scholarly journals Bariatric Surgery in Moderately Obese Patients: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Cerci ◽  
M. I. Bellini ◽  
F. Russo ◽  
D. Benavoli ◽  
M. Capperucci ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Obese Patients ◽  
Trocar Site ◽  
A Value ◽  
Obstructive Sleep ◽  
Study Support ◽  
A Prospective Study

Introduction. Moderate obesity (BMI 30–35 kg/m2) affects 25% of the western population. The role of bariatric surgery in this context is currently debated, reserved for patients with comorbidity, as an alternative to conservative medical treatment. We describe our experience in moderately obese patients treated with bariatric surgery.Materials and Methods. Between September 2011 and September 2012, 25 patients with grade I obesity and comorbidities underwent bariatric surgery: preoperative mean BMI 33.2 kg/m2, 10 males, mean age 42 years. In presence of type 2 diabetes mellitus (T2DM) (56%), gastric bypass was performed; in cases with hypertension (64%) and obstructive sleep apnea (OSA) (12%), sleeve gastrectomy was performed. All operations were performed laparoscopically.Results. Mean follow-up was 12.4 months. A postoperative complication occurred: bleeding from the trocar site was resolved with surgery in local anesthesia. Reduction in average BMI was 6 points, with a value of 27.2 kg/m2. Of the 14 patients with T2DM, 12 (86%) discontinued medical therapy because of a normalization of glycemia. Of the 16 patients with arterial hypertension, 14 (87%) showed remission and 2 (13%) improvement. Complete remission was observed in patients with OSAS.Conclusions. The results of our study support the validity of bariatric surgery in patients with BMI 30–35 kg/m2. Our opinion is that, in the future, bariatric surgery could be successful in selected cases of moderately obese patients.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

scholarly journals INFLAMMATORY DISORDERS ASSOCIATED WITH HELICOBACTER PYLORI IN THE ROUX-EN-Y BYPASS GASTRIC POUCH

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 31-34 ◽  
Author(s):  
Luiz Claudio Lopes CHAVES ◽  
Isabela Klautau Leite Chaves BORGES ◽  
Maíra Danielle Gomes de SOUZA ◽  
Ian Passos SILVA ◽  
Lyz Bezerra SILVA ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Helicobacter Pylori ◽  
Gastric Pouch ◽  
Obese Patients ◽  
Inflammatory Lesions ◽  
Low Incidence ◽  
H Pylori ◽  
A Prospective Study ◽  
Grade Iii

ABSTRACT Background: The prevalence of Helicobacter pylori in obese candidates for bariatric surgery and its role in the emergence of inflammatory lesions after surgery has not been well established. Aim: To identify the incidence of inflammatory lesions in the stomach after bariatric surgery and to correlate it with H. pylori infection. Methods: This is a prospective study with 216 patients undergoing Roux-en-Y gastric bypass. These patients underwent histopathological endoscopy to detect H. pylori prior to surgery. Positive cases were treated with antibiotics and a proton inhibitor pump followed by endoscopic follow-up in the 6th and 12th month after surgery. Results: Most patients were female (68.1%), with grade III obesity (92.4%). Preoperative endoscopy revealed gastritis in 96.8%, with H. pylori infection in 40.7% (88/216). A biopsy was carried out in 151 patients, revealing H. pylori in 60/151, related to signs of inflammation in 90% (54/60). In the 6th and 12th month after surgery, the endoscopy and the histopathological exam showed a normal gastric pouch in 84% of patients and the incidence of H. pylori was 11% and 16%, respectively. The presence of inflammation was related to H. pylori infection (p<0,001). Conclusion: H. pylori has a similar prevalence in both obese patients scheduled to undergo bariatric surgery and the general population. There is a low incidence of it in the 6th and 12th months after surgery, probably owing to its eradication when detected prior to surgery. When inflammatory disease is present in the new gastric reservoir it is directly related to H. pylori infection.

Dexamethasone Intravitreal Implant at the Time of Cataract Surgery in Eyes with Diabetic Macular Edema

2016 ◽  
Vol 27 (4) ◽  
pp. 433-437 ◽  
Author(s):  
Giacomo A. Panozzo ◽  
Elena Gusson ◽  
Giorgio Panozzo ◽  
Giulia Dalla Mura
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Foveal Thickness ◽  
Dexamethasone Intravitreal Implant ◽  
Positive Effects ◽  
Intravitreal Implant ◽  
A Prospective Study

Purpose To determine the potential role of intraoperative dexamethasone intravitreal implant (DEX-I) in reducing diabetic macular edema (DME) worsening after phacoemulsification. Methods This was a prospective study on 19 eyes of 19 patients with type 2 diabetes mellitus with DME and cataract. Mean preoperative Early Treatment Diabetic Retinopathy Study visual acuity (VA) was 16.7 letters. Mean foveal thickness (FT) was 451 μm. The DME was naive in 11 eyes and refractory in 8 eyes. All eyes underwent a standard phacoemulsification and intraocular lens implantation; DEX-I was injected at the end of surgery. Follow-up was performed at 1 week and then monthly until DME recurrence (up to 8 months). Results At 1 week, mean VA improved by 15 letters (range 0-29 letters) and mean FT decreased by 147 μm (range 69-236 μm). Improvement consolidated at month 1, with a mean VA improvement of 18 letters (range 3-32 letters) and a mean improvement in FT of 193 μm (range 76-304 μm), remaining stable at month 2 after surgery in all eyes. The DME recurred in 1 eye at month 3, in 14 eyes (73.8%) between months 4 and 5, and after month 6 in 4 eyes (21%). Refractory DMEs demonstrated the same benefit but recurred earlier than naive ones (4 months versus 5.8 months, p<0.01). Conclusions Intraoperative DEX-I prevents DME worsening after phacoemulsification. Its positive effects last for at least 3 months.

scholarly journals Changes in Trimethylamine-N-oxide Levels in Obese Patients following Laparoscopic Roux-en-Y Gastric Bypass or Sleeve Gastrectomy in a Korean Obesity Surgical Treatment Study (KOBESS)

2021 ◽  
Vol 10 (21) ◽  
pp. 5091
Author(s):  
Soo Jin Lee ◽  
Young Suk Park ◽  
Yong-Jin Kim ◽  
Sang-Uk Han ◽  
Geum-Sook Hwang ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Controlled Trial ◽  
Serum Levels ◽  
Obese Patients ◽  
Korean Patients ◽  
Gut Microbe

Trimethylamine N-oxide (TMAO), a gut microbe-dependent metabolite, has been implicated as a novel risk factor for cardiovascular events related to obesity and type 2 diabetes mellitus (T2DM). The aim of the study was to test the hypothesis if TMAO is associated with the reduction of cardiovascular disease in the Korean obese patients who underwent bariatric surgery. From a subgroup of a multicenter, nonrandomized, controlled trial, titled KOBESS, 38 obese patients, 18 with and 20 without T2DM, who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were investigated. Bariatric surgery is indicated for Korean patients with a body mass index (BMI) ≥ 35 kg/m2 or for Korean patients with a BMI ≥ 30 kg/m2 who have comorbidities. Serum levels of TMAO and its precursors, betaine, carnitine, and choline were measured before and six months after bariatric surgery. The levels of TMAO and its precursors did not differ between obese patients with T2DM and non-T2DM at baseline. However, TMAO increased more than twofold in patients with T2DM after RYGB surgery, but not in patients without T2DM. Choline levels were decreased by half in all patients after RYGB. In patients with T2DM who underwent SG, TMAO, betaine, and carnitine levels did not change after the surgery. Furthermore, in obese patients who underwent bariatric surgery, increased TMAO levels were associated with both T2DM and RYGB, while reduced choline levels were associated with RYGB. These associations need to be further elucidated in follow-up studies to gain further insights into the relationship between TMAO levels and bariatric surgery outcomes.

Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes

2017 ◽  
Author(s):  
Michael Choi ◽  
Miguel Burch
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Medical Therapy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obese Female ◽  
Patients With Diabetes ◽  
Study Intervention

This chapter provides a summary of a landmark study in bariatric surgery. In obese patients with uncontrolled type 2 diabetes, does bariatric surgery plus intensive medical therapy achieve improved glycemic control in significantly more patients than medical therapy alone? Starting with that question, this chapter describes the basics of the study, including funding, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, criticisms, and limitations. The chapter also briefly reviews other relevant studies and information, discusses implications and concludes with a relevant clinical case about bariatric surgery for a morbidly obese female patient with a BMI of 37 and type 2 diabetes.

scholarly journals Sleeve gastrectomy with loop bipartition as a novel procedure for management of type 2 diabetes in obese patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R S Ezz ◽  
M M Abouzeid ◽  
M M Helmy ◽  
M M Elhusseini
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
First Year ◽  
Obese Patients ◽  
Single Anastomosis ◽  
Marked Weight

Abstract Background Amidst the current worldwide epidemic of type 2 diabetes mellitus (T2DM), the global diabetes health burden is projected to reach 522 million in 2030, with much of this increase occurring in developing countries. Aim of the work to evaluate the role of laparoscopic sleeve gastrectomy with loop bipartition (single anastomosis sleeve ileal bypass) as a bariatric and metabolic procedure in control of type 2 diabetes in obese patients. Patients and methods This prospective cohort study included 20 obese adult patients with type 2 DM recently diagnosed within last 5 years. Some of them have other associated comorbidities. They were recruited at department of surgery Ain Shams University. The follow up was obtained during the first year post-operative. Results In this study, complete remission of diabetes was achieved in 75% of the patients by the 3rd post-operative month and in 95% by the end of the study. This was beside marked weight reduction and improvement of lipid profile without causing micronutrients deficiencies during the study period. Conclusion SASI bypass can be one of the most efficient metabolic procedures and could be associated with less risks. The procedure should be considered under investigations until enough long term data are available. Thus it is worth to be explored in research aiming for more data.

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