scholarly journals The Impact of the Pre-operative Neutrophil-lymphocyte Ratio as the Predictive Marker of Post-operative Weight Loss and Improving Diabetes in Sleeve Gastrectomy.

2020 ◽  
Author(s):  
Hideya Kashihara ◽  
Mitsuo Shimada ◽  
Kozo Yoshikawa ◽  
Jun Higashijima ◽  
Takuya Tokunaga ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Hemoglobin A1c ◽  
Excess Weight Loss ◽  
Predictive Marker ◽  
Obese Patients ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Remission Of Diabetes ◽  
The Impact

Abstract Background: The aim of this study was to investigate the impact of the neutrophil-lymphocyte ratio (NLR) in sleeve gastrectomy (SG).Methods: 15 obese patients were enrolled in this study. They consisted of 5 males and 10 females: mean body weight (BW) 127.5kg; mean body mass index (BMI) 46.7kg/m2. 10 of these were diabetics who underwent a SG. The impact of the pre-operative NLR on the percentage of excess weight loss (%EWL) and remission of diabetes 1 year post-operative were examined.Results: The BMI, %EWL and %TWL at 1 year post-operative were 35.1 kg/m2, 46.3% and 26.2%, respectively. Improvements were also evident in the diabetes at 1 year post-operative: complete remission (CR) (No medication and hemoglobin A1c (HbA1c) HbA1c<6.0%) 40%, PR (HbA1c<6.5) 20%; and (decrease of anti diabetic drug and HbA1c<7.0%) 40%. Comparing pre-operative NLR in %EWL<50% and >50% in one (1) year post-operative, <50% was 2.64 and >50% was 2.03 (p<0.05). The NLR in CR and partial remission (PR) was significantly lower than that in improved (Improve) (2.22 vs 3.27, p<0.05).Conclusions: The pre-operative NLR may be a predictive marker of weight loss and improving diabetes after SG.

Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Achieve Comparable Weight Loss at 1 Year

2012 ◽  
Vol 78 (12) ◽  
pp. 1325-1328 ◽  
Author(s):  
Arezou Yaghoubian ◽  
Amy Tolan ◽  
Bruce E. Stabile ◽  
Amy H. Kaji ◽  
Gary Belzberg ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Weight Loss Program ◽  
Excess Weight ◽  
Morbidly Obese ◽  
Preoperative Weight Loss ◽  
Obese Patients ◽  
Laparoscopic Rygb ◽  
Preoperative Weight

Laparoscopic sleeve gastrectomy has gained popularity as a weight loss surgical option for morbidly obese patients. Although initial studies have shown weight loss and comorbidity resolution comparable to those after laparoscopic Roux-en-Y gastric bypass (RYGB), many of these studies are limited by the small patient size. Thus, the purpose of this study was to compare the outcomes of laparoscopic sleeve gastrectomy and laparoscopic RYGB. A retrospective chart review of all morbidly obese patients who underwent laparoscopic RYGB or sleeve gastrectomy between 2007 and 2009 at an HMO hospital was conducted. Data points collected included age, gender, completion of a preoperative weight loss program, initial body mass index (BMI), pre- and postoperative weights, and presence of diabetes mellitus (DM), hypertension (HTN), osteoarthritis, obstructive sleep apnea, and gastroesophageal reflux disease (GERD). Outcomes measures included excess weight loss, resolution of comorbidities, postoperative complications, and mortality. A total of 345 laparoscopic RYGBs and 192 sleeve gastrectomies were performed. On average, the patients who received RYGB were younger (46 vs 48 years, P = 0.05) and had higher BMI (47 vs 43 kg/m2, P < 0.0001). There was a higher incidence of DM in the RYGB group (32 vs 22%, P = 0.01), whereas the incidences of HTN and GERD were similar in both surgical groups. Ninety-three per cent of the patients who underwent RYGB and 90 per cent of the patients who underwent sleeve gastrectomy completed a preoperative weight loss program. The median length of hospital stay for both groups was 3 days. The complication rate in both groups was 9 per cent. The incidence of gastric leak was 1 per cent in both groups. There was only one mortality, which occurred in the RYGB group. The postoperative resolution of DM was comparable in both groups. The RYGB group had greater resolution of HTN (48 vs 34%, P = 0.03) and GERD (73 vs 34%, P < 0.0001). At 12 months, sleeve gastrectomy achieved superior excess weight loss compared with RYGB (72 vs 61%, P = 0.0015). After adjusting for age and BMI, the excess weight loss for RYGB and sleeve gastrectomy was similar at 12 months (t parameter estimate -0.06, P = 0.08). Laparoscopic RYGB and sleeve gastrectomy had comparable postoperative morbidity and mortality rates. At 1 year, sleeve gastrectomy achieved only slightly greater weight loss. The two operations are both legitimate standalone bariatric procedures and their applications need to be based on individual patient characteristics and needs.

scholarly journals Our Experience with Laparoscopic Sleeve Gastrectomy in the Therapy of Morbid Obesity

2014 ◽  
Vol 14 (2) ◽  
pp. 31-39
Author(s):  
Koren R. ◽  
Marko L. ◽  
Vladovlc P.
Keyword(s):  
Diabetes Mellitus ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Minimally Invasive Surgery ◽  
Sleeve Gastrectomy ◽  
Minimally Invasive ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Obese Patients ◽  
Associated Diseases

Abstract Objective: The purpose of this study is to evaluate the results and experience with Laparoscopic sleeve gastrectomy (LSG) in the treatment of morbid obesity. Methods: The authors in their retrospective analysis evaluate their 6-years experience with LSG on the Department of Minimally Invasive Surgery and Endoscopy in Banská Bystrica. The study is aimed at the examination of the efficacy of LSG on the weight loss as well as on its effect on the associated diseases after 3, 6, 12 and 24 months after LSG. Results: The % Excess Weight Loss (%EWL) in obese patients 2 years after LSG was 74.4%. There was also regression of diabetes mellitus (DM) in 75% patients and arterial hypertension in 68.7% patients after LSG. Conclusion: Laparoscopic sleeve gastrectomy is a safe and effective method in the case of weight loss as well as in the regression of associated diseases.

Sleeve Gastrectomy Pre-Liver Transplant compared to Medical Weight Loss

@Gijournal ◽  
2021 ◽  
Vol 1 ◽  
Author(s):  
Elizabeth Aby ◽  
Suzanne Sharpton ◽  
Julie Heimbach ◽  
Anjana Pillai
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Liver Transplant ◽  
Patient Outcomes ◽  
De Novo ◽  
Obese Patients ◽  
Metabolic Complications ◽  
Nonalcoholic Fatty Liver ◽  
Medical Weight Loss ◽  
The Impact

Methods to optimize obesity-related metabolic complications post liver transplant (LT) are needed given their impact on patient outcomes.  Some transplant centers also have concerns about offering transplantation for obese patients due to concern for complications. In this study, selected patients with cirrhosis and medically complicated obesity either underwent sleeve gastrectomy (SG) or medical weight loss (MWL) and then were subsequently listed for LT. The impact of pre–LT SG and MWL on post-LT diabetes, post-LT hypertension, and recurrent and de novo nonalcoholic fatty liver disease (NAFLD) were evaluated.1   We summarize the @GIJournal discussion held on May 26, 2021, during which the article by Sharpton et al. “Sleeve gastrectomy prior to liver transplantation is superior to medical weight loss in reducing posttransplant metabolic complications” was critically discussed by our experts, Dr. Suzanne Sharpton (@SharptonSuzanne) and Dr. Julie Heimbach (@JulieHeimbach), and moderated by Dr. Anjana Pillai (@AnjanaPillaiMD).

scholarly journals C1q/TNF-Related Protein-9 (CTRP9) Levels Are Associated With Obesity and Decrease Following Weight Loss Surgery

2016 ◽  
Vol 101 (5) ◽  
pp. 2211-2217 ◽  
Author(s):  
Risa M. Wolf ◽  
Kimberley E. Steele ◽  
Leigh A. Peterson ◽  
Xiange Zeng ◽  
Andrew E. Jaffe ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Cohort Study ◽  
Hemoglobin A1c ◽  
Weight Loss Surgery ◽  
Academic Medical Center ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Related Protein ◽  
The Impact

Abstract Context: C1q/TNF-related protein-9 (CTRP9) is a novel adipokine that has beneficial metabolic and cardiovascular effects in various animal models. Alterations in circulating CTRP9 have also been observed in patients with cardiovascular disease and diabetes, but little is known about the impact of obesity and bariatric surgery on CTRP9 concentrations. Objective: The aim of this study was to compare CTRP9 levels in obese and lean subjects and to determine whether circulating CTRP9 levels in morbidly obese patients are altered by bariatric surgery. Design, Setting, and Participants: Fifty-nine obese bariatric surgical patients and 62 lean controls were recruited to participate in a cross-sectional study at an academic medical center. The obese patients were further invited to participate in a cohort study, and 21 returned for analysis at 3 and 6 months postsurgery. Intervention: Bariatric surgery (Roux-en-Y gastric bypass and vertical sleeve gastrectomy) was the intervention for this study. Main Outcome Measures: Fasting serum was obtained from all subjects on entry to the study and was analyzed in the core laboratory for hemoglobin A1c, glucose, aspartate aminotransferase, alanine aminotransferase, total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides; CTRP9, insulin, adiponectin, and leptin were measured by ELISA. Serum from the patients in the cohort study was also analyzed at 3 and 6 months. Results: Serum CTRP9 was significantly higher in the obese group compared to the lean group. CTRP9 was associated with obesity, even after controlling for age, gender, and ethnicity. Following bariatric surgery, there was a significant decrease in weight at 3 and 6 months postprocedure, accompanied by decreases in CTRP9, hemoglobin A1c and leptin, and an increase in serum adiponectin. Conclusions: CTRP9 levels are elevated in obesity and significantly decrease following weight loss surgery. Our data suggest that CTRP9 may play a compensatory role in obesity, similar to that of insulin, and is down-regulated following weight loss surgery.

scholarly journals Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3256
Author(s):  
Adam Brewczyński ◽  
Beata Jabłońska ◽  
Agnieszka Maria Mazurek ◽  
Jolanta Mrochem-Kwarciak ◽  
Sławomir Mrowiec ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Oropharyngeal Cancer ◽  
Hematological Parameters ◽  
White Blood Cells ◽  
Post Treatment ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Hpv Status ◽  
Pre Treatment ◽  
The Impact

Several immune and hematological parameters are associated with survival in patients with oropharyngeal cancer (OPC). The aim of the study was to analyze selected immune and hematological parameters of patients with HPV-related (HPV+) and HPV-unrelated (HPV-) OPC, before and after radiotherapy/chemoradiotherapy (RT/CRT) and to assess the impact of these parameters on survival. One hundred twenty seven patients with HPV+ and HPV− OPC, treated with RT alone or concurrent chemoradiotherapy (CRT), were included. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (Formalin-Fixed, Paraffin-Embedded) tissue samples and/or extracellular circulating HPV DNA was determined. The pre-treatment and post-treatment laboratory blood parameters were compared in both groups. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation (SII) index were calculated. The impact of these parameters on overall (OS) and disease-free (DFS) survival was analyzed. In HPV+ patients, a high pre-treatment white blood cells (WBC) count (>8.33 /mm3), NLR (>2.13), SII (>448.60) significantly correlated with reduced OS, whereas high NLR (>2.29), SII (>462.58) significantly correlated with reduced DFS. A higher pre-treatment NLR and SII were significant poor prognostic factors for both OS and DFS in the HPV+ group. These associations were not apparent in HPV− patients. There are different pre-treatment and post-treatment immune and hematological prognostic factors for OS and DFS in HPV+ and HPV− patients. The immune ratios could be considered valuable biomarkers for risk stratification and differentiation for HPV− and HPV+ OPC patients.

Five-year Outcomes of Sleeve Gastrectomy: A Prospective Multicenter study

2021 ◽  
pp. 000313482199198
Author(s):  
Imad El Moussaoui ◽  
Etienne Van Vyve ◽  
Hubert Johanet ◽  
André Dabrowski ◽  
Arnaud Piquard ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Body Mass ◽  
Excess Weight Loss ◽  
Prospective Multicenter Study ◽  
Weight Loss Failure ◽  
Obstructive Sleep ◽  
The Mean ◽  
Predictors Of Weight Loss

Background Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in the world. Our purpose was to evaluate the percentage of excess weight loss (%EWL), resolution of obesity-related comorbidities after SG, and identify predictive factors of weight loss failure. Methods A prospective cohort study of adults who underwent SG during 2014 in 7 Belgian-French centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically. Results Overall, 529 patients underwent SG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m2, respectively. Body mass index significantly decreased to 32.2 kg/m2 at 5 years ( P < .001). The mean %EWL was 63.6% at 5 years. A significant reduction in dyslipidemia (28.0%-18.2%), obstructive sleep apnea (OSAS) (34.6%-25.1%), and arterial hypertension (HTN) (30.4%-21.5%) was observed after 5 years, but not for diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age >50 years old, BMI >50 kg/m2, and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure. Conclusions Five years after SG, weight loss was satisfactory; the reduction of comorbidities was significant for dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age >50 years old, BMI >50 kg/m2, and previous LAGB were independent predictors of weight loss failure.

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