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Alzaben AS, Aloudah AA, Almutairi FN, Alshardan MK, Alasmari SA, Alsihman SJ, Alshamri DF, Alshlwi SS, Mortada EM. The Association Between Appetite and Quality of Life in Adults with Obesity or Severe Obesity Post-Sleeve Gastrectomy Procedure: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:1441-1454. [PMID: 38559616 PMCID: PMC10981378 DOI: 10.2147/dmso.s447743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
Background Sleeve gastrectomy (SG) is considered as the most common bariatric procedure in Saudi Arabia. It is a non-reversible procedure defined as removal of a large portion of the stomach. Objective The objective of the current study is to compare the appetite and quality of life (QoL) between adults' post-sleeve gastrectomy and obese/morbidly obese adults (pre-SG). Methods A cross-sectional study design was conducted in adults (aged between 18 and 65 years), post-sleeve gastrectomy (n = 80, 41 Males and 39 Females) and obese group (n = 60, 28 Males and 32 Females). The study population was recruited from the bariatric surgery clinic of King Abdullah Bin Abdul-Aziz University Hospital. A self-reported questionnaire was collected that included a visual analogue scale (VAS) to assess the appetite level, and SF-36 QoL questionnaire. Results No significant differences were found in age and gender between the study groups (p > 0.05). The median score feeling of fullness was significantly higher in the SG group (77.5, IQR: 48 and 50, IQR: 40, respectively) than in the obese group (p < 0.001). The amount of food eaten was statistically lower in the SG group (30, IQR: 20) than the obese group (50, IQR: 60) (p = 0.005). Patients post SG had significantly higher QoL scores in all physical and mental scales, physical component summary and mental component summary (p < 0.003). Conclusion Patients post SG have improved appetite and QoL. Satiety, less prospective food consumption, BMI, age, gender and comorbidities are associated with QoL. Future studies are needed to compare the QoL in post-SG patients with the normative values of the QoL in Saudi Arabia.
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Affiliation(s)
- Abeer Salman Alzaben
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Asma Abdulaziz Aloudah
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Fatimah Naif Almutairi
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Maram Khalid Alshardan
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Salha Ali Alasmari
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Shatha Jubran Alsihman
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Dalal Fahad Alshamri
- Department of Nutrition, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Saeed S Alshlwi
- Department of Surgery, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Eman M Mortada
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
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Hassan LS, Fahmy MH, Elmonim AMA, Elshal M. Effect of post-gastric sleeve pyloric length on control of type II diabetes mellitus. THE EGYPTIAN JOURNAL OF SURGERY 2023; 42:464-472. [DOI: 10.4103/ejs.ejs_89_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background
Although the effectiveness and safety of laparoscopic sleeve gastrectomy (LSG) have been demonstrated, there is still debate about the best surgical method, with the resection distance from pylorus (DP) being among the most contentious topics. In patients who had LSG for morbid obesity, the effect of the resection distance from the pylorus on the management of type II diabetes mellitus during the postoperative phase was examined.
Patients and methods
After receiving each patient’s agreement, a total of 46 obese individuals were enrolled. Patients were prospectively randomized into two groups, group A (‘AP group’) and group B (‘AR group’), based on the distance between the initial reload firing and the pylorus (4 cm for group A and 2 cm for group B, respectively). Blood sugar levels were measured three, six months, and one year following LSG. After a year of follow-up, the percentage of excess weight loss (%EWL) was calculated.
Results
Postoperative weight was statistically significant lower and EWL% was statistically significant higher in group B: LSG ‘2 cm’ compared to group A: LSG ‘4 cm’. As regard outcomes of type 2 diabetes mellitus after LSG, in spite of nonsignificant statistical value, we reported that there was higher frequency of complete remission after 3, 6 and 12 months in group B: LSG ‘2 cm’ compared to group A: LSG ‘4 cm’ and cases with complete remission were associated with significant higher EWL%.
Conclusion
Patients undergoing laparoscopic sleeve gastrectomy are recommended to have shorter resection distance from pylorus (DP) done. It has been linked to superior surgical results, weight reduction, and diabetes mellitus management with no problems recorded.
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Affiliation(s)
| | - Mohamed H. Fahmy
- Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Mohamed Elshal
- Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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3
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Lee JH, Park JH, Kim SM. Comparison of Dietary Quality and Surgical Satisfaction Between Patients With Suboptimal and Optimal Weight Loss After Sleeve Gastrectomy Using Food Tolerance Score and Bariatric Analysis and Reporting Outcome System Questionnaires. JOURNAL OF METABOLIC AND BARIATRIC SURGERY 2022; 11:54-62. [PMID: 36926675 PMCID: PMC10011672 DOI: 10.17476/jmbs.2022.11.2.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 03/11/2023]
Abstract
Purpose This study aimed to assess the association of dietary quality and surgical satisfaction with the amount of total weight loss (TWL) 1 year after laparoscopic sleeve gastrectomy (LSG) using the food tolerance score (FTS) and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaires. Materials and Methods This single-center retrospective study included patients who underwent LSG due to morbid obesity. Only those who have 1-year follow-up data were included and divided into 2 groups: suboptimal TWL (STWL) ≤20% and optimal TWL (OTWL) >20%. Clinical data and questionnaires recorded 1 year after surgery were collected. FTS was used to evaluate the degree of food tolerance, and BAROS assessed surgical outcomes, including weight loss, comorbidity changes, and quality of life (QoL). The total FTS and BAROS scores of the 2 groups were compared. Results Of 580 patients, 159 were included. Patients in STWL (n=17) were significantly older than those in OTWL (n=142) (42.24±9.28 vs. 35.92±8.71 years old, P=0.006). The total FTS (1-30 points) for STWL and OTWL were 24.88±3.43 and 25.04±3.14, respectively (P=0.845). Although the total BAROS scores (maximum: 9 points) were significantly lower in STWL than in OTWL (5.96±1.48 vs. 7.20±1.40, P<0.001). The only variable that made this difference was weight loss. There were no significant differences in other variables, such as medical conditions, QoL, and complications. Conclusion In terms of FTS and BAROS score, there is no difference in postoperative satisfaction and QoL between STWL and OTWL after LSG, except for the degree of weight loss.
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Affiliation(s)
- Joo Hoon Lee
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Ji-Hyeon Park
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Seong Min Kim
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.,Department of Surgery, Gachon University of Medicine and Science, Incheon, Korea
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Muacevic A, Adler JR, Alghamdi H, S. AlOtaibi A, Alshareef K, Alzahrani KM. Quality of Life and Body Mass Index Changes Three Years After Laparoscopic Sleeve Gastrectomy in Taif City, Saudi Arabia. Cureus 2022; 14:e32754. [PMID: 36686102 PMCID: PMC9851730 DOI: 10.7759/cureus.32754] [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] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Background Obesity has become a major global health challenge, and its prevalence has tripled in the last four decades. Impaired quality of life (QoL) is a strong incentive for severely obese patients to seek help. Sleeve gastrectomy (SG) is the most frequently practiced bariatric procedure worldwide. This study aimed to investigate the QoL and changes in body weight three years post laparoscopic SG. Methods A cross-sectional, observational study was performed in outpatient clinics in Taif city, Saudi Arabia. The study included 147 adult patients who underwent SG at least three years before inclusion in the study. Data were collected using a questionnaire designed based on the validated Bariatric quality of life (BQL) and Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQoL) surveys. Results All patients were suffering from class I, class II, or class III obesity before undergoing SG. Three years post-surgery, 72.8% reached their normal weight or were overweight (P<0.001). The mean± SD BMI (45± 7.0 kg/m2) significantly decreased to 26.8± 4.6 kg/m2 (P<0.001). Most of the participants (78.2%) achieved an excess weight loss percent (EWL%) of 75% or more. The mean± SD BQL score was 45.5± 5.2 points and the median (IQR) GERD-HRQoL score was 7 (15). Higher EWL% was significantly associated with a higher BQL score (P=0.041). Conclusions The current study revealed a better quality of life among patients experiencing higher rates of excess weight loss percent (EWL%) after three years of sleeve gastrectomy as compared to other patients.
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Souza MDGD, Silva LB, Ferraz ÁAB, Campos JM. ARE THERE BENEFITS IN PERFORMING GASTRO-OMENTOPEXY IN LAPAROSCOPIC VERTICAL GASTRECTOMY? ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2022; 34:e1598. [PMID: 35019118 PMCID: PMC8735264 DOI: 10.1590/0102-672020210003e1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/20/2021] [Indexed: 11/29/2022]
Abstract
Background:
Gastro-omentopexy promotes the reconnection of the stomach to the gastroesplenic and gastrocolic ligaments and constitutes an alternative for the prevention of complications in laparoscopic vertical gastrectomy.
Aim:
To demonstrate the benefits of the gastro-omentopexy technique in patients undergoing sleeve gastrectomy, with possible reduction in postoperative complications.
Methods:
Prospective, non-randomized, case series type study, consisting of a clinical population of 179 patients who underwent the technique in 2018, with follow-up between 6-12 months in the postoperative period.
Results:
From the participants 71.5% were women, aged between 30-40 years (36.3%). As for the prevalence of complications in the postoperative period, the low prevalence was evident, with emphasis on readmission (1.1%); reoperation (1.1%); wound infection (1.1%); bleeding hemorrhage (0.5%); and stricture (1.1%). However, temporary symptoms were present such as nausea/vomiting, food intolerance, epigastric pain and feeling of fullness, right after surgery.
Conclusion:
The technique promoted a significant improvement in quality of life and control of comorbidities. In addition, it was associated with a low prevalence of stenosis, and with no fistula, making the method safer.
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Affiliation(s)
- Maíra Danielle Gomes de Souza
- Postgraduate Program in Surgery, Department of Clinical Medicine, Faculty of Medicine, Center for Medical Sciences, Federal University of Pernambuco, Recife, PE, Brazil
| | - Lyz Bezerra Silva
- Postgraduate Program in Surgery, Department of Clinical Medicine, Faculty of Medicine, Center for Medical Sciences, Federal University of Pernambuco, Recife, PE, Brazil
| | - Álvaro A B Ferraz
- Postgraduate Program in Surgery, Department of Clinical Medicine, Faculty of Medicine, Center for Medical Sciences, Federal University of Pernambuco, Recife, PE, Brazil
| | - Josemberg Marins Campos
- Postgraduate Program in Surgery, Department of Clinical Medicine, Faculty of Medicine, Center for Medical Sciences, Federal University of Pernambuco, Recife, PE, Brazil
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6
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Bozan MB, Kutluer N, Aksu A, Bozan AA, Kanat BH, Böyük A. IS BODY MASS INDEX AND OBESITY SURGERY MORTALITY SCORE IMPORTANT IN PERIOPERATIVE COMPLICATIONS OF LAPAROSCOPIC SLEEVE GASTRECTOMY BEFORE DISCHARGE? ACTA ACUST UNITED AC 2021; 34:e1602. [PMID: 34669891 PMCID: PMC8521821 DOI: 10.1590/0102-672020210002e1602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/13/2021] [Indexed: 12/23/2022]
Abstract
Background:
Morbid obesity surgery and related complications have increased with time.
Aim: To evaluate the relationship between perioperative complications before discharge and preoperative body mass index and obesity surgery mortality score in laparoscopic sleeve gastrectomy.
Method:
1617 patients who met the inclusion criteria were evaluated retrospectively. The patients were examined in terms of demographic data, presence of comorbidities, whether there were complications or not, type of complications and obesity surgery mortality score.
Results:
Complications were seen in 40 patients (2.5%) and mortality wasn’t seen in the early postoperative period before discharge. The mean age of patients with complications was 36.3±10.02 years (19-57) and without complications 34.12±9.54 (15-64) years. The preoperative mean BMI values of patients with and without complications were 45.05±3.93 (40-57) kg/m2 and 44.8±3.49 (35-67) kg/m2 respectively. According to BMI groups 40-45 kg/m2, 45-50 kg/m2 and 50 and over, there was not any statistical significance seen in three groups in terms of complication positivity and major-minor complication rates. There was not any statistical significance seen between the patients with and without major-minor complications and obesity surgery mortality score.
Conclusion:
There was not any relation between perioperative laparoscopic sleeve gastrectomy complication rates before discharge and BMI and obesity surgery mortality scores.
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Affiliation(s)
- Mehmet Buğra Bozan
- Department of Surgery, Kahramanmaras Sutcu Imam University, Professor (Assistant), Kahramanmaras, Turkey
| | - Nizamettin Kutluer
- Department of Surgery, Elazig Training and Research Hospital, Specialist of General Surgery, Elazig, Turkey
| | - Ali Aksu
- Department of Surgery, Elazig Training and Research Hospital, Specialist of General Surgery, Elazig, Turkey
| | - Ayşe Azak Bozan
- Department of Surgery, Malatya Turgut Özal University, Professor (Associate), Malatya, Turkey
| | - Burhan Hakan Kanat
- Department of Anesthesiology and Reanimation, Elazig Training and Research Hospital, Specialist of General Surgery, Elazig, Turkey
| | - Abdullah Böyük
- Department of Surgery, Elazig Training and Research Hospital, Professor, Elazig, Turkey
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7
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Goldoni MB, Fontes PRO, GuimarÃes MM, Diedrich-Neto JA, Nogueira T, Teixeira UF, Giacomazzi CB, Kiss G, Pioner SR, Rodrigues PD. BYPASS VS. SLEEVE AND ITS EFFECTS IN NON-ALCOHOLIC FATTY LIVER DISEASE: WHAT IS THE BEST TECHNIQUE? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2021; 33:e1549. [PMID: 33470379 PMCID: PMC7812689 DOI: 10.1590/0102-672020200003e1549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Strongly associated with obesity, non-alcoholic fatty liver disease is considered the hepatic manifestation of the metabolic syndrome. It presents as simple steatosis and steatohepatitis, which can progress to cirrhosis and its complications. Among the therapeutic alternatives is bariatric surgery. AIM To compare the effect of the two most frequent bariatric procedures (sleeve and bypass) on liver disease regarding to epidemiological, demographic, clinical and laboratory parameters. METHODS The results of intraoperative and 12 months after surgery liver biopsies were used. The NAFLD activity score (NAS) was used to assess and compare the stages of liver disease. RESULTS Sixteen (66.7%) patients underwent Bypass procedure and eight (33.3%) Sleeve. It was observed that the variation in the NAFLD activity score was significantly greater in the Bypass group than in Sleeve (p=0.028) and there was a trend regarding the variation in fibrosis (p=0.054). CONCLUSION Both surgical techniques were effective in improving the hepatic histology of most operated patients. When comparing sleeve and bypass groups, bypass showed better results, according to the NAS score.
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Affiliation(s)
| | | | | | | | - Tiele Nogueira
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | - Guillermo Kiss
- Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
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8
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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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9
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Santoro S, Aquino CGG, Mota FC, Artoni RF. DOES EVOLUTIONARY BIOLOGY HELP THE UNDERSTANDING OF METABOLIC SURGERY? A FOCUSED REVIEW. ACTA ACUST UNITED AC 2020; 33:e1503. [PMID: 32667533 PMCID: PMC7357560 DOI: 10.1590/0102-672020190001e1503] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/04/2019] [Indexed: 02/07/2023]
Abstract
Introduction: The wide net of physiological issues involved in metabolic surgery is
extremely complex. Nonetheless, compared anatomy and phisiology can provide
good clues of how digestive tracts are shaped for more or less caloric food,
for more or less fiber, for abundance and for scarcity.
Objective: To review data from Compared Anatomy and Physiology, and in the Evolutionary
Sciences that could help in the better comprehension of the metabolic
surgery.
Method: A focused review of the literature selecting information from these three
fields of knowledge in databases: Cochrane Library, Medline and SciELO,
articles and book chapters in English and Portuguese, between 1955 and 2019,
using the headings “GIP, GLP-1, PYY, type 2 diabetes, vertebrates digestive
system, hominid evolution, obesity, bariatric surgery “.
Results: The digestive tract of superior animals shows highly specialized organs to
digest and absorb specific diets. In spite of the wide variations of
digestive systems, some general rules are observed. The proximal part of the
digestive tract, facing the scarcity of sugars, is basically dedicated to
generate sugar from different substrates (gluconeogenesis). Basic proximal
gut tasks are to proportionally input free sugars, insulin, other fuels and
to generate anabolic elements to the blood, some of them obesogenic. To
limit the ingestion by satiety, by gastric emptying diminution and to limit
the excessive elevation of major fuels (sugar and fat) in the blood are
mostly the metabolict asks of the distal gut. A rapid and profound change in
human diet composition added large amounts of high glycemic index foods.
They seem to have caused an enhancement in the endocrine and metabolic
activities of the proximal gut and a reduction in these activities of the
distal gut. The most efficient models of metabolic surgery indeed make
adjustments in this proximal/distal balance in the gut metabolic activities.
Conclusion: Metabolic surgery works basically by making adjustments to the proximal and
distal gut metabolic activities that resemble the action of natural
selection in the development the digestive systems of superior animals.
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Affiliation(s)
- Sergio Santoro
- Department of Surgery, Albert Einstein Hospital, São Paulo, SP, Brazil
| | - Caio G G Aquino
- Department of Surgery, Albert Einstein Hospital, São Paulo, SP, Brazil
| | - Filippe Camarotto Mota
- Department of Surgery, Albert Einstein Hospital, São Paulo, SP, Brazil.,Department of Surgery, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Roberto Ferreira Artoni
- Evolutionary Genetics Laboratory, Department of Structural, Molecular and Genetic Biology, Ponta Grossa State University, PR, Brazil
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Askari A, Dai D, Taylor C, Chapple C, Halai S, Patel K, Mamidanna R, Munasinghe A, Rashid F, Al-Taan O, Jain V, Whitelaw D, Jambulingam P, Adil MT. Long-Term Outcomes and Quality of Life at More than 10 Years After Laparoscopic Roux-en-Y Gastric Bypass Using Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg 2020; 30:3968-3973. [DOI: 10.1007/s11695-020-04765-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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11
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Castilho AVSS, Foratori-Junior GA, Sales-Peres SHDC. BARIATRIC SURGERY IMPACT ON GASTROESOPHAGEAL REFLUX AND DENTAL WEAR: A SYSTEMATIC REVIEW. ACTA ACUST UNITED AC 2019; 32:e1466. [PMID: 31859919 PMCID: PMC6918764 DOI: 10.1590/0102-672020190001e1466] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/09/2019] [Indexed: 12/18/2022]
Abstract
Introduction: Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux. Objective: To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear. Method: The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure. Conclusion: Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.
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Affiliation(s)
| | - Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Norero E, Quezada JL, Cerda J, Ceroni M, Martinez C, Mejía R, Muñoz R, Araos F, González P, Díaz A. RISK FACTORS FOR SEVERE POSTOPERATIVE COMPLICATIONS AFTER GASTRECTOMY FOR GASTRIC AND ESOPHAGOGASTRIC JUNCTION CANCERS. ACTA ACUST UNITED AC 2019; 32:e1473. [PMID: 31859926 PMCID: PMC6918748 DOI: 10.1590/0102-672020190001e1473] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. Total morbidity rates vary across different studies and few have evaluated postoperative morbidity according to complication severity. AIM To identify the predictors of severe postoperative morbidity. METHODS This was a retrospective cohort study from a prospective database. We included patients treated with gastrectomy for gastric or EGJ cancers between January 2012 and December 2016 at a single center. Severe morbidity was defined as Clavien-Dindo score ≥3. A multivariate analysis was performed to identify predictors of severe morbidity. RESULTS Two hundred and eighty-nine gastrectomies were performed (67% males, median age: 65 years). Tumor location was EGJ in 14%, upper third of the stomach in 30%, middle third in 26%, and lower third in 28%. In 196 (67%), a total gastrectomy was performed with a D2 lymph node dissection in 85%. Two hundred and eleven patients (79%) underwent an open gastrectomy. T status was T1 in 23% and T3/T4 in 68%. Postoperative mortality was 2.4% and morbidity rate was 41%. Severe morbidity was 11% and was mainly represented by esophagojejunostomy leak (2.4%), duodenal stump leak (2.1%), and respiratory complications (2%). On multivariate analysis, EGJ location and T3/T4 tumors were associated with a higher rate of severe postoperative morbidity. CONCLUSION Severe postoperative morbidity after gastrectomy was 11%. Esophagogastric junction tumor location and T3/T4 status are risk factors for severe postoperative morbidity.
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Affiliation(s)
- Enrique Norero
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Jose Luis Quezada
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Jaime Cerda
- Epidemiology Department, Department of Public Health, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Chile
| | - Marco Ceroni
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Cristian Martinez
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Ricardo Mejía
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Rodrigo Muñoz
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Fernando Araos
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Paulina González
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
| | - Alfonso Díaz
- Hospital Dr. Sotero del Rio, Esophagogastric Surgery Unit, Digestive Surgery Department, Pontificia Universidad Catolica de Chile, Chile
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13
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Barros FD, Negrão MG, Negrão GG. WEIGHT LOSS COMPARISON AFTER SLEEVE AND ROUX-EN-Y GASTRIC BYPASS: SYSTEMATIC REVIEW. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2019; 32:e1474. [PMID: 31859927 PMCID: PMC6918768 DOI: 10.1590/0102-672020190001e1474] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/17/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Bariatric surgery is currently the gold standard treatment for obesity. The two most accomplished surgeries are the Roux-en-Y gastric bypass and the sleeve gastrectomy, and controversies exist in which is better. OBJECTIVE To compare the two techniques in relation to weight loss with at least five years of follow-up. METHODS Search in Medline, PubMed, Embase, SciElo, Lilacs, Cochrane databases from 2001 (beginning of vertical gastrectomy) until 2018, using the following headings: "sleeve" or "sleeve gastrectomy" combined with "gastric bypass" or "Roux-en-Y gastric bypass", "weight loss" and "clinical trial". Criteria for inclusion of articles were patients aged between 18 and 65 years; clinical trial; comparison between the two techniques; minimum five-year follow-up; outcome with weight loss assessment. RESULTS The initial search identified 1940 articles, of which 185 publications were identified as clinical trials. One hundred and forty-one were excluded, 67 because they did not compare the two techniques, 57 not addressed weight loss and 17 were repeated articles. Thirty-four studies were retrieved for a more detailed analysis; 36 studies were excluded due to a follow-up of less than five years, and another compared the mini-gastric bypass. In total, seven studies were included in the systematic review, but there was no significant difference in three of them. CONCLUSION The gastric bypass had a greater weight loss than the vertical gastrectomy in all the evaluated studies.
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Affiliation(s)
- Fernando de Barros
- Department of General and Specialized Surgery, Faculty of Medicine, Fluminense Federal University, Niterói, RJ, Brazil
| | - Mayara Galisse Negrão
- Department of General and Specialized Surgery, Faculty of Medicine, Fluminense Federal University, Niterói, RJ, Brazil
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Tonatto-Filho AJ, Gallotti FM, Chedid MF, Grezzana-Filho TDJM, Garcia AMSV. BARIATRIC SURGERY IN BRAZILIAN PUBLIC HEALTH SYSTEM: THE GOOD, THE BAD AND THE UGLY, OR A LONG WAY TO GO. YELLOW SIGN! ACTA ACUST UNITED AC 2019; 32:e1470. [PMID: 31859923 PMCID: PMC6918730 DOI: 10.1590/0102-672020190001e1470] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/17/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND In Brazil, there has been a significant increase in obesity rates in all age groups. Data from 2017 show that obesity affects 19% of the population. Due to the magnitude of the problem, public health policies have aimed to prevent complications related to obesity by increasing the offerfor bariatric surgeries. AIM To analyze the current status of bariatric surgery performed in the Brazilian public health system, including data from macroregions and also the effect of digestive surgery training on the number of procedures. METHODS The database of the public health registry (DATASUS) was assessedbetween 2008 and 2018 for descriptive analysis of data and evaluation of the selected parameters. The main surgical techniques, comorbidities, mortality and the costs profile of the system were evaluated. RESULTS There was a 339% increase in the number of bariatric surgeries in the period evaluated. Gastric bypass was performed in 94% of cases whereas sleeve in 2.4%. Other techniques were used in 3.6%. There were discrepancies in the number of surgeries performed in different regions of the country. CONCLUSION There was a considerable advance in the number of bariatric surgeries performed by the public health system between 2008 and 2018. However, there is a need to increase the offer of this service and alsospecialized training, as well as a correction in the distribution of these procedures in the national territory to achieve integrality among its users.
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Affiliation(s)
| | | | | | - Tomaz de Jesus Maria Grezzana-Filho
- General Surgery, Nossa Senhora da Conceição Hospital, Porto Alegre, RS, Brazil.,Digestive Surgery, Porto Alegre Hospital de Clínicas, Porto Alegre, RS, Brazil
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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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Susmallian S, Nikiforova I, Azoulai S, Barnea R. Outcomes of bariatric surgery in patients with depression disorders. PLoS One 2019; 14:e0221576. [PMID: 31454382 PMCID: PMC6711535 DOI: 10.1371/journal.pone.0221576] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/10/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To determine the impact of sleeve gastrectomy in patients suffering from depression compared with those who are not in a depressive state. INTRODUCTION Obesity is considered a global epidemic. Often patients with obesity suffer from depressive state. Depressive disorders may be both a cause and a consequence of obesity. MATERIAL AND METHODS The study includes 300 consecutives patients that underwent laparoscopic sleeve gastrectomy. Out of the 300 patients, 253 (84.33%) of them completed the follow up for three years. RESULTS Out of the 300-patients, with the average age of 41.65±11.05 years old, the ratio of males to females was 1:2. The average baseline BMI was 42.02 kg/m2. A total of 105 (35.33%) of the patients suffer from depression, which was more common in male (43%) than in female (31.5%), with statistically significant difference (p = .05). Comparing the weight loss after surgery in both groups, the mean weight loss in the depression-group was 12.0 ΔBMI and in the non-depression group was 13.03 ΔBMI, (p< .001). After three years, 94 (88.68%) patients of the depression group responded as they were optimistic and satisfied with the results of the operation, with positive changes in their lives, 8 (7.55%) did not experience change and 4 (3.77%) expressed to have worsened their depressive state. CONCLUSION Laparoscopic sleeve gastrectomy is successful and leads to weight loss even in subjects who are affected by depression syndrome.
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Affiliation(s)
- Sergio Susmallian
- Department of General Surgery, Assuta Medical Center, Tel-Aviv, Israel
| | - Ilana Nikiforova
- Department of Nutrition, Assuta Medical Center, Tel-Aviv, Israel
| | - Shir Azoulai
- Assuta Health Services Research Institute, Assuta Medical Center, Tel-Aviv, Israel
| | - Royi Barnea
- Assuta Health Services Research Institute, Assuta Medical Center, Tel-Aviv, Israel
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Santos EPRD, Santa Cruz F, Hinrichsen EA, Ferraz ÁAB, Campos JM. INTERNAL HERNIA FOLLOWING LAPAROSCOPIC ROUX-EN-Y GASTRIC BY-PASS: INDICATIVE FACTORS FOR EARLY REPAIR. ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:160-164. [PMID: 31460580 DOI: 10.1590/s0004-2803.201900000-32] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/09/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Internal hernia (IH) following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a major complication that challenges the surgeon due to its non-specific presentation and necessity of early repair. Delayed diagnosis and surgical intervention of IH might lead to increased morbidity of patients and impairments in their quality of life. OBJECTIVE To evaluate the predictive factors for early diagnosis and surgical repair of IH after LRYGB. METHODS This study analyzed 38 patients during the postoperative period of LRYGB who presented clinical manifestations suggestive of IH after an average of 24 months following the bariatric procedure. RESULTS The sample consisted of 10 men and 28 women, with a mean age of 37.5 years and a mean body mass index (BMI) of 39.6 kg/m2 before LRYGB. All patients presented pain, 23 presented abdominal distension, 10 had nausea and 12 were vomiting; three of them had dysphagia, three had diarrhea and one had gastro-esophageal reflux. The patients presented symptoms for an average of 15 days, varying from 3 to 50 days. Seventeen (45.9%) patients were seen once, while the other 20 (54.1%) went to the emergency room twice or more times. Exploratory laparoscopy was performed on all patients, being converted to laparotomy in three cases. Petersen hernia was confirmed in 22 (57.9%). Petersen space was closed in all patients and the IH correction was performed in 20 (52.6%) cases. The herniated loop showed signs of vascular suffering in seven patients, and two (5.3%) had irreversible ischemia, requiring bowel resection. CONCLUSION The presence of recurrent abdominal pain is one of the main indicators for the diagnosis of IH after LRYGB. Patients operated at an early stage, even with negative imaging tests for this disease, benefited from rapid and simple procedures without major complications.
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Affiliation(s)
| | | | - Eduarda Araújo Hinrichsen
- Curso de Medicina, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil
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Lins DDC, Gadelha PS, Santa-Cruz F, Siqueira LTD, Campos JM, Ferraz ÁAB. Bariatric surgery and the coronary artery calcium score. ACTA ACUST UNITED AC 2019; 46:e20192170. [PMID: 31241686 DOI: 10.1590/0100-6991e-20192170] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/03/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE to investigate the impact of bariatric surgery on the coronary artery calcium score (CACS), and to establish predictors of progression of this score in patients with obesity. METHODS prospective study that evaluated 18 obese patients before and after bariatric surgery. All patients were submitted to computed tomography scans and blood tests (total cholesterol, LDL, HDL, triglycerides, fasting plasma glucose, A1C, insulin, serum calcium, C-peptide and C-Reactive Protein) in order to determine CACS and Framingham risk score (FRS). RESULTS the FRS decreased 50% between the pre and postoperative evaluations. The mean CACS increased significantly at the late postoperative period, going from 8.5 to 33.1. HDL levels had also increased between the pre and postoperative periods. All of the other quantitative variables reduced significantly at the postoperative evaluation. When dividing CACS into four degrees, it was observed that 22.2% presented CACS=0 at the postoperative evaluation. The prevalence of mild CACS decreased from 77.8% to 50%, while moderate CACS remained the same (11.1%). Severe CACS increased from 11.1% to 16.7%. Older ages were linked to CACS progression, and this was the only variable that presented statistical association with progression. CONCLUSION bariatric surgery leads to positive cardiovascular outcomes, apparently regardless of CACS.
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Affiliation(s)
- Daniel da Costa Lins
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Programa de Pós-Graduação em Cirurgia, Recife, PE, Brasil
| | - Patrícia S Gadelha
- Real Hospital Português de Beneficência de Pernambuco, Serviço de Radiologia, Recife, PE, Brasil
| | - Fernando Santa-Cruz
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Curso de Medicina, Recife, PE, Brasil
| | - Luciana Teixeira de Siqueira
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Curso de Medicina, Departamento de Cirurgia, Recife, PE, Brasil
| | - Josemberg Marins Campos
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Curso de Medicina, Departamento de Cirurgia, Recife, PE, Brasil
| | - Álvaro Antônio Bandeira Ferraz
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Curso de Medicina, Departamento de Cirurgia, Recife, PE, Brasil
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