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Navarro F, Gaete MI, Riquoir C, Azócar C, Pimentel F. Recidiva intestinal única de melanoma cutáneo maligno: reporte de un caso. Rev Med Chil 2021; 149:1236-1240. [DOI: 10.4067/s0034-98872021000801236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022]
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Quezada N, Maturana G, Irarrázaval MJ, Muñoz R, Morales S, Achurra P, Azócar C, Crovari F. Bariatric Surgery in Cirrhotic Patients: a Matched Case-Control Study. Obes Surg 2020; 30:4724-4731. [PMID: 32808168 DOI: 10.1007/s11695-020-04929-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/06/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Laparoscopic bariatric surgery (LBS) in liver end-stage organ disease has been proven to improve organ function and patients' symptoms. A series of LBS in patients with cirrhosis have shown good results in weight loss, but increased risk of complications. Current literature is based on clinical series. This paper aims to compare LBS (69% gastric bypass) between patients with cirrhosis and without cirrhosis. METHODS We conducted a retrospective 1:3 matched case-control study including bariatric patients with cirrhosis and without cirrhosis. Demographics, operative variables, postoperative complications, long-term weight loss, and comorbidity resolution were compared between groups. RESULTS Sixteen Child A patients were included in the patients with cirrhosis (PC) group and 48 in patients without cirrhosis (control) group. Mean age was 50 years; preoperative BMI was 39 ± 6.8 kg/m2. Laparoscopic gastric bypass and laparoscopic sleeve gastrectomy were performed in 69% and 31%, respectively. Follow-up was 81% at 2 years for both groups. PC group had a higher rate of overall (31% vs. 6%; p < 0.05) and severe (Clavien-Dindo ≥ III; 13% vs. 0%; p = 0.013) complications than that of the control group. Mean %EWL of PC at 2 years of follow-up was 84.9%, without differences compared with that of the control group (83.1%). Comorbidity remission in PC was 14%, 50%, and 85% for hypertension, type 2 diabetes, and dyslipidemia, respectively. Patients without cirrhosis had a higher resolution rate of hypertension (65% vs. 14%, p = 0.03). CONCLUSION LBS is effective for weight loss and comorbidity resolution in patients with obesity and Child A liver cirrhosis. However, these results are accompanied by significantly increased risk of complications.
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Affiliation(s)
- Nicolás Quezada
- Department of Digestive Surgery, Upper Gastrointestinal and Hernia surgery division, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, 362 Diagonal Paraguay, 4th Floor - Office 410, Santiago, Región Metropolitana, Chile.
| | - Gregorio Maturana
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, Avda. Libertador Bernando O'Higgins 340, Santiago, Chile
| | - María Jesús Irarrázaval
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, Avda. Libertador Bernando O'Higgins 340, Santiago, Chile
| | - Rodrigo Muñoz
- Department of Digestive Surgery, Upper Gastrointestinal and Hernia surgery division, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, 362 Diagonal Paraguay, 4th Floor - Office 410, Santiago, Región Metropolitana, Chile
| | - Sebastián Morales
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, Avda. Libertador Bernando O'Higgins 340, Santiago, Chile
| | - Pablo Achurra
- Department of Digestive Surgery, Upper Gastrointestinal and Hernia surgery division, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, 362 Diagonal Paraguay, 4th Floor - Office 410, Santiago, Región Metropolitana, Chile
| | - Cristóbal Azócar
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, Avda. Libertador Bernando O'Higgins 340, Santiago, Chile
| | - Fernando Crovari
- Department of Digestive Surgery, Upper Gastrointestinal and Hernia surgery division, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile, 362 Diagonal Paraguay, 4th Floor - Office 410, Santiago, Región Metropolitana, Chile
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