scholarly journals Is the Sleeve Gastrectomy Sufficient or Does it Require Additional Surgical Procedures?

2021 ◽  
Vol 10 (1) ◽  
pp. 9-13
Author(s):  
Sung Il Choi
Keyword(s):  
Sleeve Gastrectomy ◽  
Surgical Procedures

scholarly journals Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity: Comparison of Gastric Bypass, Sleeve Gastrectomy, and Usual Care

2021 ◽  
Author(s):  
Ali Aminian ◽  
Rickesha Wilson ◽  
Alexander Zajichek ◽  
Chao Tu ◽  
Kathy E. Wolski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Surgical Procedures ◽  
Cumulative Incidence ◽  
Cox Regression ◽  
Cleveland Clinic ◽  
Major Adverse Cardiovascular Events ◽  
Cox Regression Analysis

<p><b>Objective:</b> To determine which one of the two most common metabolic surgical procedures is associated with greater reduction in risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2DM) and obesity.</p> <p><b> </b></p> <p><b>Research Design and Methods:</b> A total of 13,490 patients including 1,362 Roux-en-Y gastric bypass (RYGB), 693 sleeve gastrectomy (SG), and 11,435 matched non-surgical patients with T2DM and obesity who received their care at the Cleveland Clinic (1998-2017) were analyzed with follow-up through December 2018. Multivariable Cox regression analysis estimated time to incident extended MACE, defined as first occurrence of coronary artery events, cerebrovascular events, heart failure, nephropathy, atrial fibrillation, and all-cause mortality. </p> <p><b> </b></p> <p><b>Results:</b> The cumulative incidence of the primary endpoint at 5 years was 13.7% [95%CI 11.4-15.9] in the RYGB groups and 24.7% [95%CI 19.0-30.0] in the SG group with an adjusted HR of 0.77 [95%CI 0.60 to 0.98], p=0.04. Of the 6 individual endpoints, RYGB was associated with a significantly lower cumulative incidence of nephropathy at 5 years compared with SG (2.8% vs 8.3%, respectively); HR 0.47 [95%CI 0.28-0.79], p=0.005. Furthermore, RYGB was associated with a greater reduction in body weight, glycated hemoglobin, and use of medications to treat diabetes and cardiovascular diseases. Five years after RYGB, patients required more upper endoscopy (45.8% vs 35.6%, p<0.001) and abdominal surgical procedures (10.8% vs 5.4%, p=0.001) compared with SG. </p> <p><b> </b></p> <p><b>Conclusion:</b> In patients with obesity and T2DM, RYGB may be associated with greater weight loss, better diabetes control, and lower risk of MACE and nephropathy compared with SG.</p>

scholarly journals Management of sleeve gastrectomy leakage: case report

2021 ◽  
Vol 8 (11) ◽  
pp. 3433
Author(s):  
Ana C. Almeida ◽  
Andreia Guimarães ◽  
Maria J. Amaral ◽  
Rita Andrade ◽  
António Bernardes
Keyword(s):  
Sleeve Gastrectomy ◽  
Enteral Nutrition ◽  
Surgical Procedures ◽  
Splenic Abscess ◽  
Oral Feeding ◽  
Water Soluble ◽  
Gastric Fistula ◽  
Subphrenic Abscess ◽  
Esophageal Transit ◽  
Purulent Peritonitis

Treatment of postoperative gastric fistula complicated by local and systemic infection is difficult and controversial, particularly when treating obese patients with multiple prior surgical procedures. A 41-year-old male patient was transferred to our hospital to be admitted in the Intensive Care Unit with respiratory failure and postoperative sepsis, after being submitted to bariatric surgery. He had been through four subsequent surgical procedures: 1- a laparoscopic sleeve gastrectomy; 2- an exploratory laparotomy for unproven suspected subphrenic abscess; 3- a laparotomy with splenectomy and peritoneal drainage for splenic and peri-splenic abscess; 4-celiotomy and lavage for purulent peritonitis. Due to persistent clinical and analytical deterioration, and suspicion of left subphrenic abscess and digestive fistula, we proceeded to: identification and drainage of the abscess, adhesiolysis, identification of fistula orifice at the cardiac incisure (methylene blue and perioperative endoscopy), placement of a Pezzer tube for directed and controlled fistulization, Shirley’s drain in the subphrenic space for continuous lavage, jejunostomy for enteral nutrition. Under clinical and imaging control (esophageal transit, fistulography and computed tomography with water-soluble contrasts) he was started on a water diet 2 months after and the Shirley’s drain was later removed. Patient was discharged two and a half months after the intervention, maintaing the Pezzer tube and under enteral nutrition by jejunostomy. Oral feeding started in the 3rd postoperative month and jejunostomy and Pezzer probes were removed. Patient was asymptomatic at seven-month postoperative outpatient appointment.

scholarly journals A case of Gastric Sleeve Stricture Resistant to Endoscopic Dilatation

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Paritosh Gupta ◽  
Dhruv Nayan Kundra ◽  
Amanpriya Khanna ◽  
Chinmay Arora
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Surgical Procedures ◽  
Common Disease ◽  
Endoscopic Dilatation ◽  
Gastric Sleeve ◽  
Restrictive Procedure ◽  
The World

Obesity is becoming an increasingly common disease across the world. Various restrictive and malabsorbptive surgical procedures have been developed to tackle morbid obesity. These procedures though efficient in causing weight loss and decrease in co – morbidities present with their own unique complications. Sleeve gastrectomy is one of the more recent, mainly restrictive procedure which has been gaining rapid popularity. Stricture of the gastric sleeve pouch is a rare and distressing complication of this procedure. Here we present a case of a 44-year-old woman who underwent Sleeve gastrectomy in Gulf 5 years back. She developed a stricture of the sleeve pouch for which she underwent two endoscopic dilatations which did not provide much relief. She was finally treated with a Roux – en – y gastro-jejunostomy which finally improved her symptoms.

Anaesthesia for obesity

2018 ◽  
Author(s):  
Nick Kennedy ◽  
Mark Abou-Samra
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastric Banding ◽  
Obesity Surgery ◽  
Surgical Procedures ◽  
Intragastric Balloon ◽  
Anaesthetic Management ◽  
Risk Scoring

This chapter discusses the anaesthetic management of obesity surgery (bariatric surgery). It begins with an introduction to obesity surgery, risk scoring, indications for when obesity surgery should be offered, a discussion of common co-morbidities, airway considerations, handling and positioning, pharmacology, and thromboprophylaxis. Surgical procedures covered include intragastric balloon insertion and removal, gastric banding, gastric bypass, and sleeve gastrectomy.

Anaesthesia for obesity

2016 ◽  
Author(s):  
Nick Kennedy ◽  
Mark Abou-Samra
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastric Banding ◽  
Obesity Surgery ◽  
Surgical Procedures ◽  
Intragastric Balloon ◽  
Anaesthetic Management ◽  
Risk Scoring

This chapter discusses the anaesthetic management of obesity surgery (bariatric surgery). It begins with an introduction to obesity surgery, risk scoring, indications for when obesity surgery should be offered, a discussion of common co-morbidities, airway considerations, handling and positioning, pharmacology, and thromboprophylaxis. Surgical procedures covered include intragastric balloon insertion and removal, gastric banding, gastric bypass, and sleeve gastrectomy.

Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials

2013 ◽  
Vol 9 (5) ◽  
pp. 816-829 ◽  
Author(s):  
Stefano Trastulli ◽  
Jacopo Desiderio ◽  
Salvatore Guarino ◽  
Roberto Cirocchi ◽  
Vittorio Scalercio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Surgical Procedures ◽  
Randomized Trials

Bariatric surgery

2021 ◽  
pp. 685-694
Author(s):  
Nicholas Kennedy ◽  
Katherine Reeve
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastric Banding ◽  
Obesity Surgery ◽  
Surgical Procedures ◽  
Intragastric Balloon ◽  
Anaesthetic Management ◽  
Risk Scoring

This chapter discusses the anaesthetic management of obesity surgery (bariatric surgery). It begins with an introduction to obesity surgery; risk scoring; indications for when obesity surgery should be offered. Surgical procedures covered include intragastric balloon insertion and removal; gastric banding; gastric bypass, and sleeve gastrectomy.

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