><i>Results:</i></b> Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (<i>n</i> = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (<i>p</i> = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. <b><i>Conclusion:</i></b> Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.


Sign in / Sign up

Export Citation Format

Share Document