scholarly journals Effect of Conventional Medical Therapy or Laparoscopic Sleeve Gastrectomy on Urinary Albumin in Japanese Subjects with Severe Obesity: An Observational Study

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Yasuhiro Watanabe ◽  
Takashi Yamaguchi ◽  
Shuhei Yamaoka ◽  
Kazuki Abe ◽  
Hiroki Onda ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Medical Therapy ◽  
Severe Obesity ◽  
Therapy Group ◽  
Urinary Albumin ◽  
Conventional Medical Therapy ◽  
Japanese Subjects

<b><i>Introduction:</i></b> In patients with severe obesity, albuminuria can be improved by both conventional medical therapy and bariatric surgery. The purpose of this study was to compare the impact of weight loss achieved through conventional medical therapy or laparoscopic sleeve gastrectomy (LSG) on albuminuria in Japanese subjects with severe obesity and identify the factors involved. <b><i>Methods:</i></b> We retrospectively evaluated the clinical characteristics including the urinary albumin/creatinine ratio (UACR) of 340 consecutive subjects with a body mass index ≥35 who received LSG (<i>n</i> = 242) or medical therapy (<i>n</i> = 98) between 2010 and 2018 and were followed for at least 12 months. <b><i>Results:</i></b> The baseline of the UACR was not different between the 2 groups. At the 12-month follow-up, total weight loss (TWL) and decreases in glycosylated hemoglobin (HbA1c) and log<sub>e</sub> UACR were greater in the LSG group than in the medical therapy group (body weight; −35.7 kg vs. −8.0 kg, <i>p</i> &#x3c; 0.001, HbA1c; −1.4% vs. −0.7%, <i>p</i> &#x3c; 0.001, log<sub>e</sub> UACR; −0.3 vs. 0.9, <i>p</i> &#x3c; 0.001). The rate of complete remission of diabetes was significantly higher in the LSG group than in the medical therapy group. At 12 and 36 months (<i>n</i> = 111 in the medical therapy group, <i>n</i> = 56 in the LSG group at 36 months), log<sub>e</sub> UACR increased in the medical therapy group, while it remained unchanged or decreased in the LSG group. In subjects with microalbuminuria and macroalbuminuria, changes in the log<sub>e</sub> UACR correlated with percent total body weight loss (%TWL) in both groups at 12 months. Percent TWL contributed independently to the change in the log<sub>e</sub> UACR, irrespective of whether LSG was performed. In receiver-operating characteristic analysis, a weight loss of 7.8% predicted a decrease in the UACR (∆UACR &#x3c;0 at 12 months). <b><i>Conclusion:</i></b> Our analysis suggests that albuminuria may increase over time if only medical therapy is continued. To improve albuminuria, weight loss may be more important than whether LSG is performed.

Initial experience with endoscopic sleeve gastroplasty in Poland

2018 ◽  
Vol 90 (2) ◽  
pp. 16-22 ◽  
Author(s):  
Aleksander Sowier ◽  
Przemysław Pyda ◽  
Anna-Maria Borucka ◽  
Sebastian Sowier ◽  
Jacek Białecki ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Sleeve Resection ◽  
Less Invasive ◽  
Endoscopic Sleeve Gastroplasty ◽  
Sleeve Gastroplasty

Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

scholarly journals Technical Details of Laparoscopic Sleeve Gastrectomy Leading to Lowered Leak Rate: Discussion of 1070 Consecutive Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
David L. Warner ◽  
Kent C. Sasse
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Weight Loss ◽  
Patient Characteristics ◽  
Leak Rate ◽  
Surgeon Experience ◽  
Technical Modifications ◽  
Technical Details

Introduction. Laparoscopic sleeve gastrectomy is a widely utilized and effective surgical procedure for dramatic weight loss in obese patients. Leak at the sleeve staple line is the most serious complication of this procedure, occurring in 1–3% of cases. Techniques to minimize the risk of sleeve gastrectomy leaks have been published although no universally agreed upon set of techniques exists. This report describes a single-surgeon experience with an approach to sleeve leak prevention resulting in a progressive decrease in leak rate over 5 years. Methods. 1070 consecutive sleeve gastrectomy cases between 2012 and 2016 were reviewed retrospectively. Patient characteristics, sleeve leaks, and percent body weight loss at 6 months were reported for each year. Conceptual and technical changes aimed towards leak reduction are presented. Results. With the implementation of the described techniques of the sleeve gastrectomy, the rate of sleeve leaks fell from 4% in 2012 to 0% in 2015 and 2016 without a significant change in weight loss, as depicted by 6-month change in body weight and percent excess BMI lost. Conclusion. In this single-surgeon experience, sleeve gastrectomy leak rate has fallen to 0% since the implementation of specific technical modifications in the procedure.

scholarly journals A sympathetic gut connection drives the metabolic benefits of Roux-en-Y gastric bypass

Cell Stress ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. 265-269
Author(s):  
Mohammed K. Hankir
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Severe Obesity ◽  
Resting Metabolic Rate ◽  
Splanchnic Nerve ◽  
Negative Energy ◽  
Recent Issue ◽  
White Fat

Surgery is regarded by many as the go-to treatment option for severe obesity; yet how physically altering the gastrointestinal tract produces such striking results on body weight and overall metabolic health is poorly understood. In a recent issue of Cell Reports Ye et al. (2020) compare mouse models of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the two most commonly performed weight loss surgeries in the clinic today, to show that the former reconfiguring procedure selectively increases resting metabolic rate through splanchnic nerve-mediated browning of mesenteric white fat. More significantly, they demonstrate that this effect for RYGB is required for the maintained negative energy balance and improved glycemic control that it confers.

Initial experience with endoscopic sleeve gastroplasty in Poland

2018 ◽  
Vol 90 (4) ◽  
pp. 6-11 ◽  
Author(s):  
Przemysław Pyda ◽  
Aleksander Sowier ◽  
Sebastian Sowier ◽  
Anna-Maria Borucka ◽  
Joanna Kapturzak ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Sleeve Resection ◽  
Less Invasive ◽  
Endoscopic Sleeve Gastroplasty ◽  
Sleeve Gastroplasty

Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

scholarly journals The effect of the distance from the pyloric sphincter and size of the calibration tube on ­postoperative outcomes of the laparoscopic sleeve gastrectomy

2020 ◽  
Vol 101 (5) ◽  
pp. 669-676
Author(s):  
T I Omarov ◽  
N Yu Bayramov ◽  
M R Huseynova ◽  
N A Zeynalov
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Weight Loss ◽  
Tube Diameter ◽  
Pyloric Sphincter ◽  
Women Patients ◽  
Initial Body Weight ◽  
Comparison Criteria

Aim. To study of the effect of the diameter of the calibration tube and the distance from the pyloric sphincter on the outcomes of the laparoscopic sleeve gastrectomy. Methods. The study included 945 (915 women) patients with a body mass index 51.59 kg/m2. The average age of the patients was 53.58.5 years. The patients were divided into 2 groups by the type of laparoscopic surgery: in the first group (n=463), a 36 Fr calibration tube was used, the distance from the pyloric sphincter was 46 cm; in the second group (n=482), a 32 Fr calibration tube was used, the distance from the pyloric sphincter was 23 cm. The main comparison criteria was the percentage of body weight loss in the first 6 and 12 months, and an additional comparison criteria was the of concomitant diseases progress in postoperative and the existence of complications. Results. A comparative analysis showed that the first group in the first 6 months lost 593% of its initial body weight, while in 12 months 714%; in the second group, 733 and 873% of the initial weight, respectively. Concomitant diseases in the first group decreased by 7080% by the 6th month after surgery and by 8596% by the 12th month. In the 2nd group, similar remission with improvement was between 84 and 94% at the 6th month, and remained the same at the 12th month. Conclusion. The results of the study show that in laparoscopic sleeve gastrectomy with a calibration tube diameter 32 Fr and a distance of 23 cm from the pyloric sphincter, compared to a calibration tube diameter 36 Fr or more and a distance of 46 cm from the pyloric sphincter, a body weight loss faster and more effective with earlier remission of concomitant diseases, while the number of complications is comparable.

Thyroid Function Improved after Laparoscopic Sleeve Gastrectomy in Severe Obesity and Related to Inflammatory Changes

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2060-P
Author(s):  
CUILING ZHU ◽  
FANGYUN MEI ◽  
JINGYANG GAO ◽  
XINGCHUN WANG ◽  
LIANG LI ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Thyroid Function ◽  
Severe Obesity ◽  
Inflammatory Changes
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