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El Khoury L, Catheline JM, Taher M, Roussel J, Bendacha Y, Romero R, Dbouk R, Cohen R. Re-sleeve gastrectomy is a safe and sensible intervention in selected patients: retrospective cohort study. Int J Surg 2023; 109:4145-4150. [PMID: 37707529 PMCID: PMC10720822 DOI: 10.1097/js9.0000000000000743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/24/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION Sleeve gastrectomy is a good treatment intervention to control the metabolic syndrome in patients with obesity worldwide. However, weight regain is of great concern and would usually necessitate a reintervention. In recent years, re-sleeve gastrectomy (ReSG) has been proposed to treat weight regain in the context of a large residual stomach. Our objective was to analyze the long-term results and safety profile of this intervention in a large case series. METHODS From September 2010 to March 2021, a retrospective cohort study in a tertiary nonuniversity hospital was performed. Seventy-nine patients received a ReSG by laparoscopy. Preoperative radiologic imaging showed a dilation of the gastric pouch exceeding 250 cc in all cases. RESULTS A total of 79 patients (87% females) with a mean age of 44.8 years old and a mean BMI of 40.0 kg/m 2 were enrolled in the study. The mean follow-up was 44.8 months. The ReSG indication was insufficient weight loss in 37 patients (46.8%) and weight regain in 39 patients (53.2%). The authors noticed a 10.1% complications rate: gastric stenosis (5.1%), bleeding (2.5%), and incisional site hernia in 2.5%, with no death. There was no gastric fistula detected. The mean BMI decreased to 33.1 kg/m 2 after ReSG (a decrease of 6.9 kg/m 2 ). CONCLUSION After insufficient weight loss or weight regain following sleeve gastrectomy and in the presence of localized or global gastric tube dilation, ReSG seems to be a good treatment choice and a safe procedure.
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Affiliation(s)
| | | | | | | | | | | | | | - Regis Cohen
- Department of Digestive Surgery, Centre Hospitalier de Saint-Denis, 2 rue du Docteur Delafontaine, Saint-Denis, France
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Giannis D, Geropoulos G, Kakos CD, Lu W, El Hadwe S, Fornasiero M, Robertson A, Parmar C. Portomesenteric Vein Thrombosis in Patients Undergoing Sleeve Gastrectomy: an Updated Systematic Review and Meta-Analysis of 101,914 Patients. Obes Surg 2023; 33:2991-3007. [PMID: 37523131 DOI: 10.1007/s11695-023-06714-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION Portomesenteric vein thrombosis (PMVT) is a rare but potentially fatal complication of sleeve gastrectomy (SG). The rising prevalence of SG has led to a surge in the occurrence of PMVT, while the associated risk factors have not been fully elucidated. This study aims to determine the incidence and risk factors of PMVT in patients undergoing SG. METHODS A comprehensive literature search was performed in PubMed and EMBASE databases. Proportion and regression meta-analyses were conducted. RESULTS In a total of 76 studies including 101,914 patients undergoing SG, we identified 357 patients with PMVT. Mean follow-up was 14.4 (SD: 16.3) months. The incidence of PMVT was found to be 0.50% (95%CI: 0.40-0.61%). The majority of the population presented with abdominal pain (91.8%) at an average of 22.4 days postoperatively and PMVT was mainly diagnosed with computed tomography (CT) (96.0%). Hematologic abnormalities predisposing to thrombophilia were identified in 34.9% of the population. Advanced age (p=0.02) and low center volume (p <0.0001) were significantly associated with PMVT, while gender, BMI, hematologic abnormality, prior history of deep vein thrombosis or pulmonary embolism, type of prophylactic anticoagulation, and duration of prophylactic anticoagulation were not associated with the incidence of PMVT in meta-regression analyses. Treatment included therapeutic anticoagulation in 93.4% and the mortality rate was 4/357 (1.1%). CONCLUSION PMVT is a rare complication of sleeve gastrectomy with an incidence rate <1% that is associated with low center volume and advanced age but is not affected by the duration or type of thromboprophylaxis administered postoperatively.
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Affiliation(s)
- Dimitrios Giannis
- Department of Surgery, North Shore University Hospital/Long Island Jewish Medical Center, Northwell Health, Manhasset, NY, 11030, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA.
| | | | - Christos D Kakos
- Department of Transplant Surgery, Aristotle University of Thessaloniki School of Medicine, 54124, Thessaloniki, Greece
| | - Weiying Lu
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA
| | - Salim El Hadwe
- Department of Clinical Neurosciences, Cambridge School of Medicine, Cambridge University, Cambridge, CB2 0QQ, UK
| | | | | | - Chetan Parmar
- Department of Surgery, Whittington Hospital, London, N19 5NF, UK
- Department of Surgery, UCLH, London, NW1 2BU, UK
- Apollo Hospitals, Research and Education Foundation, Delhi, 500096, India
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3
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Bonaldi M, Rubicondo C, Giorgi R, Cesana G, Ciccarese F, Uccelli M, Zanoni A, Villa R, De Carli S, Oldani A, Ismail A, Di Capua F, Olmi S. Re-sleeve gastrectomy: weight loss, comorbidities and gerd evaluation in a large series with 5 years of follow-up. Updates Surg 2023:10.1007/s13304-023-01471-1. [PMID: 36849646 DOI: 10.1007/s13304-023-01471-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy (SG) has rapidly become one of the most commonly performed procedures in bariatric surgery. Weight regain and insufficient weight loss are the most common causes for surgical failure. Re-sleeve gastrectomy (ReSG) can represent an option when there is evidence of a dilated gastric tube. OBJECTIVES The aim of the study is to evaluate safety, efficacy and rate of gastro-esophageal reflux disease (GERD) after ReSG in one of the largest series present in literature with long-term follow up. METHODS AND STUDY DESIGN Retrospective study design. From February 2010 to August 2018, 102 patients underwent ReSG at our Centre. We divided patients into two groups, according to the main reason for surgical failure: insufficient weight loss or progressive weight regain. RESULTS One hundred-two patients (78 women, 24 men) with BMI 38 ± 6 kg/m2 underwent ReSG (mean age 44 years). Rate of postoperative complications was 3.9% (4/102). After a mean follow-up of 55 months, mean BMI decreased to 30,4 kg/m2 and the mean percentage of excess weight loss (%EWL) was 51 ± 38.6. Symptoms of GERD were present in 35/102 patients (34.3%) and the need for a new operation occurred in six patients. Forty-five patients were submitted to ReSG for progressive weight regain (group A) and 57 for insufficient weight loss (group B). No differences were found in terms of postoperative BMI and %EWL. CONCLUSION ReSG is a feasible procedure after primary SG failure in selected patients, but its efficacy in reducing the BMI under 30 kg/m2 is still unclear. In addition, over 30% of patients suffer from long-term gastro-esophageal reflux.
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Affiliation(s)
- Marta Bonaldi
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy.
| | - Carolina Rubicondo
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Riccardo Giorgi
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Giovanni Cesana
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Francesca Ciccarese
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Matteo Uccelli
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Adelinda Zanoni
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Roberta Villa
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Stefano De Carli
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Alberto Oldani
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Ayman Ismail
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Francesco Di Capua
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
| | - Stefano Olmi
- Division of General and Oncological Surgery and Obesity Center of Policlinico San Marco, Corso Europa, 7, Zingonia, 24040, Osio Sotto, BG, Italy
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Nedelcu M, Manos T, Noel P, Danan M, Zulian V, Vilallonga R, Nedelcu A, Carandina S. Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy? J Clin Med 2023; 12:jcm12041376. [PMID: 36835912 PMCID: PMC9963979 DOI: 10.3390/jcm12041376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Despite the unanimous acknowledgement of the laparoscopic sleeve gastrectomy (LSG) worldwide, the leak remains its deficiency. For the last decade, the surgical treatment was practically considered mandatory for almost any collection following LSG. The aim of this study is to evaluate the need for surgical drainage for leak following LSG. METHODS All consecutive patients having gone through LSG from January 2017 to December 2020 were enrolled in our study. Once the demographic data and the leak history were registered, we analyzed the outcome of the surgical or endoscopic drainage, the characteristics of the endoscopic treatment, and the evolution to complete healing. RESULTS A total of 1249 patients underwent LSG and the leak occurred in 11 cases (0.9%). There were 10 women with a mean age of 47.8 years (27-63). The surgical drainage was performed for three patients and the rest of the eight patients underwent primary endoscopic treatment. The endoscopic treatment was represented with pigtails for seven cases and septotomy with balloon dilation for four cases. In two out of these four cases, the septotomy was anticipated by the use of a nasocavitary drain for 2 weeks. The average number of endoscopic procedures was 3.2 (range 2-6). The leaks achieved complete healing after an average duration of 4.8 months (range 1-9 months). No mortality was recorded for a leak. CONCLUSIONS The treatment of the gastric leak must be tailored to each patient. Although there is still no consensus for the endoscopic drainage of leaks after LSG, the surgical approach can be avoided in up to 72%. The benefits of pigtails and nasocavitary drains followed by endoscopic septotomy are undeniable, and they should be included in the armamentarium of any bariatric center.
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Affiliation(s)
- Marius Nedelcu
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83000 Toulon, France
- ELSAN, Clinique Bouchard, 13006 Marseille, France
- Correspondence: ; Tel.: +33-695-950-965
| | - Thierry Manos
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83000 Toulon, France
| | - Patrick Noel
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83000 Toulon, France
- Emirates Specialty Hospital, Dubai Healthcare City, Dubai 505240, United Arab Emirates
- Mediclinic Airport Road Hospital, Abu Dhabi 48481, United Arab Emirates
| | - Marc Danan
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83000 Toulon, France
| | - Viola Zulian
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83000 Toulon, France
| | - Ramon Vilallonga
- ELSAN, Clinique Bouchard, 13006 Marseille, France
- Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Hospital Vall d’Hebron, 08035 Barcelona, Spain
- Surgery Department, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | | | - Sergio Carandina
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83000 Toulon, France
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Noel P, Layani L, Manos T, Adala M, Carandina S, Nedelcu A, Nedelcu M. The Reflux and BariClip: Initial Results and Mechanism of Action. J Clin Med 2022; 11:jcm11226698. [PMID: 36431175 PMCID: PMC9696891 DOI: 10.3390/jcm11226698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Laparoscopic BariClip Gastroplasty (LBCG) represents a new bariatric procedure that mimics the principle of the Laparoscopic Sleeve Gastrectomy (LSG), but using a completely reversible mechanism, which is essential for gastroesophageal reflux disease (GERD). The purpose of our study was to evaluate the evolution of GERD following the initial experience with LBCG. METHODS The first 43 obese patients who underwent LBCG performed by the same surgeon in two different medical centers in May 2018-December 2019 were included in the current study. Twelve patients had issues of reflux, regularly receiving PPIs (proton pump inhibitors) treatment in eight cases, and occasionally in four cases. Thirty-two patients completed the follow-up at one year and the GERD was evaluated using the PPI medications and the GerdQ. RESULTS The median preoperative GerdQ score was (14.58 ± 1.9). Three patients out of the twelve who had complained about preoperative GERD did not consent to the one year follow-up form. For the rest of nine patients, the median post-operative GerdQ score was (10.11 ± 3.2). The PPIs were used at one year follow-up in six patients: four with occasional use, one patient with regular use showing no improvement, and one who experienced de novo GERD symptomatology (3.1%). No statistically significant difference between the groups was recorded in terms of GERD. We recorded no intraoperative complications. No case of erosion occurred in the post-operative period, but we encountered two cases of slippage. One additional BariClip was removed at 14 months. CONCLUSION LBCG represents a new bariatric procedure that mimics the principle of the laparoscopic sleeve gastrectomy, but with a completely reversible mechanism. Even with limited cases, our experience reports several mechanisms of action that will be evaluated and discussed in further prospective clinical trials. After this preliminary clinical study, LBCG's effects on GERD and its safety are highly encouraging.
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Affiliation(s)
- Patrick Noel
- Emirates Specialty Hospital, Dubai 505240, United Arab Emirates
- Mediclinic Airport Road Hospital, Abu Dhabi 48481, United Arab Emirates
- ELSAN, Clinique Bouchard, 13000 Marseille, France
| | | | | | | | - Sergio Carandina
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83100 Toulon, France
| | - Anamaria Nedelcu
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83100 Toulon, France
| | - Marius Nedelcu
- ELSAN, Clinique Bouchard, 13000 Marseille, France
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l’Óbesite, 83100 Toulon, France
- Correspondence: ; Tel.: +33-695-950-965
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6
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Nocca D, Galtier F, Taleb S, Picot MC, Jaussent A, Silvestri M, Lefebvre P, de Jong A, Gautier T, Loureiro M, Nedelcu M. Peri-operative Morbidity of Nissen Sleeve Gastrectomy: Prospective Evaluation of a Cohort of 365 Patients, Beyond the Learning Curve. Obes Surg 2022; 32:1-7. [PMID: 35524904 DOI: 10.1007/s11695-022-06066-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Over the last decade, an important interest was taken to prevent the reflux following sleeve. A new variant, Nissen-sleeve, was described with the purpose to prevent GERD and to decrease the occurrence of leak. The current study reports the preliminary results of a prospective trial. MATERIALS AND METHODS All consecutive patients who underwent a Nissen-Sleeve between January 2018 and September 2020 were included. Baseline characteristics including age, gender, weight, body mass index (BMI), GERD symptoms, and treatment were evaluated after 1 year. Operative time, length of stay, complication, and reoperation data were also collected. RESULTS Three hundred sixty-five consecutive patients decided to undergo Nissen-sleeve: 75% females with median age of 41.2 years (+ / - 14.1) and an average BMI of 41.6 kg/m2 (+ / - 5.4). There were 16 cases (4.4%) of early postoperative complications (< 30 days): six cases of acute wrap perforation (1.6%), intraabdominal bleeding for 5 patients (1.4%), one case of wrap dilatation (0.3%), one case of acute complete aphagia, one case of incarcerated umbilical hernia, and 2 cases (0.5%) of pulmonary atelectasis/pneumonia and one venous pulmonary embolism. We recorded the following complications: 16 patients (4.4%) mild dysphagia; 3 patients (0.8%) chronic dysphagia; and 2 cases of wrap perforation that have been diagnosed 8 and 9 months respectively, after the procedure due to the use of steroids not associated with PPI intake. The mean operative time was 83 min (46-125 min). The conversion and mortality rates were nil. CONCLUSION Following the initial learning curve and additional technical modifications, the Nissen-Sleeve appears to be a safe surgical technique with an acceptable early postoperative complication rate. CLINICAL TRIAL REGISTRATION NCT02310178.
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Affiliation(s)
- David Nocca
- CHU de Montpellier, CHU Saint Eloi 80 Av Augustin FlicheCedex 5, 34295, Montpellier, France. .,Institut de Génomique Fonctionnelle, UMR 5203 CNRS- U1191, INSERM- Univ Montpellier, Montpellier, France.
| | - Florence Galtier
- CHU de Montpellier, CHU Saint Eloi 80 Av Augustin FlicheCedex 5, 34295, Montpellier, France.,Inserm CIC 1411, Montpellier, France
| | - Sulaiman Taleb
- CHU de Montpellier, CHU Saint Eloi 80 Av Augustin FlicheCedex 5, 34295, Montpellier, France
| | - Marie-Christine Picot
- Institut de Génomique Fonctionnelle, UMR 5203 CNRS- U1191, INSERM- Univ Montpellier, Montpellier, France.,Inserm CIC 1411, Montpellier, France.,Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Audrey Jaussent
- Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | | | - Patrick Lefebvre
- CHU de Montpellier, CHU Saint Eloi 80 Av Augustin FlicheCedex 5, 34295, Montpellier, France
| | - Audrey de Jong
- CHU de Montpellier, CHU Saint Eloi 80 Av Augustin FlicheCedex 5, 34295, Montpellier, France
| | | | - Marcelo Loureiro
- CHU de Montpellier, CHU Saint Eloi 80 Av Augustin FlicheCedex 5, 34295, Montpellier, France.,Universidade Positivo, Curitiba, Brazil
| | - Marius Nedelcu
- ELSAN Clinique Bouchard, Marseille, France.,ELSAN Clinique Saint Michel, Toulon, France
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Demerdash HM. Weight regain after bariatric surgery: Promoters and potential predictors. World J Meta-Anal 2021; 9:438-454. [DOI: 10.13105/wjma.v9.i5.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/07/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity is globally viewed as chronic relapsing disease. Bariatric surgery offers the most efficient and durable weight loss approach. However, weight regain after surgery is a distressing issue as obesity can revert. Surgical procedures were originally designed to reduce food intake and catalyze weight loss, provided that its role is marginalized in long-term weight maintenance. Consequently, it is essential to establish a scientifically standardized applicable definitions for weight regain, which necessitates enhanced comprehension of the clinical situation, as well as have realistic expectations concerning weight loss. Moreover, several factors are proposed to influence weight regain as psychological, behavioral factors, hormonal, metabolic, anatomical lapses, as well as genetic predisposition. Recently, there is a growing evidence of utilization of scoring system to anticipate excess body weight loss, along with characterizing certain biomarkers that identify subjects at risk of suboptimal weight loss after surgery. Furthermore, personalized counseling is warranted to help select bariatric procedure, reinforce self-monitoring skills, motivate patient, encourage mindful eating practices, to avoid recidivism.
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Affiliation(s)
- Hala Mourad Demerdash
- Department of Clinical Pathology, Alexandria University Hospitals, Alexandria 21311, Egypt
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Du D, Wang L, Sang Q, Zheng X, Lian D, Zhang N. Outcome Analysis of Single-Incision Trans-Umbilical Laparoscopic Sleeve Gastrectomy in Obese Chinese Adolescents. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2020.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Dexiao Du
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Liang Wang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Qing Sang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Xuejing Zheng
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Dongbo Lian
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, China
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9
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Luo L, Li H, Wu Y, Bai Z, Xu X, Wang L, Mendez-Sanchez N, Qi X. Portal venous system thrombosis after bariatric surgery: A systematic review and meta-analysis. Surgery 2021; 170:363-372. [PMID: 33875250 DOI: 10.1016/j.surg.2021.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/10/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Portal venous system thrombosis can develop after bariatric surgery. A systematic review and meta-analysis was conducted to evaluate the incidence of portal venous system thrombosis after bariatric surgery and clarify the role of anticoagulation for the prevention of portal venous system thrombosis after bariatric surgery. METHODS PubMed, EMBASE, and Cochrane Library databases were searched. The incidence of portal venous system thrombosis after bariatric surgery was pooled by a random-effect model. Subgroup analyses were performed to explore the incidence of portal venous system thrombosis according to the average duration of prophylactic anticoagulation (extended versus short-term). Meta-regression and sensitivity analyses were performed to explore the source of heterogeneity. RESULTS Among 2,714 papers initially screened, 68 studies were included. Among 100,964 patients undergoing bariatric surgery, 300 developed portal venous system thrombosis. The pooled overall incidence of portal venous system thrombosis after bariatric surgery was 0.419% (95% confidence interval: 0.341%-0.505%). The pooled incidence of portal venous system thrombosis after bariatric surgery was numerically lower in patients who received extended prophylactic anticoagulation protocol after bariatric surgery than those who received short-term prophylactic anticoagulation protocol (0.184% vs 0.459%). Meta-regression analyses demonstrated that sample size (P = .006), type of surgery (P < .001), and average duration of prophylactic anticoagulation (P = .024) might be sources of heterogeneity, but not region, publication year, history of bariatric surgery, follow-up duration, or use of prophylactic anticoagulation. Sensitivity analyses could not identify any source of heterogeneity. The estimated mortality of portal venous system thrombosis after bariatric surgery was 1.33%. CONCLUSION Portal venous system thrombosis after bariatric surgery is rare, but potentially lethal. Extended prophylactic anticoagulation protocol may be considered in patients at a high risk of developing portal venous system thrombosis after bariatric surgery.
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Affiliation(s)
- Li Luo
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China; Postgraduate College, Jinzhou Medical University, Jinzhou, China
| | - Hongyu Li
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China
| | - Yanyan Wu
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China
| | - Zhaohui Bai
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China
| | - Xiangbo Xu
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China
| | - Le Wang
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China
| | - Nahum Mendez-Sanchez
- Liver Research Unit, Medica Sur Clinic & Foundation, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Xingshun Qi
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China.
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10
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El-Abd R, Al-Sabah S. Quality of Life and Bariatric Surgery. LAPAROSCOPIC SLEEVE GASTRECTOMY 2021:403-408. [DOI: 10.1007/978-3-030-57373-7_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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11
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Çalışır S, Çalışır A, Arslan M, İnanlı İ, Çalışkan AM, Eren İ. Assessment of depressive symptoms, self-esteem, and eating psychopathology after laparoscopic sleeve gastrectomy: 1-year follow-up and comparison with healthy controls. Eat Weight Disord 2020; 25:1515-1523. [PMID: 31576497 DOI: 10.1007/s40519-019-00785-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 09/21/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of this study was to assess depressive symptoms, self-esteem, and eating psychopathology in bariatric surgery patients at the preoperative period (t0) and at the 6-month (t1) and 12-month (t2) follow-ups after laparoscopic sleeve gastrectomy (LSG). A second aim was to investigate associations between these variables and weight loss. METHOD The study participants were 48 bariatric surgery candidates and 50 non-obese controls. Both groups underwent assessment with the Sociodemographic Data Form, Hamilton Depression Rating Scale (HDRS), Eating Disorder Examination Questionnaire (EDE-Q), and Rosenberg Self-esteem Scale (RSES). These assessments were repeated for the patient group at t1 and t2. RESULTS The HDRS, RSES, and EDE-Q scores were higher in the patients before LSG (t0) than in the control group. A significant progressive improvement was identified in the patient HDRS and RSES scores as well as EDE-Q weight and shape subscale scores at t1 and t2. However, the patient EDE-Q total and dietary restraint scores improved at t1 then stabilized. The patient EDE-Q eating concern subscale improved at t1, but then worsened. The patient HDRS scores at t2 were similar to the control group, but the EDE-Q and RSES scores were still higher than the control scores at t2. Regression analyses revealed no association between the preoperative scores and percent changes in postoperative scores for any scale and patient weight loss at t2. CONCLUSION Depressive symptoms, self-esteem, and eating psychopathology showed an improving trend in patients after LSG. However, some aspects of eating psychopathology worsened despite an initial improvement. LEVEL OF EVIDENCE III, prospective cohort and case-control study.
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Affiliation(s)
- Saliha Çalışır
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Akın Çalışır
- Department of General Surgery, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Mehmet Arslan
- Department of Psychiatry, Babaeski State Hospital, 39200, Kırklareli, Turkey.
| | - İkbal İnanlı
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Ali Metehan Çalışkan
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - İbrahim Eren
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
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12
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Nocca D, Picot MC, Donici I, Emungania O, Jaussent A, Akouete S, Robert A, Nedelcu M, Nedelcu A. Evaluating the impact of the antrum size following laparoscopic sleeve gastrectomy: a randomized multicenter study. Surg Obes Relat Dis 2020; 16:1731-1736. [DOI: 10.1016/j.soard.2020.06.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/14/2020] [Accepted: 06/23/2020] [Indexed: 01/26/2023]
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Abstract
The aim of this study was to evaluate healthy lifestyle behaviors and the quality of life of obese individuals in 3-12 months after sleeve gastrectomy. The study is a descriptive design and was conducted at the obesity surgery outpatient clinic of a government hospital between May and December 2017. The study sample included 172 patients agreeing to participate. Data were gathered with a questionnaire composed of questions about sociodemographic features, the Health Promoting Lifestyle Profile II (HPLP II), and the WHO Quality of Life BREF-TR (WHOQOL-BREF-TR). The total HPLP II score was above average; participants had the highest and lowest scores for the subscales spiritual growth and physical activity, respectively. The total score for the WHOQOL-BREF-TR was above average. The highest and lowest scores were obtained for the subscales psychological health and social relations, respectively. There was a significant correlation between the scores for HPLP II and its subscales and the scores for WHOQOL-BREF-TR. Promotion of health and a healthy lifestyle need to be an integral part of health services provided for patients after sleeve gastrectomy.
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14
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Noel P, Eddbali I, Manos T, Nedelcu M, Nedelcu A. Laparoscopic Banded Resleeve Gastrectomy. J Laparoendosc Adv Surg Tech A 2020; 30:912-914. [PMID: 32634342 DOI: 10.1089/lap.2020.0367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: The recurrence of the morbid obesity disease after laparoscopic sleeve gastrectomy is a well-known complication. The banded resleeve gastrectomy (ReSG) is considered an innovative procedure and an alternative restrictive option to other malabsorptive procedures. Materials and Methods: We present an edited video on the placement of a MIDCAL™ (MID, Dardilly, France) ring during a revised sleeve gastrectomy with the main steps of the procedure. The subject is a male patient with a body mass index of 44 kg/m2. After the fundus resection, the MIDCAL is placed and fixed to the stomach by two sutures. Results: We present the steps of the operation. The intervention is performed by posterior approach using a three-port technique. The dissection of the previous staple line of the sleeve was continued upward with the visualization of the left crura. The gastric tube was calibrated with a 36F bougie. The restapling of the previous sleeve was carried out by respecting the incisura angularis. The dissection of the pars flaccida allowed the posterior passage of the MIDCAL ring, which was locked and then fixed to the gastric wall with two nonabsorbable sutures. The operative outcome was favorable. The total body weight loss was 9% at 1 month and 27% at 2 years follow-up. Conclusion: Banded ReSG is a safe procedure with acceptable results at short term. Other comparative studies are suitable to provide with long-term follow-up results.
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Affiliation(s)
- Patrick Noel
- Mediclinic Parkview Hospital, Dubai, United Arab Emirates.,ELSAN, Clinique Bouchard, Marseille, France
| | - Imane Eddbali
- Emirates Specialty Hospital, Dubai, United Arab Emirates
| | | | - Marius Nedelcu
- ELSAN, Clinique Bouchard, Marseille, France.,ELSAN, Clinique Saint Michel, Centre Chirurgical de l'Obesite, Toulon, France
| | - Anamaria Nedelcu
- ELSAN, Clinique Saint Michel, Centre Chirurgical de l'Obesite, Toulon, France
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15
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Palermo M, Serra E, Duza G. N-SLEEVE GASTRECTOMY: AN OPTION FOR OBESITY AND GERD. ACTA ACUST UNITED AC 2019; 32:e1482. [PMID: 31859934 PMCID: PMC6918749 DOI: 10.1590/0102-672020190001e1482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/01/2019] [Indexed: 12/15/2022]
Abstract
Background: Obesity represents a growing threat to population health all over the world. Laparoscopic sleeve gastrectomy induces alteration of the esophagogastric angle due to surgery itself, hypotony of the lower esophageal sphincter after division of muscular sling fibers, decrease of the gastric volume and, consequently, increase of intragastric pressure; that’s why some patients have reflux after sleeve. Aim: To describe a technique and preliminary results of sleeve gastrectomy with a Nissen fundoplication, in order to decrease reflux after sleeve. Method: In the current article we describe the technique step by step mostly focused on the creation of the wrap and it care. Results: This procedure was applied in a case of 45 BMI female of 53 years old, with GERD. An endoscopy was done demonstrating a hiatal hernia, and five benign polyps. A Nissen sleeve was performed due to its GERD, hiatal hernia and multiple polyps on the stomach. She tolerated well the procedure and was discharged home uneventfully 48 h after. Conclusion: N-sleeve is a feasible and safe alternative in obese patients with reflux and hiatal hernia when Roux-en-Y gastric bypass it is not indicated.
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Affiliation(s)
- Mariano Palermo
- Division of Bariatric Surgery, Centro CIEN - DIAGNOMED, Affiliated to the University of Buenos Aires, Buenos Aires, Argentina
| | - Edgardo Serra
- Division of Bariatric Surgery, Centro CIEN - DIAGNOMED, Affiliated to the University of Buenos Aires, Buenos Aires, Argentina
| | - Guillermo Duza
- Division of Bariatric Surgery, Centro CIEN - DIAGNOMED, Affiliated to the University of Buenos Aires, Buenos Aires, Argentina
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16
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Le Foll D, Lechaux D, Rascle O, Cabagno G. Weight loss and quality of life after bariatric surgery: a 2-year longitudinal study. Surg Obes Relat Dis 2019; 16:56-64. [PMID: 31753793 DOI: 10.1016/j.soard.2019.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bariatric surgery is currently recognized as being an effective technique for weight loss and the improvement of patients' postoperative well-being. OBJECTIVES The objective of the study was to measure changes in quality of life (QoL) and body mass index (BMI) according to patients' sex and 2 types of surgical procedures. SETTING Longitudinal cohort study using an online platform from a private hospital in West France. METHODS Two hundred six patients (38 men and 168 women) undergoing one-anastomosis gastric bypass or sleeve gastrectomy surgery provided online information concerning their QoL and weight both before the operation and then every 3 months over a postoperative period of 24 months. RESULTS BMI clinically decreased on average by 19.6% in the first 3 months and up to 39.2% 24 months after surgery. Slight differences between men and women appeared as from 18 months after the operation, with men experiencing increased BMI between 18 and 24 months, contrary to women whose BMI remained unchanged during the same period. QoL also improved significantly. The average level of women's quality of life increased between 3 and 15 months after surgery, then decreased between 15 and 24 months. As for men, no change was observed in their improved QoL between 3 and 24 months after the operation. CONCLUSIONS This study highlights the importance of optimizing patients' monitoring, notably around 15 to 18 months after bariatric surgery. This period can be identified as a first "critical" period during which weight regain (especially for men) and diminished self-perceived quality of life (especially for women) appear.
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Affiliation(s)
- David Le Foll
- Department of Sports Sciences, University of Rennes, Rennes, France.
| | | | - Olivier Rascle
- Department of Sports Sciences, University of Rennes, Rennes, France
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Felsenreich DM, Prager G, Kefurt R, Eilenberg M, Jedamzik J, Beckerhinn P, Bichler C, Sperker C, Krebs M, Langer FB. Quality of Life 10 Years after Sleeve Gastrectomy: A Multicenter Study. Obes Facts 2019; 12:157-166. [PMID: 30879011 PMCID: PMC6547272 DOI: 10.1159/000496296] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/17/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Sleeve gastrectomy (SG) has recently become the most commonly applied bariatric procedure worldwide. Substantial regaining of weight or severe reflux might compromise quality of life (QOL) after SG in the long-term follow-up. Long-term data on patients' QOL is limited, even though the persistent improvement in QOL is one of the aims of bariatric surgery. The objective of this study was to present patients' QOL 10 years after SG. METHODS Of 65 SG patients with a follow-up of ≥10 years after SG who were asked to fill out the Bariatric Quality of Life Index (BQL) and Short Form 36 (SF36) questionnaires, 48 (74%) completed them. This multicenter study was performed in a university hospital setting in Austria. RESULTS The BQL score revealed nonsignificant differences between the patients with > 50% or < 50% excess weight loss (EWL). It did show significant differences between patients with and without any symptoms of reflux. Patients with < 50% EWL scored significantly lower in 3/8 categories of SF36. Patients suffering from reflux had significantly lower scores in all categories. CONCLUSIONS EWL and symptomatic reflux impair patients' long-term QOL after SG.
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Affiliation(s)
| | - Gerhard Prager
- Division of General Surgery, Department of Surgery, Vienna Medical University, Vienna, Austria,
| | - Ronald Kefurt
- Division of General Surgery, Department of Surgery, Vienna Medical University, Vienna, Austria
| | - Magdalena Eilenberg
- Division of General Surgery, Department of Surgery, Vienna Medical University, Vienna, Austria
| | - Julia Jedamzik
- Division of General Surgery, Department of Surgery, Vienna Medical University, Vienna, Austria
| | | | - Christoph Bichler
- Division of General Surgery, Department of Surgery, Vienna Medical University, Vienna, Austria
| | | | - Michael Krebs
- Division of Endocrinology, Department of Internal Medicine, Vienna Medical University, Vienna, Austria
| | - Felix Benedikt Langer
- Division of General Surgery, Department of Surgery, Vienna Medical University, Vienna, Austria
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18
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Al Khalifa K, Al Ansari A. Quality of life, food tolerance, and eating disorder behavior after laparoscopic gastric banding and sleeve gastrectomy - results from a middle eastern center of excellence. BMC OBESITY 2018; 5:44. [PMID: 30607252 PMCID: PMC6307176 DOI: 10.1186/s40608-018-0220-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/06/2018] [Indexed: 01/02/2023]
Abstract
Background Obesity is a major health problem in Arab countries. Bariatric surgery can improve the quality of life of an obese individual. However, different types of bariatric surgery result in varying levels of food intolerance as a side effect. Many patients who undergo bariatric surgery are also at risk of subsequently developing eating disorder behaviors. The aim of the study was to compare the quality of life, food tolerance, and behaviors of eating disorders related to laparoscopic sleeve gastrectomy and gastric banding. Methods A retrospective review of medical records and a questionnaire-based survey was completed for all patients who had undergone either bariatric sleeve gastrectomy or gastric banding at the Bahrain Defense Force Hospital between 2011 and 2014. Each patient was administered 3 questionnaires to assess the quality of life, food tolerance, and eating disorder behaviors. Results Forty-eight patients who had undergone sleeve gastrectomy and 36 who had undergone gastric banding participated in the study. Sleeve gastrectomy patients showed better food tolerance (P < 0.001) and better eating behaviors (P = 0.001) post-surgery compared with gastric banding patients. Health-related quality of life (HRQOL) did not differ significantly between the 2 groups. Only sleeve patients had preoperative evaluation of these parameters (HRQOL). However, in the gastric sleeve group, after the surgery, significant improvement was found in all parameters of HRQOL except for mental health status. Conclusion Laparoscopic gastric sleeve surgery patients had superior outcomes in both food tolerance and eating disorder behaviors. The quality of life did not significantly differ between the gastric sleeve and gastric banding surgery groups.
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Affiliation(s)
- Khalid Al Khalifa
- Department of General Surgery, Bahrain Defence Force Hospital, P. O. Box - 28743, Riffa, Bahrain
| | - Ahmed Al Ansari
- Training and Education Department, Bahrain Defence Force Hospital, Off Waly Alahed Avenue, West Riffa, P. O. Box - 28743, Riffa, Bahrain
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19
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Saliba C, El Rayes J, Diab S, Nicolas G, Wakim R. Weight Regain After Sleeve Gastrectomy: A Look at the Benefits of Re-sleeve. Cureus 2018; 10:e3450. [PMID: 30564529 PMCID: PMC6298623 DOI: 10.7759/cureus.3450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introduction Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed weight loss procedures due to its simpler technique and lower complication rate as compared to the Roux-en-Y gastric bypass and duodenal switch. However, weight regain is seen in patients with a large gastric fundus. In these cases, a revision laparoscopic sleeve gastrectomy (reLSG) aiming at resecting the excess pouch is a promising option for correction. Methods From April 2013 to March 2016, six patients underwent a reLSG for a failure of weight loss after the demonstration of a large gastric fundus on the upper gastrointestinal (UGI) series. Results One patient out of six (16.7%) suffered from a gastric leak and was lost to subsequent follow-up. The rest (83.3%) had a smooth recovery and were followed up for a mean of 18 months. Mean excess weight loss (EWL) was 68%, with a minimum of 48% and a maximum of 75%. Conclusion reLSG is a promising option for failed weight loss after LSG in patients who demonstrate the presence of a large gastric pouch. It carries a higher complication rate than the initial procedure. Further trials and meta-analyses are needed to prove the efficacy of this procedure.
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Affiliation(s)
- Christian Saliba
- General Surgery, Lebanese American University-Medical Center, Beirut, LBN
| | | | - Samer Diab
- General Surgery, Lebanese American University-Medical Center, Beirut, LBN
| | - Gregory Nicolas
- General Surgery, Lebanese American University-Medical Center, Beirut, LBN
| | - Raja Wakim
- General Surgery, Mount Lebanon Hospital, Beirut, LBN
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20
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Noel P, Nedelcu AM, Eddbali I, Zundel N. Laparoscopic vertical clip gastroplasty – quality of life. Surg Obes Relat Dis 2018; 14:1587-1593. [PMID: 30449515 DOI: 10.1016/j.soard.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/08/2018] [Accepted: 07/16/2018] [Indexed: 02/07/2023]
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Charalampakis V, Seretis C, Daskalakis M, Fokoloros C, Karim A, Melissas J. The effect of laparoscopic sleeve gastrectomy on quality of life: A prospective cohort study with 5-years follow-up. Surg Obes Relat Dis 2018; 14:1652-1658. [PMID: 30072237 DOI: 10.1016/j.soard.2018.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/05/2018] [Accepted: 06/17/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obesity has a negative effect on quality of life (QoL). Bariatric surgery results in significant weight loss with improvement of QoL. Very few studies have evaluated QoL after sleeve gastrectomy (SG), especially with a long-term follow-up. OBJECTIVES To assess long-term longitudinal changes of QoL of a laparoscopic SG cohort, with the obesity specific Moorehead-Ardelt II questionnaire (MAII) and to identify parameters associated with QoL outcome. SETTING Bariatric Unit, University Hospital of Heraklion, Greece. METHODS Morbidly obese patients admitted for laparoscopic SG over a 30-month period were prospectively studied. QoL was assessed using the Greek version of the MAII questionnaire and a visual analog scale preoperatively and at 6, 12, 24, and 60 months postoperatively. Anthropometric data and obesity-related co-morbidities were recorded. RESULTS A total of 95 patients with mean age of 37.4 ± 9.2 years and body mass index of 48.3 ± 7.1 kg/m2 completed the 5-year follow-up. Percentage excess body mass index loss was 51.7 ± 14.2, 64.8 ± 16.9, 67.4 ± 17.7, and 55.8 ± 25.5 at 6, 12, 24, and 60 months, respectively. All obesity-related co-morbidities improved significantly. MAII score increased from -.38 ± 1.3 preoperatively to 1.77 ± .8, 2.08 ± 0.8, 2.12 ± .7, and 1.67 ± 1.1 at the above time points, respectively (trend P < .001), and visual analog scale increased from 3.05 ± 1.6 to 9.11 ± 1.0, 9.2 ± 1.1, 9.03 ± 1.3, and 7.85 ± 2.4 (P < .001). Overall QoL scores at 6 and 24 months (P < .001), as well as patients' female sex, correlated significantly with higher QoL at the end of the study. CONCLUSIONS Laparoscopic SG is an effective bariatric operation, resulting in significant weight loss and improvements in QoL. Female sex and higher MAII score at 6 and 24 months predict better long-term QoL outcome.
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Affiliation(s)
- Vasileios Charalampakis
- Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece; Department of General Surgery, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom.
| | - Charalampos Seretis
- Department of General Surgery, George Elliot Hospital, Nuneaton, United Kingdom
| | - Markos Daskalakis
- Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece; Upper GI Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Christos Fokoloros
- Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece
| | - Ahmed Karim
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - John Melissas
- Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece
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Long-Term Results After Sleeve Gastrectomy for Gastroesophageal Reflux Disease: a Single-Center French Study. Obes Surg 2018; 27:2890-2897. [PMID: 28474318 DOI: 10.1007/s11695-017-2698-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Many studies have analyzed the impact of sleeve gastrectomy (SG) on weight loss and/or the evolution of obesity-related comorbid conditions, but few have reported the long-term outcomes after surgery. The objective of this study was to investigate the outcomes after SG on weight loss, obesity-related comorbid conditions, quality of life (QoL), and GERD symptoms (GERDS) beyond 5 years. METHODS A prospective database was retrospectively searched for the following factors: gender, age, anthropometrics, presence of comorbid conditions, QoL (BAROS questionnaire), and presence of GERDS. The data were analyzed before and at 1 and 6 years after surgery. RESULTS Of the 64 patients included, 32.8% were lost to follow-up (76% during the first postoperative year). A complete follow-up of >5 years was obtained for 41 patients. Before surgery, mean excess BMI was 22 ± 7 kg/m2, and 26.8% of patients had GERDS. Percent excess BMI loss was 55 ± 30% at 1 year and 48 ± 27% at 6 years. Preoperative BMI and absence of type 2 diabetes (T2D) before surgery were the only independent variables for long-term failure. Six years after SG, remission from metabolic comorbidities was as follows: 50% for T2D, 28% for blood hypertension, 58% for dyslipidemia, and 33% for sleep-apnea syndrome. Thirty percent of patients with preoperative GERD had resolution of symptoms at 6 years whereas 9 patients (32%) had de novo GERD. QoL was improved for 62% of patients at 6 years. CONCLUSION The benefits of SG on weight loss, resolution of comorbidities, and QoL were maintained in the long term for most patients.
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Ahmed HO. Pattern of changes in quality of life of obese patients after sleeve gastrectomy in Sulaimani provence -Kurdistan-Iraq, based on 4 years experience in two bariatric centers. Ann Med Surg (Lond) 2018; 26:9-14. [PMID: 29904608 PMCID: PMC5904781 DOI: 10.1016/j.amsu.2017.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/29/2017] [Accepted: 12/12/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obesity influences all aspects of the life of obese patients physically, psychologically, socially and monetarily, it is not only a disease but rather a beginning point of a group of ailments and inabilities, which gradually impacts and changes all aspects of their life. OBJECTIVES The changes in the Quality of life in respect to the amount of access weight lost after sleeve gastrectomy. PATIENTS MATERIALS AND METHODS A prospective longitudinal study evaluating 40 female patients who underwent laparoscopic sleeve gastrectomy within 4 years, starting from July 4th, 2012 up to July 5th, 2016. RESULTS More than three-quarter of the patients were not satisfied with their body before their operation, but six to twelve months after their weight loss; (N = 36, 90%) of them were satisfied with their new body image. Half of the patients were unhappy before their operation, but twelve months later (N = 31, 77.5%) of them became much happier. Regarding satisfaction with the body image, noticeable improvement occurred since (N = 36, 90%) of them were satisfied with their new body image. While, most of them have had low self-esteem and (N 27, 67.5%) of the patients had no self-esteem at all, 12 months after the operation (N = 35, 87.5%) felt great improvement in their self-esteem (p-value = .040). A significant decrease in appetite was noticed in (N = 39, 97.5%) of the patients after 12 months. CONCLUSION Significant changes in the parallel pattern to the extent of EWL were noticed in the quality of life of morbidly obese patients after laparoscopic sleeve gastrectomy.
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Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed bariatric procedures, largely due to several advantages it carries over more complex bariatric procedures. LSG is generally considered a straightforward procedure, but one of the major concerns is a staple line leak. OBJECTIVE The objectives of this study are to evaluate the correlation between surgeon's experience and leak rate and to assess the different risk factors for developing a gastric leak after LSG. SETTING Private hospital, France. METHODS The analysis of a single surgeon's yearly leak rate since the introduction of LSG for possible risk factors was done. RESULTS A total of 2012 LSGs were performed in between September, 2005 and December, 2014. Twenty cases (1 %) of gastric leak were recorded. Of these, 17 patients were women (94.4 %) with a mean age of 39.4 years (range 22-61) and mean body mass index (BMI) 41.2 kg/m(2) (range 34.8-57.1). On a yearly basis, the leak rate was 4.8 % (2006), 5.7 % (2007), 0 (2008), 2.6 % (2009), 2 % (2010), 0.8 % (2011), 0.6 % (2012), 0.2 % (2013), and 0 (2014). In the first 1000 cases (group A), there were 18 cases of gastric leak and in the last 1000 cases, there were 800 with GORE® SEAMGUARD® Bioabsorbable Staple Line Reinforcement (group B) 2 cases of gastric leak (p = 0.009). A revisional LSG, 395 patients after gastric banding and 61 patients re-sleeve gastrectomy, was performed in 456 cases (22.7 %). There were 3 cases of leak (0.65 %). There were two deaths. CONCLUSION LSG can be performed with a low complication rate. This large series of a single surgeon's experience demonstrated that the leak rate after LSG could be significantly decreased over time with changes in techniques.
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Gallart-Aragón T, Fernández-Lao C, Galiano-Castillo N, Cantarero-Villanueva I, Lozano-Lozano M, Arroyo-Morales M. Improvements in Health-Related Quality of Life and Pain: A Cohort Study in Obese Patients After Laparoscopic Sleeve Gastrectomy. J Laparoendosc Adv Surg Tech A 2017; 28:53-57. [PMID: 28850292 DOI: 10.1089/lap.2017.0415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The principal aim of the study was to investigate the effect of the sleeve gastrectomy (SG) in the quality of life (QoL) and pain in a population of morbidly obese patients. METHODS Seventy-two SG patients were assessed in this descriptive observational study, before the surgery and 6 months after that. We evaluated health-related QoL (Gastrointestinal Quality of Life Index [GIQLI]) and pain (spontaneous low back pain by Numerical Point Rate Scale [NPRS] and pressure pain thresholds [PPTs]). RESULTS The results of the analysis of variance (ANOVA) revealed significant improvements in nearly all of the subscales of GIQLI questionnaire after 6 months: gastrointestinal symptoms (P = .01), physical well-being (P < .001), social well-being (P = .03), and total GIQLI score (P < .001), but not for the emotional condition (P = .20). Patients also had improvements in spontaneous low back pain (P = .002), but not in the PPTs in all the body areas explored, including the cervical area, low back, and hands (P > .05). CONCLUSION Patients receiving SG improved their health-related QoL and low back pain 6 months after the intervention, but this improvement was not so important for pressure pain thresholds in different body areas.
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Affiliation(s)
| | - Carolina Fernández-Lao
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
| | - Noelia Galiano-Castillo
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
| | - Irene Cantarero-Villanueva
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
| | | | - Manuel Arroyo-Morales
- 2 Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada , Granada, Spain
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Elrefai M, Hasenberg T, Diouf S, Weiß C, Kienle P, Otto M. Quality of Life After Bariatric Surgery: Comparison of Four Different Surgical Procedures. Bariatr Surg Pract Patient Care 2017. [DOI: 10.1089/bari.2016.0050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Mohamad Elrefai
- Department of Surgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
- Surgery Department, Gastro-enterology Surgical Center, Mansoura University, Mansoura, Egypt
| | - Till Hasenberg
- Alfried Krupp Krankenhaus, Department of Surgery, Essen, Germany
| | - Stefanie Diouf
- Department of Surgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Christel Weiß
- Department of Medical Statistics, Biomathematics and Information Processing, Heidelberg University, Mannheim, Germany
| | - Peter Kienle
- Department of Surgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Mirko Otto
- Department of Surgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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Nedelcu M, Noel P. Ring-banded sleeve gastrectomies: can we prevent the dilation? Surg Obes Relat Dis 2017; 13:1265. [PMID: 28528710 DOI: 10.1016/j.soard.2017.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 04/07/2017] [Accepted: 04/07/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Marius Nedelcu
- Clinique Saint Michel-Centre Chirurgical de l'Obesite, Toulon, France
| | - Patrick Noel
- Clinique Saint Michel-Centre Chirurgical de l'Obesite, Toulon, France; The American Surgecenter, Abu Dhabi, United Arab Emirates
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Noel P, Nedelcu M, Eddbali I, Manos T, Gagner M. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis 2017; 13:1110-1115. [PMID: 28755888 DOI: 10.1016/j.soard.2017.03.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/25/2017] [Accepted: 03/08/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) became the most frequent bariatric procedure performed in France (2011) and in the United States (2013), but studies reporting long-term results are still rare. SETTING Private hospital, France. METHODS This is a retrospective analysis of a prospective cohort of 168 patients who underwent LSG between 2005 and 2008. The objective of this study was to present the 8-year outcome concerning weight loss, modification of co-morbidities, and to report the revisional surgery after sleeve. RESULTS The preoperative mean body mass index was 42.8 kg/m2 (31.1-77.9), 35 patients were super obese, and 64 patients had a previous gastric band. For LSG as a definitive bariatric procedure, 8 years of follow-up data were available for 116 patients (follow-up: 69%). Of the remainder, 23 patients underwent revisional surgery and 29 were lost to follow-up. For the entire cohort, the mean excess weight loss (EWL) was 76% (0-149) at 5 years and 67% (4-135) at 8 years, respectively. Of the 116 patients with 8 years of follow-up, 82 patients had>50% EWL at 8 years (70.7%). Percentages of co-morbidities resolved were hypertension, 59.4%; type 2 diabetes, 43.4%; and obstructive sleep apnea, 72.4%. Twenty-three patients had revisional surgery for weight regain (n = 14) or for severe reflux (n = 9) at a mean period of 50 months (9-96). Twelve patients underwent resleeve gastrectomy, 6 patients underwent conversion to a bypass, and 5 patients to duodenal switch (1 single anastomosis duodeno-ileostomy). A total of 31% of patients reported gastroesophageal reflux symptoms at 8 years. CONCLUSIONS At 8 years postoperatively, the LSG as a definitive bariatric procedure remained effective for 59% of cases. The results appear to be more favorable especially for the non-super-obese patients and primary procedures. LSG is a well-tolerated bariatric procedure with low long-term complication rates.
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Affiliation(s)
- Patrick Noel
- The American Surgecenter, Abu Dhabi, United Arab Emirates
| | - Marius Nedelcu
- Centre Chirurgical de l'Obesite, Clinique Saint Michel, Toulon, France; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
| | - Imane Eddbali
- The American Surgecenter, Abu Dhabi, United Arab Emirates
| | | | - Michel Gagner
- Professor of surgery, Sacre Cœur Hospital, Montreal, Canada
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Peterhänsel C, Nagl M, Wagner B, Dietrich A, Kersting A. Predictors of Changes in Health-Related Quality of Life 6 and 12 months After a Bariatric Procedure. Obes Surg 2017; 27:2120-2128. [DOI: 10.1007/s11695-017-2617-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ramada Faria GF, Nunes Santos JM, Simonson DC. Quality of life after gastric sleeve and gastric bypass for morbid obesity. Porto Biomed J 2017; 2:40-46. [PMID: 32258584 DOI: 10.1016/j.pbj.2016.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/21/2016] [Indexed: 01/20/2023] Open
Abstract
Highlights Quality-of-life measures improve as early as 3 months after bariatric surgery.There is wide variability in reporting that renders direct comparisons difficult.The available comparisons between RYGB and sleeve gastrectomy could not detect any difference.Improvement in PRO measures might be related to weight loss.Larger and better designed studies are required to achieve discrimination in PRO measures. Background Obesity is associated with reduced quality-of-life (QoL), which generally improves after bariatric surgery. The differential effect of each type of surgery (gastric sleeve [SG] and gastric bypass [RYGB]) on QoL is not yet fully understood. Objectives To understand which of these surgeries offers greatest improvement in QoL and patient satisfaction. Methods Systematic literature search on Pubmed in July 2014. Relevant articles were selected in a step-wise approach. The 2482 titles were scanned for relevance and 191 were selected for abstract reviewing; and 88 papers were selected for full text analysis. Results Only 5 papers compared the 2 techniques and only 17 more had retrievable data either on SG or RYGB. The reports were very heterogeneous, preventing a direct comparison of patient reported outcomes (PRO) among studies.Improved results have been reported as early has 3 months and SF-36 scores were improved in all domains in medium to long-term. The question remains whether the improvement in QoL is related to the weight loss and which factors are associated with improved patients' perceptions. Conclusions There is wide heterogeneity in the reporting of PRO measures after bariatric surgery, but data is consistent with a significant improvement after both surgeries.Larger and better-designed studies are required to understand if there are significant differences in the quality of life after SG or RYGB.
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Affiliation(s)
- Gil Filipe Ramada Faria
- Department of Surgery, Unidade de Investigação em Cirurgia Digestiva e Metabólica, Centro Hospitalar do Porto, Hospital de Sto António, Portugal.,Center for Health Technology and Services Research (CINTESIS), Instituto de Ciências Biomédicas de Abel Salazar, Portugal
| | - Jorge Manuel Nunes Santos
- Department of Surgery, Unidade de Investigação em Cirurgia Digestiva e Metabólica, Centro Hospitalar do Porto, Hospital de Sto António, Portugal.,Instituto de Ciências Biomédicas de Abel Salazar, Portugal
| | - Donald C Simonson
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, United States
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Bužgová R, Bužga M, Holéczy P, Zonča P. Evaluation of Quality of Life, Clinical Parameters, and Psychological Distress after Bariatric Surgery: Comparison of the Laparoscopic Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Radka Bužgová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Marek Bužga
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Pavol Holéczy
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Pavel Zonča
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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Quality of life and bariatric surgery: a systematic review of short- and long-term results and comparison with community norms. Eur J Clin Nutr 2016; 71:441-449. [PMID: 27804961 DOI: 10.1038/ejcn.2016.198] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/27/2016] [Accepted: 08/04/2016] [Indexed: 12/28/2022]
Abstract
Currently the effects of bariatric surgery are generally expressed in excess weight loss or comorbidity reduction. Therefore the aim of this review was to provide insight in the available prospective evidence regarding the short and long-term effects of bariatric surgery on Quality of Life (QoL) and a comparison with community norms. A systematic multi-database search was conducted for 'QoL' and 'Bariatric surgery'. Only prospective studies with QoL before and after bariatric surgery were included. The 'Quality Assessment Tool for Before-After Studies with No Control Group' was used to assess the methodological quality. Thirty-six studies met the inclusion criteria. Most studies were assessed to be of 'fair' to 'good' methodological quality. Ten different questionnaires were used to measure QoL. Follow-up ranged from 6 months to 10 years, sample sizes from 26 to 1276 and follow-up rates from 45 to 100%. A significant increase in QoL after bariatric surgery was found in all studies (P⩽0.05), however, mostly these outcomes stay below community norms. Only outcomes of the IWQoL, SF-36 and OWQoL show QoL outcomes that exceed community norms. The QoL is increased after bariatric surgery on both the short and long term. However, due to the heterogeneity of the studies and the generality of the questionnaires is it hard to make a distinction between different surgeries and difficult to see a relation with medical profit. Therefore, tailoring QoL measurements to the bariatric population is recommended as the focus of future studies.
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Nedelcu M, Eddbali I, Noel P. Three-port sleeve gastrectomy: complete posterior approach. Surg Obes Relat Dis 2016; 12:925-927. [DOI: 10.1016/j.soard.2015.12.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 12/24/2015] [Accepted: 12/28/2015] [Indexed: 01/24/2023]
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Alvarenga ES, Lo Menzo E, Szomstein S, Rosenthal RJ. Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surg Endosc 2015; 30:2673-8. [DOI: 10.1007/s00464-015-4548-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 09/01/2015] [Indexed: 12/19/2022]
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Efthymiou V, Hyphantis T, Karaivazoglou K, Gourzis P, Alexandrides TK, Kalfarentzos F, Assimakopoulos K. The effect of bariatric surgery on patient HRQOL and sexual health during a 1-year postoperative period. Obes Surg 2015; 25:310-8. [PMID: 25085222 DOI: 10.1007/s11695-014-1384-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Negative consequences of the obesity epidemic include decreased physical, psychological, and sexual health. Bariatric surgery is a well-tolerated and effective treatment for morbid obesity. This study aimed to determine the effect of bariatric surgery on health-related quality of life (HRQOL) and sexual functioning and to identify potential predictors of this effect. METHODS Eighty morbidly obese patients (50 women) completed the study. HRQOL was measured using the Short Form 36 questionnaire (SF-36). Sexual functioning was assessed using the Female Sexual Functioning Index (FSFI) and the International Index of Erectile Function (IIEF). All participants were evaluated four times as follows: presurgery (T1), 1 month (T2), 6 months (T3), and 1 year (T4) after surgery. RESULTS Body mass index (BMI) significantly decreased over time (p < 0.001). Apart from male orgasm, all sexual functioning components as well as all SF-36 sub-scales improved between T1 and T4. The maximum improvement was observed between T2 and T3. Baseline HRQOL scores correlated with postoperative improvement in all HRQOL components. BMI improvement was correlated with improvement in role physical, bodily pain, and mental health scores. Baseline total sexual satisfaction score independently predicted total satisfaction improvement in both genders. CONCLUSIONS The present findings indicate that bariatric surgery represents an effective obesity treatment, leading to significant BMI reduction and improvement in HRQOL and sexual functioning, especially in the first 6 months postoperatively.
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Affiliation(s)
- Vasileios Efthymiou
- Department of Endocrinology, University of Patras, Medical School, Rion, Patras, Greece
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Lao WL, Malone DC, Armstrong EP, Voellinger D, Somers S, Jin J, Dreyer N, Globe D. Effect of adjustable gastric banding on quality of life and weight loss in the Helping Evaluate Reduction in Obesity (HERO) registry study: 2 year analysis. Curr Med Res Opin 2015; 31:1451-60. [PMID: 26154653 DOI: 10.1185/03007995.2015.1059802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This report from the Helping Evaluate Reduction in Obesity (HERO) Study investigated weight loss, health-related quality of life (HRQOL), and factors predictive of HRQOL improvement during a 2 year period following Lap-Band AP implantation (post-LBAP). RESEARCH DESIGN AND METHODS This prospective, observational study included patients with 1 and 2 year follow-up data post-LBAP (N = 585). Changes in body mass index (BMI), percentage of weight loss (%WL), excess weight loss (%EWL) and HRQOL (Impact of Weight on Quality of Life [IWQOL]-Lite measure), and differences between <30% EWL and ≥30% EWL subgroups were assessed at 1 and 2 years post-LBAP. Multiple linear regression examined association of %EWL groups with IWQOL-Lite scores controlling for age, gender, region (US vs outside US), household income, employment status, and comorbidities. RESULTS Most patients were female (80.2%) and from the US (64.8%); overall mean (SD) age was 43.6 (11.28) years and 65.8% of patients had ≥30% EWL at year 2. At 2 years post-LBAP, mean %EWL was 43.5%; %EWL was 12.4% in the <30% EWL group and 59.6% in ≥30% EWL group (P ≤ 0.0001). Changes in IWQOL total and subscores were significantly greater in ≥30% EWL versus <30% EWL patients (all P < 0.0005) at years 1 and 2; Self-Esteem and Physical subscores had the largest changes. Multiple regression analysis showed that patients with ≥30% EWL had clinically meaningful improvements in HRQOL compared with patients having <30% EWL (P ≤ 0.001). Similarly, US patients and females had a clinically significant change in IWQOL score versus their counterparts (P ≤ 0.001). Conversely, income, comorbidities and employment status were not significant predictors of change in IWQOL scores at year 2. CONCLUSIONS These results support and extend findings regarding the effectiveness of LBAP for weight loss and illustrate the importance of ≥30% EWL as a significant factor in predicting clinically significant improvement in HRQOL 1 and 2 years post-LBAP. CLINICAL TRIAL REGISTRATION NCT00953173.
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Affiliation(s)
- W-L Lao
- a a University of Arizona , Tucson , AZ , USA
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Lindekilde N, Gladstone BP, Lübeck M, Nielsen J, Clausen L, Vach W, Jones A. The impact of bariatric surgery on quality of life: a systematic review and meta-analysis. Obes Rev 2015; 16:639-51. [PMID: 26094664 DOI: 10.1111/obr.12294] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 12/13/2022]
Abstract
This study aims to review the obesity literature in order to assess the impact of bariatric surgery on quality of life and the between-study variation by examining the standardized mean magnitude of effect in change in the levels of quality of life. The following databases EMBASE, PubMed, PsycINFO, CINAHL, the Cochrane Library and Web of Science were systematically searched for studies examining change in quality of life in adults receiving bariatric surgery for obesity. Seventy-two studies were included with a total of 9,433 participants treated for obesity with bariatric surgery. The average impact of bariatric surgery on quality of life corresponded to an effect size of 0.88 (95% CI: 0.80-0.96), indicating that bariatric surgery has a significant positive influence on quality of life in general. The impact varied considerably across studies with bariatric surgery showing a significantly greater positive influence on physical quality of life compared to mental quality of life. Bariatric surgery is effective in improving quality of life, especially when looking at physical well-being. Greater focus on the psychological well-being of the person undergoing surgery for obesity may lead to a better post-surgery prognosis for more people.
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Affiliation(s)
- N Lindekilde
- Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - B P Gladstone
- Institute of Medical Biometry and Medical Informatics, University Medical Centre Freiburg, Freiburg im Breisgau, Germany
| | - M Lübeck
- Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - J Nielsen
- Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - L Clausen
- Centre of Child- and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - W Vach
- Institute of Medical Biometry and Medical Informatics, University Medical Centre Freiburg, Freiburg im Breisgau, Germany
| | - A Jones
- Institute of Psychology, University of Southern Denmark, Odense, Denmark
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Nedelcu M, Noel P, Iannelli A, Gagner M. Revised sleeve gastrectomy (re-sleeve). Surg Obes Relat Dis 2015; 11:1282-8. [PMID: 26048518 DOI: 10.1016/j.soard.2015.02.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/31/2015] [Accepted: 02/09/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) has rapidly become increasingly popular in bariatric surgery. However, in the long-term follow-up, weight loss failure and intractable severe reflux after primary LSG can necessitate further surgical interventions. OBJECTIVES To evaluate the safety and the efficiency of revisional sleeve gastrectomy (ReSG). SETTING Private hospital. METHODS From October 2008 to October 2014, 61 patients underwent ReSG. All patients with failure after primary LSG underwent radiologic evaluation, and an algorithm of treatment was proposed. RESULTS Sixty-one patients (54 women, 7 men; mean age 40.8 yr) with a body mass index (BMI) of 39.4 kg/m² underwent ReSG. The primary LSG was performed for mean BMI of 46.2 kg/m² (range 35.4-77.9). The mean interval time from the primary LSG to ReSG was of 37.5 months (9-80 mo). The indication for ReSG was insufficient weight loss in 28 patients (45.9%), weight regain in 29 patients (47.5%), and gastroesophageal reflux disease (GERD) in 4 patients. In 42 patients the gastrografin swallow results were interpreted as primary dilation and in the remaining 19 cases as secondary dilation. The computed tomography (CT) scan volumetry was obtained in 38 patients with mean gastric volume of 436.3 cc (275-1056 cc). All cases were completed by laparoscopy with no intraoperative incidents. The mean operative time was 39 minutes (range 29-70 min) and the mean hospital stay was 3.5 days (range 3-16 d). One perigastric hematoma and 2 cases of gastric stenosis were recorded. The mean BMI decreased to 29.2 kg/m(2) (range 20.2-37.5); the mean percentage of excess weight loss (%EWL) was 58.5% (±25.3) (P<.0004) for a mean follow-up of 20 months (range 6-56 mo). CONCLUSION The ReSG may be a valid option for failure of primary LSG. Further prospective clinical trials are required to compare the outcomes of ReSG with those of laparoscopic Roux-en-Y gastric bypass or duodenal switch for weight loss failure after LSG.
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Affiliation(s)
- Marius Nedelcu
- Hôpital Prive La Casamance, Aubagne, France; Centre Hospitalier Universitaire Strasbourg, France.
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Charalampakis V, Bertsias G, Lamprou V, de Bree E, Romanos J, Melissas J. Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study. Surg Obes Relat Dis 2015; 11:70-6. [DOI: 10.1016/j.soard.2014.04.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 03/31/2014] [Accepted: 04/15/2014] [Indexed: 12/19/2022]
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Brunault P, Frammery J, Couet C, Delbachian I, Bourbao-Tournois C, Objois M, Cosson P, Réveillère C, Ballon N. Predictors of changes in physical, psychosocial, sexual quality of life, and comfort with food after obesity surgery: a 12-month follow-up study. Qual Life Res 2014; 24:493-501. [PMID: 25113238 DOI: 10.1007/s11136-014-0775-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE Although obesity surgery provides significant postoperative improvement in quality of life (QoL), it is still unclear which factors might predict improvement in QoL after surgery. We aimed to determine which factors might predict changes in physical, psychosocial, sexual QoL, and comfort with food 12 months after surgery, by putting to the test a QoL model based on Wilson and Cleary's model. METHODS We included 126 obese patients (48.4% had gastric banding, 34.1% had sleeve gastrectomy, and 17.5% had gastric bypass). At baseline, we assessed QoL (Quality of Life, Obesity and Dietetics rating scale), BMI, depression (Beck Depression Inventory), and binge eating (Bulimic Investigatory Test, Edinburgh). At 12 months, we assessed QoL and BMI. To determine the predictors for changes in each QoL dimension after surgery, we used linear mixed models adjusted for preoperative age, BMI, time, type of surgery, preoperative binge eating severity, and preoperative depression severity. RESULTS After 12 months, we found significant improvement in physical, psychosocial, sexual QoL, but not in comfort with food. Increased weight loss was associated with better improvement in physical and psychosocial QoL. Higher preoperative depression severity predicted poorer improvement in physical, psychosocial, and sexual QoL. Higher preoperative binge eating severity predicted poorer improvement in psychosocial, sexual QoL, and comfort with food. CONCLUSIONS In addition to weight loss, preoperative levels of binge eating and depression should be considered as important predictors for QoL changes after bariatric surgery. Screening and treatment for preoperative depression and binge eating might improve QoL after bariatric surgery.
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Affiliation(s)
- Paul Brunault
- Équipe de Liaison et de Soins en Addictologie, CHRU de Tours, Tours, France,
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Health-related quality of life in morbid obesity: the impact of laparoscopic sleeve gastrectomy. Open Med (Wars) 2014. [DOI: 10.2478/s11536-013-0294-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractOur aim in this prospective study was to determine the impact of laparoscopic sleeve gastrectomy on the quality of life of patients with morbid obesity in comparison with population standards. The study evaluated 76 morbidly obese patients who underwent laparoscopic sleeve gastrectomy. The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) was used to evaluate quality of life in the following four areas: physical health, mental health, social relations, and environment. Patients completed the questionnaire before their planned operation and again 3 and 6 months after surgery. Compared with the population standard, patients with morbid obesity had significantly lower quality of life scores in the physical and mental health domains, including on independent questions related to of overall health and quality of life (p<0.001). Women scored lower on indicators of mental health than men. Three and 6 months following surgery a significant trend of body mass index (BMI) reduction was seen, as well as increased quality of life in all indicated areas (p<0.001). Laparoscopic sleeve gastrectomy treatment in morbidly obese patients reduced BMI on a long-term basis, a change seen as early as 3 months after surgery. By 6 months after surgery, patients had the same quality of life scores as the reference population.
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Revised sleeve gastrectomy: another option for weight loss failure after sleeve gastrectomy. Surg Endosc 2013; 28:1096-102. [PMID: 24170068 DOI: 10.1007/s00464-013-3277-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 10/11/2013] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy (LSG) is becoming a very common bariatric procedure, based on several advantages it carries over more complex bariatric procedures such as gastric bypass or duodenal switch (DS), and a better quality of life over gastric banding. However, in the long-term follow-up, weight loss failure and intractable severe reflux after primary LSG can necessitate further surgical interventions, and revisional sleeve gastrectomy (ReSG) can represent an option to correct these. METHODS From October 2008 to June 2013, 36 patients underwent an ReSG for progressive weight regain, insufficient weight, or severe gastroesophageal reflux in 'La Casamance' Private Hospital. All patients with weight loss failure after primary LSG underwent radiological evaluation. If Gastrografin swallow showed a huge unresected fundus or an upper gastric pouch dilatation, or if the computed tomography (CT) scan volumetry revealed a gastric tube superior to 250 cc, ReSG was proposed. RESULTS Thirty-six patients (34 women, two men; mean age 41.3 years) with a body mass index (BMI) of 39.9 underwent ReSG. Thirteen patients (36.1 %) had their original LSG surgery performed at another hospital and were referred to us for weight loss failure. Twenty-four patients (66.6 %) out of 36 had a history of gastric banding with weight loss failure. Thirteen patients (36.1 %) were super-obese (BMI > 50) before primary LSG. The LSG was realized for patients with morbid obesity with a mean BMI of 47.1 (range 35.4-77.9). The mean interval time from the primary LSG to ReSG was 34.5 months (range 9-67 months). The indication for ReSG was insufficient weight loss for 19 patients (52.8 %), weight regain for 15 patients (41.7 %), and 2 patients underwent ReSG for invalidating gastroesophageal reflux disease. In 24 cases the Gastrografin swallow results were interpreted as primary dilatation, and in the remaining 12 cases results were interpreted as secondary dilatation. The CT scan volumetry was realized in 21 cases, and it has revealed a mean gastric volume of 387.8 cc (range 275-555 cc). All 36 cases were completed by laparoscopy with no intraoperative incidents. The mean operative time was 43 min (range 29-70 min), and the mean hospital stay was 3.9 days (range 3-16 days). One perigastric hematoma was recorded. The mean BMI decreased to 29.2 (range 20.24-37.5); the mean percentage of excess weight loss was 58.5 % (±25.3) (p < 0.0004) for a mean follow-up of 20 months (range 6-56 months). CONCLUSIONS The ReSG may be a valid option for failure of primary LSG for both primary or secondary dilatation. Long-term results of ReSG are awaited to prove efficiency. Further prospective clinical trials are required to compare the outcomes of ReSG with those of Roux en Y Gastric Bypass or DS for weight loss failure after LSG.
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Giordano S, Victorzon M, Koskivuo I, Suominen E. Physical discomfort due to redundant skin in post-bariatric surgery patients. J Plast Reconstr Aesthet Surg 2013; 66:950-5. [DOI: 10.1016/j.bjps.2013.03.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 02/19/2013] [Accepted: 03/09/2013] [Indexed: 01/09/2023]
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Rieber N, Giel KE, Meile T, Enck P, Zipfel S, Teufel M. Psychological dimensions after laparoscopic sleeve gastrectomy: reduced mental burden, improved eating behavior, and ongoing need for cognitive eating control. Surg Obes Relat Dis 2012; 9:569-73. [PMID: 22784946 DOI: 10.1016/j.soard.2012.05.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 05/02/2012] [Accepted: 05/24/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity as a chronic disease has spread worldwide. Conservative treatment, especially with severe obesity, often fails. Obesity surgery has been shown to be an effective treatment. Laparoscopic sleeve gastrectomy (LSG), as a restrictive procedure, has low risks and results in good weight loss outcomes. However, to date, no studies have investigated the changes in psychological dimensions-especially concerning eating behavior and cognitive restraint-after LSG. The present study investigated, for the first time, eating behavior (cognitive restraint, disinhibition, hunger), depression, and perceived stress before and 1 year after LSG. The setting was a university hospital, comprehensive obesity center. METHODS Of 59 patients who had undergone LSG from 2008 to 2010, 40 patients were evaluated using questionnaires on eating behavior, depression, and stress, with measurements made before and 1 year after surgery. RESULTS The body mass index had decreased, on average, by 15.5 kg/m(2) 1 year after LSG (62.7% excess weight loss). The eating behaviors had changed, with patients experiencing less hunger, fewer food cravings, and decreased disinhibition. Depressive symptoms and perceived stress improved. However, the results showed high levels in the dimension of cognitive restraint of eating 1 year after LSG. CONCLUSIONS Most psychological dimensions improved as expected. The patients were less distracted by food, experienced less hunger, and were less disturbed by emotional distress. However, we found persistent cognitive restraint, reflecting an ongoing need for central eating control. Additional investigations are needed to describe the communication between the gut and brain after surgery.
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Affiliation(s)
- Nicole Rieber
- Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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