1,721,062 research outputs found
Benchmarks in low anterior rectal resection to prevent anastomotic leakage: the BASIC checklist
No full textThree reasons to consider interval appendectomy for the management of complicated appendicitis
No full textWhat are risk factors for COVID-19 vaccine breakthrough infections in patients with previous history of bariatric surgery?
No full textGastroesophageal Reflux After Sleeve Gastrectomy: New Onset and Effect on Symptoms on a Prospective Evaluation
No full textGastroesophageal reflux disease (GERD) is present in half of the obese candidates for bariatric surgery. Variability of symptoms and new onset of GERD are often debated. Prior studies have demonstrated that sleeve gastrectomy (SG) is associated with significant weight loss
One-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after failed laparoscopic sleeve gastrectomy (LSG): systematic review and meta-analysis of comparative studies
No full textIntroduction: The aim of this study was to compare weight loss and gastroesophageal reflux disease (GERD) remission after one-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after laparoscopic sleeve gastrectomy (LSG). Methods: In PubMed, Embase, and Cochrane Library, a search was performed using the terms "Roux-en-Y gastric bypass versus one anastomosis gastric bypass," "revisional surgery," and "sleeve gastrectomy." Only original articles in English language comparing OAGB and RYGB were included. No temporal interval was set. The primary outcome measure was weight loss (%TWL). The secondary endpoints were leak, bleeding, marginal ulcer, and GERD. PRISMA flowchart was used. Differences in continuous and dichotomous outcome variables were expressed as mean difference (MD) and risk difference (RD) with 95% CI, respectively. Heterogeneity was assessed by using I2 statistic. Results: Six retrospective comparative articles were included in the present meta-analysis. Weight loss analysis showed a MD = 5.70 (95% CI 4.84-6.57) in favor of the OAGB procedure with a statistical significance (p = 0.00001) and no significant statistical heterogeneity (I2 = 0.00%). There was no significant RD for leak, bleeding, or marginal ulcer after the two revisional procedures. After conversion to OAGB, remission from GERD was 68.6% (81/118), and it was 80.6% (150/186) after conversion to RYGB with a RD = 0.10 (95% CI -0.04, 0.24), no statistical significance (p = 0.19), and high heterogeneity (I2 = 96%). De novo GERD was 6.3% (16/255) after conversional OAGB, and it was 0.5% (1/180) after conversion to RYGB with a RD = -0.23 (95% CI -0.57, 0.11), no statistical significance (p = 0.16), and high heterogeneity (I2 = 92%)
Is the Sleeve Gastrectomy Always a Better Procedure? Five-Year Results from a Retrospective Matched Case-Control Study
No full textIntroduction: Bariatric surgery is considered the most effective treatment for obesity. A recent worldwide survey demonstrated that Laparoscopic Sleeve Gastrectomy (LSG) is the most commonly performed bariatric procedure, while Laparoscopic Adjustable Gastric Banding (LAGB) has been almost abandoned. Objectives: The aim of this retrospective study was to compare 5-year results of LSG and LAGB at our Institution. Materials and Methods: Prospective maintained database of our Institution was reviewed to find all patients who had undergone LSG between January 2009 and December 2011. Inclusion criteria were BMI of 40–50 kg/m2and age of 18–60 years old. Patients with Class I and II obesity, superobese subjects, and patients with previous history of bariatric surgery were excluded. Data on sex, age, pre-operative BMI, obesity-related diseases (diabetes, hypertension, dyslipidemia), and early and late complications were collected. Each subject who underwent LSG was matched one-to-one with a patient that had undergone LAGB. Outcomes were analyzed at 1, 3, and 5 years of follow-up. Results: A total number of 122 patients were included in this study, 61 in each group. Better %EWL was observed in the LSG group at 1, 3, and 5 years. Both procedures induced improvements of obesity-related diseases without significant difference. In the LAGB group, ten patients underwent uneventful band removal. In the LSG group, two patients had serious postoperative complications. Conclusion: LSG achieves better %EWL than LAGB within 5 years, but comorbidities improvement is not significantly different. Severity of complication is higher after LSG. LAGB is still a good option for selected patients
Rhabdomyolysis after bariatric surgery: A multicenter, prospective study on incidence, risk factors, and therapeutic strategy in a cohort from South Italy
No full textBackground At present, prospectively collected data on rhabdomyolysis (RML) after bariatric surgery are limited. Objectives To evaluate the incidence, risk factors, and therapeutic strategy of RML in different bariatric procedures. Setting University hospitals, Italy. Methods Obese patients were prospectively enrolled. Preoperative demographic characteristics and clinical data, as well as type of anesthesia and type and total duration of surgery, were recorded as potential risk factors for RML. RML was defined as postoperative creatine kinase (CK)>1000 U/L. Incidence, possible risk factors, and therapeutic outcome of RML were assessed and compared with comparative groups. Results Four hundred eighty obese patients were included in the study. After surgery, RML was diagnosed in 62 (12.9%) patients. Muscular pain was present in 12 patients (19.3%). In RML patients, mean CK value was 1346±2132.5 U/L (range 1191-37,400). Only duration of surgery was identified as an independent risk factor for RML (P230 minutes. CK testing should be performed in all patients after bariatric surgery to make an early diagnosis and properly start fluids and diuretics
Long-Term Results of the Mediterranean Diet After Sleeve Gastrectomy
No full textBackground: To assess dietary habits in a cohort of patients at minimum follow-up of 4 years after sleeve gastrectomy (SG) by comparing their dietary records to the Italian Mediterranean diet (IMD) recommendations. Methods: We prospectively evaluated in 74 patients who had the SG in 2014 dietary habits by a 7-day food dietary records, weight and micronutrient status, evolution of comorbidities, use of micronutrient supplements, and frequency of physical activity. Results: The IMD recommendations in terms of daily/weekly portions of fruits, vegetables, and complex carbohydrates were followed by 40.5%, 35.1%, and 40.5% of the participants, respectively. Concerning milk/dairy, olive oil, poultry, fish/shellfish, eggs, legumes, processed/red meat, and cold cuts, 54.1%, 85.1%, 44.5%, 75.7%, 67.6%, 35.1%, 87.8%, and 55.4% of the participants, respectively, followed the IMD recommendations. Weight regain appeared in 37.8% of participants, while physical activity was reported by the 54.0% of them. Deficiencies of vitamin B12, vitamin D, folate, iron, and anemia were found present in 6.8%, 8.1%, 24.3%, 33.8%, and 59.5% of the participants, respectively, and 18.9% of them were found to take micronutrient supplements. Improvement/remission of type 2 diabetes, hypertension, or obstructive sleep apnea was 73.3%, 64.7%, and 100% respectively. Conclusions: In this prospective cohort with a minimum follow-up of 4 years after SG, we found an inadequate intake of fruit, vegetables, poultry, and complex carbohydrates according to the IMD recommendations; the frequency of physical activity and the use of micronutrients supplements were also inadequate. This may contribute to weight regain and micronutrient deficiencies in the long term
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