Response to Starvation before and after a Jejuno-Ileal Bypass Operation for Morbid Obesity

1979 ◽  
Vol 24 (3) ◽  
pp. 206-210 ◽  
Author(s):  
G. A. A. Al Shamma ◽  
G. S. Fell ◽  
S. N. Joffe
Keyword(s):  
Morbid Obesity ◽  
Metabolic Response ◽  
Ketone Bodies ◽  
The Body ◽  
Metabolic Adaptation ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Bypass Operation ◽  
Before And After ◽  
Ileal Bypass

A greater metabolic response developed during a seven day starvation in two morbidly obese patients three months after a 90 per cent jejuno-ileal bypass operation when compared with a similar fast before operation. There was a greater degree of ketosis, a decreased urinary urea excretion and an earlier utilization of ketone bodies. These changes suggest a metabolic adaptation of the body to the semistarvation state caused by the operation with a more rapid utilization of adipose tissue as a fuel and a sparing of lean body mass.

scholarly journals Robotic Roux-en-Y gastric bypass: operative results in 100 patients

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 9-12 ◽  
Author(s):  
Carlos Eduardo DOMENE ◽  
Paula VOLPE ◽  
Frederico A. HEITOR
Keyword(s):  
Morbid Obesity ◽  
Gastric Bypass ◽  
Gastric Pouch ◽  
The Body ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Super Obese ◽  
Robotic Gastric Bypass ◽  
Operative Complications ◽  
Biliopancreatic Limb

BACKGROUND: Laparoscopic gastric bypass is gold-standard for morbid obesity treatment. AIM: To describe the results of robotic gastric bypass for morbid obesity patients. METHOD: Were operated on 100 morbidly obese patients through totally robotic gastric bypass between 2013 and 2014. They were 83% female. The age ranged from 20 to 65 years old (medium 48,5 years); the body mass index varied between 38-67 (medium 42,3 kg/cm2). The procedure was designed with 3 cm long gastric pouch, 1 m biliopancreatic limb, 1,2 m alimentary limb, manual or stapled anastomosis. There were four super-super-obese patients and four revisional surgeries. RESULTS: Docking time varied from 1 to 20 min (medium 4 min). Console time varied from 40-185 min (medium 105 min). There were no intra operative complications or mortality. There were two lower limb deep venous thrombosis. There was no readmission in the first 30 days. CONCLUSION: Totally robotic gastric bypass is safe and reproduceable, with excellent results even during the initial experience with regular surgeries, revisional surgeries or in super-obese patients. Adequate training may shortens or obviates the learning curve.

scholarly journals Functional lung rejuvenation in obese patients after bariatric surgery

2016 ◽  
Vol 62 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Saulo Maia Davila Melo ◽  
Pedro Alves Argentino ◽  
Murilo Matos de Santana Oliveira ◽  
Gabriela Nabuco Chaves Melo ◽  
Gildo Lima Souza Neto
Keyword(s):  
Bariatric Surgery ◽  
The Body ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obese People ◽  
Prospective Longitudinal Study ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Prospective Longitudinal

Summary Objective: To determine the lung age (LA) in obese people before and after bariatric surgery, compare the LA with the chronological age (CA) before and after the peration, and verify whether there was a functional pulmonary rejuvenation after it. Methods: A prospective longitudinal study including 43 morbidly obese patients who underwent bariatric surgery. The patients underwent clinical and spirometric evaluation in two stages, before and after the surgery. In both stages, LA, CA and spirometric variables were measured. Results: A significant improvement in the spirometric variables (FVC; FEV1; and FEV1/FVC ratio) was found after the operation (p≤ 0.0001). Comparing the LA before (50.93±13.36 years) and after the surgery (39.02±12.95 years), there was an important reduction of 11.90±9.12 years (95CI:9.10-14.71; p≤0.0001) in LA after surgery. The difference between LA and CA before surgery was 12.20± 11.71 years (95CI:8.60-15.81) with significant difference (p≤0.0001), and the difference between LA and CA after surgery was -1.95±11.83 years (95CI: -5.59-1.69) with no significant difference (p≤0.28). Regarding LA, we observed a pulmonary aging of 12.20±11.71 years before the surgery and a pulmonary rejuvenation of 11.90±9.12 years after it. Conclusion: Morbid obesity is responsible for early damage and functional accelerated pulmonary aging. After the correction of the body weight by surgery, there is a functional pulmonary rejuvenation demonstrated by the normalization of LA in relation to CA.

scholarly journals Oxidative Modification of Biomolecules in the Nonstimulated and Stimulated Saliva of Patients with Morbid Obesity Treated with Bariatric Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Katarzyna Fejfer ◽  
Piotr Buczko ◽  
Marek Niczyporuk ◽  
Jerzy R. Ładny ◽  
Hady R. Hady ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Oxidative Damage ◽  
Progressive Failure ◽  
Protein Carbonyl ◽  
Oxidative Modification ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Whole Saliva ◽  
Before And After

Morbid obesity leads to progressive failure of many human organs and systems; however, the role of oxidative damage to salivary composition is still unknown in the obese patients. In this study, we assessed the effect of bariatric surgery on oxidative damage in nonstimulated (NS) and stimulated (S) whole saliva. The study included 47 subjects with morbid obesity as well as 47 age- and gender-matched healthy volunteers. Oxidative modifications to lipids (4-hydroxynonenal (4-HNE) and 8-isoprostanes (8-isoP)), proteins (advanced oxidation protein products (AOPP) and protein carbonyl groups (PC)), and DNA (8-hydroxy-D-guanosine (8-OHdG)) were analyzed in morbidly obese patients before and after bariatric surgery as well as in the healthy controls. The concentrations of 8-isoP, AOPP, PC, and 8-OHdG were significantly higher in both NS and S of patients with morbid obesity than in the control patients and compared to the results obtained 6 months after bariatric surgery. The levels of oxidative damage markers were also higher in S versus NS of morbidly obese patients. In summary, morbid obesity is associated with oxidative damage to salivary proteins, lipids, and DNA, while bariatric treatment generally lowers the levels of salivary oxidative damage.

Hand-assisted laparoscopic nephrectomy in morbidly obese patients

2020 ◽  
Vol 99 (6) ◽  
pp. 271-276
Keyword(s):  
Body Weight ◽  
Surgical Technique ◽  
Blood Loss ◽  
Hospital Stay ◽  
Kidney Cancer ◽  
The Body ◽  
Laparoscopic Nephrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbid Obese

Introduction: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. Methods: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were analyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. Results: The patient age was 38−67 years; the cohort included 2 females and 5 males, the body weight was 117−155 kg and the BMI was 40.3−501 kg/m2. Surgery time was 73−98 minutes, blood loss was 20−450 ml, and hospital stay was 5−7 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48–110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

scholarly journals Towards Precision Health in Weight Reduction: Thematic Content Analysis of an Open-Ended Survey on Reasons Why Morbidly Obese Patients Want to Lose Weight.

2020 ◽  
Author(s):  
Mazapuspavina Md-Ya ◽  
Ilham Ameera Ismail ◽  
Khasnur Abd Malek ◽  
Khalid Yusoff ◽  
Awang Bulgiba
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Content Analysis ◽  
Weight Reduction ◽  
Extensive Study ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
The Impact

Abstract Background: Addressing individuals’ motivation to lose weight among patients with morbid obesity is an essential entity in weight reduction. Failures to shift motivation into weight loss actions are common. These could be contributed by the inadequacy to identify and subsequently address the key reasons, that are of particular concern to the patient' individual needs. We aimed to understand the motivations better and identify the reasons why morbidly obese patients attending hospital-based weight management programmes (WMP) wanted to lose weight. Methods: The study used a qualitative approach to analyze part of a quantitative questionnaire of a more extensive study to understand factors influencing weight loss among morbidly obese patients. We used thematic content analysis to analyze responses from a self-administered open-ended question "What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics in two tertiary hospitals responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2. Four themes emerged for the reasons why morbidly obese patients wanted to lose weight. Health was the most commonly inferred theme (84%). Patients were concerned about the impact obesity had on their health. Overcoming obesity was seen as a reward not just for physical health, but also for their psychological wellbeing. Patients regard being functional to care for themselves, their family members, as well as their religious and career needs as the next most crucial theme (25.8%). Patients raised the theme appearance (12.9%), especially with regards to wanting to look and feel beautiful. The last theme was perceived stigmatization for being morbidly obese as they were mocked and laughed at for their appearance (3.1%).Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Concerns about the impact of morbid obesity on health, physical, social and obligatory function, appearance and perceived stigma warrant detailed exploration by the managing health professionals. Identifying and addressing these unique personal motivations in a focused approach is vital at the beginning and throughout a weight reduction program in this unique group.

scholarly journals Airway Tube Exchanger Techniques in Morbidly Obese Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Danai Udomtecha
Keyword(s):  
Morbid Obesity ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Surgical Procedures ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Tube Exchange ◽  
Airway Tube

Morbidly obese patients may present a challenge during airway management. When airway tube exchange is required, it can even be more challenging than the primary intubation. With the increasing prevalence of morbid obesity over the years, there will be increasing numbers of these patients presenting for surgical procedures, including ones that require endotracheal tube exchanges. It is therefore important for anesthesiologists to be familiar with options and limitations of the airway tube exchanger techniques.

scholarly journals Bariatric Surgery Normalizes Protein Glycoxidation and Nitrosative Stress in Morbidly Obese Patients

Antioxidants ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 1087
Author(s):  
Barbara Choromańska ◽  
Piotr Myśliwiec ◽  
Magdalena Łuba ◽  
Piotr Wojskowicz ◽  
Hanna Myśliwiec ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Oxidative Damage ◽  
Nitrosative Stress ◽  
High Specificity ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Plasma Tryptophan ◽  
Nitrative Stress ◽  
Specificity And Sensitivity

The results of recent studies indicate the key role of nitrosative stress and protein oxidative damage in the development of morbid obesity. Nevertheless, the effect of bariatric surgery on protein oxidation/glycation and nitrosative/nitrative stress is not yet known. This is the first study evaluating protein glycoxidation and protein nitrosative damage in morbidly obese patients before and after (one, three, six and twelve months) laparoscopic sleeve gastrectomy. The study included 50 women with morbid obesity as well as 50 age- and gender-matched healthy controls. We demonstrated significant increases in serum myeloperoxidase, plasma glycooxidative products (dityrosine, kynurenine, N-formyl-kynurenine, amyloid, Amadori products, glycophore), protein oxidative damage (ischemia modified albumin) and nitrosative/nitrative stress (nitric oxide, peroxy-nitrite, S-nitrosothiols and nitro-tyrosine) in morbidly obese subjects as compared to lean controls, whereas plasma tryptophan and total thiols were statistically decreased. Bariatric surgery generally reduces the abnormalities in the glycoxidation of proteins and nitrosative/nitrative stress. Noteworthily, in the patients with metabolic syndrome (MS+), we showed no differences in most redox biomarkers, as compared to morbidly obese patients without MS (MS−). However, two markers: were able to differentiate MS+ and MS− with high specificity and sensitivity: peroxy-nitrite (>70%) and S-nitrosothiols (>60%). Further studies are required to confirm the diagnostic usefulness of such biomarkers.

The Rise of Obesity among Total Knee Arthroplasty Patients

2020 ◽  
Author(s):  
Nequesha S. Mohamed ◽  
Wayne A. Wilkie ◽  
Ethan A. Remily ◽  
Iciar M. Dávila Castrodad ◽  
Mirlande Jean-Pierre ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
The United States ◽  
National Database ◽  
Categorical Variables ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Total Knee ◽  
Nonobese Patients

AbstractIn the United States, one-third of adults are considered obese, and demand for total knee arthroplasty (TKA) is expected to rise in these patients. Surgeons are reluctant to operate on obese patients, but it is important to understand how obesity has affected TKA utilization. This study utilizes a national database to evaluate incidence, demographics, outcomes, charges, and cost in nonobese, overweight, nonmorbidly obese, and morbidly obese TKA patients. We queried the National Inpatient Sample from 2009 to 2016 for primary TKA patients identifying 4,053,037 nonobese patients, 40,077 overweight patients, 809,649 nonmorbidly obese patients, and 428,647 morbidly obese patients. Chi-square was used to analyze categorical variables, and one-way analysis of variance was used to analyze continuous variables. Nonmorbidly obese and morbidly obese patients represented 23.2% of all TKAs. TKA utilization increased 4.1% for nonobese patients, 121.6% for overweight patients, 73.6% for nonmorbidly obese patients, and 83.9% for morbidly obese patients. Morbidly obese patients were younger (p < 0.001), female (p < 0.001), Black (p < 0.001), poor (p < 0.001), and utilized private insurance (p < 0.001). They also had the longest length of stay (p < 0.001) and the highest mortality rate (p < 0.001). More morbidly obese patients were discharged to other facilities (p < 0.001), and they had the highest rate of complications (p < 0.001). Patients with morbid obesity had the highest charges (p < 0.001), but overweight patients had the highest costs (p < 0.001). The results of this study demonstrate the rise in obese and morbidly obese patients seeking TKAs, which may be reflection of the obesity epidemic in America. Although TKA utilization has increased for morbidly obese patients, this body mass index (BMI) category also has the highest rates of charges and complications, suggesting morbid obesity to be a modifiable risk factor leading to worse surgical and economic outcomes. Obese patients undergoing TKA may benefit from preoperative optimization of their weight, in an effort to reduce the risk of adverse outcomes.

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