scholarly journals Determinants of Adequate Response of Patient Undergoing Roux-en-y Gastric Bypass Surgery

2020 ◽  
Author(s):  
Thales Philipe Rodrigues Silva ◽  
Flávia Moraes Silva ◽  
Larissa Loures Mendes ◽  
Alexandra Dias Moreira D'assunção ◽  
Lauro Pinheiro Ferreira de Araujo ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Logistic Regression ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Inadequate Response ◽  
Post Surgery ◽  
Adequate Response ◽  
Follow Up Care

Abstract INTRODUCTION: Roux-en-Y gastric bypass surgery (RYGB) is known to induce, on average,60 to 75% excess body weight loss between 18 and 24 months post-surgery. However, several studies have shown weight regain after two years post-surgery, thus patients must have adequate follow-up in order to guarantee and/or maintain response to RYGB. AIM: To evaluate the determinants of adequate response in patients who underwent RYGB. METHODS: A longitudinal study with 193 adults who underwent RYGB between 2012 and 2014. Adequate response to RYGB was determined by Excess Weight Loss (%EWL). Logistic regression models were constructed to verify the degree of association between adequate response of patient after RYGB and determinants of variable risk based on estimate Odds Ratios (OR). RESULTS: RYGB improves Systemic arterial hypertension (SAH), Diabetes Mellitus (DM) and body mass index (BMI). From the multivariate logistic regression model, being female and not having SAH and DM reduce the chance of inadequate RYGB response. Regarding preoperative BMI, an increase in one unit of kg/m2 was associated with increased odds of inadequate response after RYGB. And patients who did not receive follow-up care with a psychologist or psychiatrist in the postoperative period presented higher odds of inadequate response to RYGB. CONCLUSION: The findings of this study contribute to the effective planning of interventions by multi-professional teams involved in RYGB, aimed at offering a better follow-up care focused mainly on post-surgery changes and adequate RYGB response.

scholarly journals Improved heart rate recovery after marked weight loss induced by gastric bypass surgery: Two-year follow up in the Utah Obesity Study

Heart Rhythm ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Stephen L. Wasmund ◽  
Theophilus Owan ◽  
Frank G. Yanowitz ◽  
Ted D. Adams ◽  
Steven C. Hunt ◽  
...  
Keyword(s):  
Heart Rate ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Heart Rate Recovery ◽  
Gastric Bypass Surgery ◽  
Marked Weight

scholarly journals Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-Month Follow-Up Study

2015 ◽  
Vol 25 (10) ◽  
pp. 1909-1916 ◽  
Author(s):  
Marney A. White ◽  
Melissa A. Kalarchian ◽  
Michele D. Levine ◽  
Robin M. Masheb ◽  
Marsha D. Marcus ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Depressive Symptoms ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Prognostic Significance ◽  
Psychosocial Outcomes ◽  
Follow Up Study

Impact of Weight Loss on Inflammation State and Endothelial Markers Among Individuals with Extreme Obesity After Gastric Bypass Surgery: a 2-Year Follow-up Study

2020 ◽  
Vol 30 (5) ◽  
pp. 1881-1890 ◽  
Author(s):  
Gisele Farias ◽  
Bárbara Dal Molin Netto ◽  
Katia Boritza ◽  
Solange Cravo Bettini ◽  
Regina Maria Vilela ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Extreme Obesity ◽  
Endothelial Markers ◽  
Follow Up Study

scholarly journals Twelve-year changes in protein profiles in patients with and without gastric bypass surgery

2020 ◽  
Author(s):  
Noha A. Yousri ◽  
Rudolf Engelke ◽  
Hina Sarwath ◽  
Rodrick D. McKinlay ◽  
Steven C. Simper ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Rapid Weight Loss ◽  
Beneficial Effects ◽  
Protein Levels ◽  
Post Surgery ◽  
Protein Change

Gastric bypass surgery results in long-term weight loss due to re-routing of the gastro-intestinal anatomy and dietary intake alterations. Studies have examined protein change during rapid weight loss (up to 1 year post-surgery), but whether protein changes are maintained long-term after weight stabilization is unknown. To identify proteins and pathways involved with the long-term beneficial effects of weight loss, abundances of 1297 blood-circulating proteins were measured at baseline, 2 and 12 years after Roux-en-Y gastric bypass surgery. Protein changes were compared between 234 surgery and 144 non-surgery subjects with severe obesity, with discovery and replication subgroups. Seventy-one protein changes were associated with 12-year BMI changes and 58 (7 unique) with surgical status. Protein changes, including ApoM, were most strongly associated with long-term changes in lipids (HDL-C and triglycerides). Inflammation, adipogenesis, cellular signaling, and complement pathways were implicated. Short-term improvements in protein levels were maintained long-term, even after some weight regain.

scholarly journals Influence of the gastric stump’s volume on the long-term results of laparoscopic Roux-en-Y gastric bypass surgery

2021 ◽  
Vol 180 (1) ◽  
pp. 81-88
Author(s):  
A. G. Khitaryan ◽  
D. A. Melnikov ◽  
A. A. Orekhov ◽  
A. V. Mezhunts ◽  
S. A. Adizov ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Weight Gain ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Long Term Results ◽  
Gastric Stump ◽  
Insufficient Weight Loss

The objective was to retrospectively analyze the dependence of long-term results of laparoscopic Roux-en-Y gastric bypass surgery according to the size of the formed gastric stumpMethods and materials. We retrospectively analyzed the long-term results of 207 morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass surgery by two different techniques. The median follow-up was 36 months. Two groups of patients were identified according to the method of formation of the gastric stump: using 2 (1st group) or 3 (2nd group) stapler cassettes and performing of computed tomography volumetry to determine thevolume of the created gastric stump.Results. Statistically significant differences in the volume of the formed gastric stump, depending on the method of operation, were as follows: 23.8 ml (8.9–37.3 ml) in the 1st group and 47.7 ml (31.9–72.8 ml) in the 2nd group (p<0.0001). Significant differences were observed in the following indicators: relapse of weight gain or insufficient weight loss (loss of < 70 % overweight) at median follow-up of 36 months were observed in 2 (2.3 %) and 12 (9.9 %) cases in the 1st and 2nd groups, respectively (p<0.05).Conclusion. We revealed that the formation of the gastric stump of a very small volume by 2 stapler cassettes compared to using 3 stapler cassettes contributes to improving the results in the long-term postoperative period and minimizing the frequency of relapse of weight gain and insufficient weight loss. The restrictive component of the surgery with equal malabsorptive is fundamental for the clinical parameters of its effectiveness, that leads to increasing the frequency of relapses of weight gain and insufficient weight loss in the 2nd group in comparison with the 1st and group of patients (p<0.05). Based on computed tomography volumetry, the volume of a small-sized stomach stump can be reliably measured and, accordingly, weight loss is predicted in the long term after the surgery, as well as the absence of relapses of weight gain or insufficient weight loss.

Abstract 13780: JNK Inhibition Mimics the Beneficial Effect of Roux-en-Y Gastric Bypass Surgery on Obesity-Induced Endothelial Dysfunction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Petia Doytcheva ◽  
Elena Osto ◽  
Thomas Baechler ◽  
Marco Bueter ◽  
Christian M Matter ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Endothelial Dysfunction ◽  
Bypass Surgery ◽  
Ex Vivo ◽  
Gastric Bypass Surgery ◽  
Specific Inhibitor ◽  
Aortic Tissue ◽  
Post Surgery ◽  
Enos Phosphorylation

Introduction: Roux-en-Y gastric bypass surgery (RYGB) reduces weight and long-term cardiovascular risk in obese patients. We previously demonstrated that in diet-induced obese rats RYGB improves aortic endothelial vasorelaxation 8 days after surgery in a weight loss-independent manner. Improved endothelial function was associated with decreased JNK phosphorylation and increased Akt and eNOS phosphorylation in the aorta. Hypothesis: We investigated whether in vivo inhibition of JNK activity in sham-operated ad libitum-fed rats mimics these endothelial effects of RYGB. Methods: Male Wistar rats were fed a high fat (60%) high cholesterol (1.25%) diet for 7 weeks before undergoing either RYGB or sham surgery; sham-operated rats received vehicle (sham_AL) or the JNK-specific inhibitor SP600125 40mg/kg/day s.c. for 8 days post-surgery (sham_SP). Then, thoracic aortic rings were isolated and subjected to ex vivo isometric tension recordings. After submaximal contraction with norepinephrine (10-6mol/L), cumulative relaxation responses were performed to GLP-1 (7-36) amide (10-12 to 10-6mol/L) or insulin (10-12 to 10-5mol/L); tests were repeated after preincubation with the eNOS inhibitor L-NAME (10-4mol/L). Western blot analysis of JNK, Akt and eNOS was also performed on aortic tissue lysates. Results: Body weight did not differ between sham_SP and sham_AL rats, while the weight loss of RYGB rats was significant 8 days after surgery. GLP-1- and insulin-induced vasorelaxation responses improved in RYGB compared to sham_AL rats; interestingly, sham_SP rats had endothelial relaxation similar to RYGB rats. All responses were blocked by preincubation with L-NAME, suggesting an eNOS-dependent effect. JNK protein phosphorylation in aortic lysates was decreased in RYGB and sham_SP rats compared to sham_AL, while Akt phosphorylation was increased. eNOS phosphorylation and dimerization were also increased in RYGB and sham_SP compared to sham_AL rats. Conclusion: JNK inhibition seems to mimic the immediate eNOS-mediated endothelial protective effects of RYGB. Further, our study underlines a crucial role of JNK in obesity-associated endothelial dysfunction, suggesting a novel mechanism for the cardiovascular effects of RYGB.

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