1055 Performance of Gastric Bypass vs. Sleeve Gastrectomy in Hypertension Remission

Aim Bariatric surgery is gradually becoming a surgical field of paramount importance to global health. Our aim is to assess the performance of RYGB and SG in achieving remission of hypertension in bariatric patients. Secondarily, we aim to assess how age, gender, referral BMI, severity of hypertension, and association with T2DM, affects hypertension remission rates. Method In this observational, retrospective cohort study, we included 475 out of 505 total bariatric patients operated at the Worcestershire Royal Hospital between 2012 and 2019. Overall, 193 patients (40.6%) where taking anti-hypertensive medications pre-operatively. Hypertensive patients were divided into three categories: Mild (1 anti-hypertensive medication) 44%, moderate (2 anti-hypertensive medications) 39%, and severe (3 or more anti-hypertensive medications) 17%. All patients underwent either a RYGB 52% (101/193) or a SG 48% (92/193). We assessed hypertension remission after 1 and after 2 years. Results Hypertension remission rates post-RYGB where 40.0% after 1 year (38/95), and 43.0% (34/79) after 2 years. Rates post-SG where 40.8% after 1 year (31/76) and 43.1% (22/51) after 2 years. There was no statistically significant difference in hypertension remission rates between RYGB and SG, nor with any of secondary variable, including gender, age, BMI, severity of hypertension and association with T2DM. Conclusions Our data showed no significant difference between RYGB and SG in hypertension remission rates after 1- and 2-years post-procedure. This provides novel insights into the risk-benefit assessment of the bariatric patient, and helps define the SG as a much simpler, cheaper and safer surgical option for bariatric patients with hypertension as their major co-morbidity.

A Bariatric Patient at a Gastroenterologist's Appointment Before and After Surgery

The article deals with diseases of the digestive system, pathogenetically associated with obesity; presents a description of the two most common bariatric surgeries at present, with an emphasis on changes in the gastrointestinal tract in the postoperative period

Endoscopic Management of Weight Regain in the Bariatric Patient

Despite initial weight loss following bariatric surgery, weight recidivism is common. While weight regain is multifactorial and includes behavioral, psychosocial, and medical causes, changes in anatomy also play a role. Dilation of the gastrojejunal anastomosis following Roux-en-Y gastric bypass and enlargement of the gastric sleeve following sleeve gastrectomy are both important considerations. Historically, surgical revision has been performed to address weight regain; however, morbidity and mortality are not insignificant. Over the past decade, a variety of endoscopic approaches have been described for weight recidivism, several of which have proven to be safe, effective, and durable. This article will review each of these techniques in detail.

Dental care for the bariatric patient

As the overweight and obese population increases, one must be mindful of the implications on the delivery of dental care to this group. Appropriate facilities must be available, which may warrant structural and equipment adaptations to clinical and non-clinical areas. The complexity of dental treatment planning and delivery may be compounded by medical comorbidities, and careful consideration must be given to the suitability and safety of conscious sedation and general anaesthesia in order to facilitate treatment. This article aims to discuss how safe provision and equitable access to dental care can be achieved for the bariatric population. CPD/Clinical Relevance: This article aims to discuss the challenges posed by the increase in the overweight and obese population and considerations to be taken for provision of safe and equitable bariatric dental care.

The bariatric patient: basic aspects preparation for surgical treatment of obesity and conducting after it. Lecture for practitioners

Over the past years and decades, in the world in general and particularly in Russia, bariatric surgery is becoming more widespread for the treatment of severe forms of obesity. There is an increase in the number of operations performed along with the effectiveness and minimising risks of the operations held due to the improvement of surgical techniques. In this lecture, there are clearly stated indications and contraindications for the surgical treatment of obesity. Here are presented various types of bariatric surgeries and their pathophysiological mechanisms which affect on body weight, carbohydrate and lipid metabolism. There is also presented their effectiveness in comorbid obesity pathology, primarily among patients with type 2 diabetes. Here was held an analysis of possible negative effects after surgical treatment for obesity, including secondary hyperparathyroidism, post-bariatric hypoglycemia, etc., as well as predictors of postoperative prognosis in relation on metabolic control among patients with obesity and type 2 diabetes.