scholarly journals Limb length in bariatric surgery of Roux-en-Y gastric bypass (RYGB): An integrative review

2021 ◽  
Vol 46 (2) ◽  
pp. 52-59
Author(s):  
Bruno Landal Cavassin ◽  
Carolina Cabral Brandalizze
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Literature Review ◽  
Limb Length ◽  
Nutritional Deficiencies ◽  
Current Evidence ◽  
Nutritional Complications ◽  
Severe Type

Introduction:  Roux-en-Y gastric bypass is considered the gold standard surgical technique for obesity. The variation in limb length may be related to metabolic improvement and nutritional deficiencies. However, the ideal measurement still a controversial subject in the literature. This study aims to perform an integrative literature review and associate the optimal limb length, considering the maximum weight loss with the minimum nutritional complications. Methods: Integrative literature review conducted using electronic searches (1992 - 2020) in databases MEDLINE/Pubmed and BVS (Biblioteca Virtual da Saúde)/LILACS, through the terms "(bariatric surgery) AND (limb length)". A total of 340 articles were found, 26 articles were included in this review. Results: Current evidence supports using shorter limb lengths in patients with BMI < 50 kg/m2, and longer limbs in patients with severe type 2 diabetes mellitus and/or dyslipidemia or superobese patients (BMI >= 50 kg/m2), considering the benefits in comorbidities resolution. A shorter common limb increases the incidence of nutritional disorders. There is a wide variation in jejunoileal length among patients. Conclusion: Measuring the intraoperative jejunoileal length and individualizing the surgery may bring benefits in weight loss, comorbidities resolution, and reduce the incidence of nutritional disorders. However, more randomized controlled trials are needed on this topic.

scholarly journals Impact of Excessive Weight Loss on Cardiovascular Risk After Two Years of Bariatric Surgery

2021 ◽  
Author(s):  
FLAVIANA FREITAS PEDRON ◽  
Glauco da Costa Alvarez ◽  
Luciana Dapieve Patias ◽  
Ana Cristina de Assunção Machado ◽  
Lidiany Oliveira de Lima ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Cardiovascular Risk ◽  
Medical Records ◽  
Positive Impact ◽  
Excessive Weight ◽  
High Incidence ◽  
Group 1

Abstract Overweightness is related to a high incidence of dyslipidemia, being considered a risk factor for cardiovascular diseases.Objective: Analysis of the effect of weight loss in reducing type 2 diabetes mellitus and cardiovascular risk 2 years after Roux-en-Y gastric bypass.Methods: A retrospective study with patients who underwent Roux-en-Y gastric bypass involving accessing the database of an Obesity Surgery Clinic from March 2018 to March 2019. Male and female patients, aged 18 and over, who underwent bariatric surgery from March 2014 to March 2016 were analyzed. The following data were obtained from the medical records of patients: body weight, height, age, sex, glucose and glycated hemoglobin (HbA1C) after 24 months of surgery.Results: In total, 351 patients were studied, 80.9% of whom were female. There was a reduction in weight and in the concentrations of all biochemical parameters, except HDLc, along with a decrease in the frequency of dyslipidemia and cardiovascular risk 24 months after surgery. When comparing variations between 6 and 12 months, only group 1 reduced Hb1Ac and decreased CVR. There was a significant reduction in the level of glucose in group 1 (p = 0.036) at T4 (18 months) and T5 (24 months).Conclusion: The positive impact determined by bariatric surgery on weight loss was shown to be effective in improving the dyslipidemic profile, reducing morbidities associated with obesity and, consequently, reducing CVR after 24 months.

scholarly journals Proceedings from the 2018 Association for Chemoreception Annual Meeting Symposium: Bariatric Surgery and Its Effects on Taste and Food Selection

2018 ◽  
Vol 44 (3) ◽  
pp. 155-163 ◽  
Author(s):  
Alan C Spector ◽  
Natasha Kapoor ◽  
Ruth K Price ◽  
M Yanina Pepino ◽  
M Barbara E Livingstone ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Annual Meeting ◽  
Food Selection ◽  
Food Preferences ◽  
Empirical Support ◽  
Clinical Findings

Abstract This article provides a summary of the topics discussed at the symposium titled “Bariatric Surgery and Its Effects on Taste and Food Selection,” which was held at the Fortieth Annual Meeting of the Association for Chemoreception Sciences. Bariatric surgery such as Roux-en-Y gastric bypass (RYGB) is currently one of the most effective treatments available for weight loss and Type 2 diabetes. For this reason, it is of great interest to clinicians as well as to basic scientists studying the controls of feeding and energy balance. Despite the commonly held view by clinicians that RYGB patients change their food preferences away from fats and sugars in favor of less energy dense alternatives such as vegetables, the empirical support for this claim is equivocal. It is currently thought that the taste and palatability of fats and sugars are affected by the surgery. Some key preclinical and clinical findings addressing these issues were evaluated in this symposium.

scholarly journals CRITICAL ANALYSIS OF SURGICAL TREATMENT TECHNIQUES OF MORBID OBESITY

2019 ◽  
Vol 32 (3) ◽  
Author(s):  
Bruno ZILBERSTEIN ◽  
Marco Aurélio SANTO ◽  
Marnay Helbo CARVALHO
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Biliopancreatic Diversion ◽  
Morbidity And Mortality ◽  
Good Resolution ◽  
Obstructive Sleep

ABSTRACT Introduction: Obesity is a disease of high prevalence in Brazil and in the world, and bariatric surgery, with its different techniques, is an alternative treatment. Objective: To compare techniques: adjustable gastric band (AGB), sleeve gastrectomy), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) analyzing leaks, bleeding, death, weight loss, resolution of type 2 diabetes, systemic arterial hypertension, dyslipidemia and obstructive sleep apnea. Methods: Were selected studies in the PubMed database from 2003 to 2014 using the descriptors: obesity surgery; bariatric surgery; biliopancreatic diversion; sleeve gastrectomy; Roux-en-Y gastric bypass and adjustable gastric banding. Two hundred and forty-four articles were found with the search strategy of which there were selected 116 studies through the inclusion criteria. Results: Excess weight loss (EWL) after five years in AGB was 48.35%; 52.7% in SG; 71.04% in RYGB and 77.90% in BPD. The postoperative mortality was 0.05% in the AGB; 0.16% on SG; 0.60% in RYGB and 2.52% in BPD. The occurrence of leak was 0.68% for GBA; 1.93% for SG; 2.18% for RYGB and 5.23% for BPD. The incidence of bleeding was 0.44% in AGB; 1.29% in SG; 0.81% in RYGB and 2.09% in BPD. The rate of DM2 resolved was 46.80% in AGB, 79.38% in SG, 79.86% in RYGB and 90.78% in BPD. The rate of dyslipidemia, apnea and hypertension resolved showed no statistical differences between the techniques. Conclusion: The AGB has the lowest morbidity and mortality and it is the worst in EWL and resolution of type 2 diabetes. The SG has low morbidity and mortality, good resolution of comorbidities and EWL lower than in RYGB and BPD. The RYGB has higher morbidity and mortality than AGB, good resolution of comorbidities and EWL similar to BPD. The BPD is the worst in mortality and bleeding and better in EWL and resolution of comorbidities.

scholarly journals Food preferences and underlying mechanisms after bariatric surgery

2015 ◽  
Vol 74 (4) ◽  
pp. 419-425 ◽  
Author(s):  
Preeshila Behary ◽  
Alexander D. Miras
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Eating Behaviour ◽  
Food Preferences ◽  
Gut Hormones ◽  
High Energy ◽  
Sweet Taste ◽  
Current Evidence ◽  
Fatty Food

Bariatric surgery leads to significant long-term weight loss, particularly Roux-en-Y gastric bypass (RYGB). The mechanisms underlying weight loss have not been fully uncovered. The aim of this review is to explore the changes in food preferences, as a novel mechanism contributing to weight loss, and also focus on the underlying processes modulating eating behaviour after bariatric surgery. Patients after gastric bypass are less hungry and prefer healthier food options. They develop an increased acuity to sweet taste, which is perceived as more intense. The appeal of sweet fatty food decreases, with functional MRI studies showing a corresponding reduction in activation of the brain reward centres to high-energy food cues. Patients experiencing post-ingestive symptoms with sweet and fatty food develop conditioned aversive behaviours towards the triggers. Gut hormones are elevated in RYGB and have the potential to influence the taste system and food hedonics. Current evidence supports a beneficial switch in food preferences after RYGB. Changes within the sensory and reward domain of taste and the development of post-ingestive symptoms appear to be implicated. Gut hormones may be the mediators of these alterations and therefore exploiting this property might prove beneficial for designing future obesity treatment.

scholarly journals Effects of Laparoscopic Roux-en-Y Gastric Bypass on Anthropometric Characteristics, Hypertension, Type 2 Diabetes Mellitus and Metabolic Syndrome: An Iranian Experience

2014 ◽  
Vol 3 (3) ◽  
pp. 167-75
Author(s):  
Morteza Ghoghaei ◽  
Elias Khajeh ◽  
Foad Taghdiri ◽  
Mohammad Mahdi Zamani ◽  
Soudeh Taghdiri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Morbidly Obese ◽  
Obese Patients

 Background: Surgically induced weight loss is a treatment option for the management of obesity and the related common disorders. This study evaluated the beneficial effects of bariatric surgery on metabolic profile and the prevalence of metabolic syndrome (MetS) among Iranian patients.Materials and Methods: A prospective observational study was performed on 26 morbidly obese patients scheduled for bariatric surgery, using laparoscopic Roux-en-Y gastric bypass (LRYGB). The parameters of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemia, MetS prevalence, and anthropometric measurements of Iranian patients, were recorded, at the preoperative visit and in follow-ups. The follow-up was performed for a median of 12 months, and the change in MetS prevalence and its componnts were assesed.Results: LRYGB induced a mean weight loss of 69.0±21.2%, after 12 months. Preoperative MetS was diagnosed in 21 patients (84%) and decreased to 6 patients (24%) after LRYGB (P=0.001). Likewise, the prevalence of hypertension was significantly decreased from 76% (pre-LRYGB values) to 20% (post-LRYGB values) (P=0.001). The prevalence of T2DM was also decreased from 20% to 8% (P=0.5).Conclusion: According to our results, RYGB produced a rapid and significant weight loss and improvement in hypertension and MetS within one year but there was a controversy about the improvement of T2DM, in Iranian morbidly obese patients.

Interventions for Weight Regain after Bariatric Surgery

2021 ◽  
Author(s):  
Rodrigo Muñoz ◽  
Pedro Soto
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Current Evidence ◽  
Revisional Procedure ◽  
Insufficient Weight Loss ◽  
Associated Diseases ◽  
Number Of Patients ◽  
Increased Risk ◽  
Nutritional Complications

AbstractBariatric surgery is the most effective available treatment for obesity, inducing a significant and durable weight loss, and improving several obesity-associated diseases. However, as the number of bariatric surgeries performed increases, so does the prevalence of patients who experience either insufficient weight loss or weight regain, accompanied by relapse or the emergence of new obesity-related diseases. Endoscopic and surgical bariatric revisional procedures are used to promote weight loss and improve metabolic function to address these problems. After a psychological, nutritional, medical, and anatomical evaluation of the gastrointestinal anatomy has been completed, patient candidacy to a revisional procedure must be defined. In those patients with insufficient weight loss or weight regain associated with relapse, the emergence of new obesity-related diseases, or quality-of-life deterioration, a revisional procedure must be selected. Although current evidence comes mainly from observational and retrospective studies, with a limited number of patients and short follow-up times, the available data indicate that revisional procedures are useful to induce a significant weight loss and/or promote remission of obesity-associated diseases, albeit an increased risk of surgical and/or nutritional complications. Thus, careful selection of patients is needed to minimize risk and maximize the benefit of these procedures.

scholarly journals Long-Term Weight Loss Results, Remission of Comorbidities and Nutritional Deficiencies of Sleeve Gastrectomy (SG), Roux-En-Y Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) on Type 2 Diabetic (T2D) Patients

2020 ◽  
Vol 17 (20) ◽  
pp. 7644
Author(s):  
Maria-Jose Castro ◽  
Jose-Maria Jimenez ◽  
Miguel-Angel Carbajo ◽  
Maria Lopez ◽  
Maria-Jose Cao ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
The Other ◽  
Nutritional Deficiencies ◽  
Remission Of Comorbidities ◽  
Type 2 Diabetic

This study aimed to compare the long-term weight loss results, remission of comorbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and One-Anastomosis gastric bypass (OAGB) on type 2 diabetic (T2D) patients. Patients and Methods: A retrospective analysis of all the morbidly obese and diabetic patients undergoing SG, RYGB, and OAGB as primary bariatric procedures between February 2010 and June 2015 was performed. Anthropometric parameters, remission of comorbidities, nutritional deficiencies and supplementation requirements at 1, 2 and 5 years’ follow-up were monitored. Patients lost to follow-up 5 years after surgery were excluded from the analysis. Results: 358 patients were included. The follow-up rate was 84.8%. Finally, 83 SG, 152 RYGB, and 123 OAGB patients were included in the analysis. OAGB obtained significantly greater weight loss and remission of dyslipidemia than the other techniques. There was a trend towards greater T2D and hypertension remission rate after OAGB, while fasting glucose and glycated hemoglobin levels were significantly lower after OAGB. There were no significant differences in hemoglobin or protein levels between groups. SG obtained lower iron deficiencies than the other techniques, while there were no significant differences in other nutritional deficiencies between groups. Conclusion: OAGB obtained greater weight loss and remission of dyslipidemia than RYGB or SG. Excluding lower iron deficiency rates after SG, there were no significant differences in the development of nutritional deficiencies between groups.

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

2011 ◽  
Vol 301 (1) ◽  
pp. R15-R27 ◽  
Author(s):  
William R. Scott ◽  
Rachel L. Batterham
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Cell Function ◽  
Lifestyle Modifications ◽  
Gastric Restriction

Obesity increases the likelihood of diseases like type 2 diabetes (T2D), heart disease, and cancer, and is one of the most serious public health problems of this century. In contrast to ineffectual prevention strategies, lifestyle modifications, and pharmacological therapies, bariatric surgery is a very effective treatment for morbid obesity and also markedly improves associated comorbidities like T2D. However, weight loss and resolution of T2D after bariatric surgery is heterogeneous and specific to type of bariatric procedure performed. Conventional mechanisms like intestinal malabsorption and gastric restriction do not fully explain this, and potent changes in appetite and the enteroinsular axis, as a result of anatomical reorganization and altered hormonal, neuronal, and nutrient signaling, are the portended cause. Uniquely these signaling changes appear to override vigorous homeostatic defenses of stable body weight and compelling self-gratifying motivations to eat and to reverse defects in beta-cell function and insulin sensitivity. Here we review mechanisms of weight loss and T2D resolution after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy bariatric surgery, two markedly different procedures with robust clinical outcomes.

Sign in / Sign up

Export Citation Format

Share Document