Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
-
Surg Obes Relat Dis · Nov 2013
Review Comparative StudyVitamin B12 deficiency in patients undergoing bariatric surgery: preventive strategies and key recommendations.
Advances in bariatric surgery have brought about a paradigm shift in the management of obesity, with benefits extending beyond weight loss. However, nutritional deficiencies are an inherent problem in the postoperative period and often require lifelong supplementation. Vitamin B12, also referred to as cobalamin, is one of the most common micronutrient deficiencies affecting this population. This review explores the pathophysiology of cobalamin deficiency in patients undergoing bariatric surgery and provides an overview of the effectiveness of various available vitamin B12 formulations. ⋯ Patients undergoing bariatric surgery must be continuously educated on proper nutrition, the risk of developing significant vitamin B12 deficiency, and the role of supplements in avoiding catastrophic consequences.
-
Surg Obes Relat Dis · Nov 2013
Comparative StudySexual functioning and sex hormones in persons with extreme obesity and seeking surgical and nonsurgical weight loss.
Many individuals with obesity are motivated to lose weight to improve weight-related co-morbidities or psychosocial functioning, including sexual functioning. Few studies have documented rates of sexual dysfunction in persons with obesity. This study investigated sexual functioning, sex hormones, and relevant psychosocial constructs in individuals with obesity who sought surgical and nonsurgical weight loss. ⋯ Women and men who present for bariatric surgery, compared with individuals who sought nonsurgical weight loss, were not significantly more likely to experience a sexual dysfunction. There were few differences in reproductive hormones and psychosocial constructs between candidates for bariatric surgery and individuals interested in nonsurgical weight loss.
-
Surg Obes Relat Dis · Nov 2013
Randomized Controlled Trial Comparative StudyLaparoscopic gastric plication versus mini-gastric bypass surgery in the treatment of morbid obesity: a randomized clinical trial.
Laparoscopic gastric plication (LGP) is emerging as a safe and effective bariatric procedure. However, there are no reports on the comparison between the efficacy and complications of LGP and laparoscopic mini-gastric bypass (LMGB), which is still an investigational bariatric procedure. The objective of this study was to compare safety and efficacy of LGP and LMGB in the treatment of morbid obesity in a one-year follow-up study. ⋯ Both LGP and LMGB are effective weight loss procedures. LGP proved to be a simpler and less costly procedure compared with LMGB with a lower risk of iron deficiency during a 1-year follow-up study.
-
Surg Obes Relat Dis · Nov 2013
Overcoming the learning curve of laparoscopic Roux-en-Y gastric bypass: a 12-year experience.
Surgical treatment of morbid obesity with laparoscopic Roux-en-Y gastric bypass (LRYGB) is technically challenging and involves high-risk patients. In this study, the short-term outcome of LRYGB in a large population of patients has been evaluated, and morbimortality before and after overcoming the learning curve has been assessed. The objective of this study was to establish the learning curve for laparoscopic Roux-en-Y gastric bypass. ⋯ Operating time and risks of adverse outcome were significantly reduced after a long learning curve of 500 consecutive procedures. The number of surgeries performed and the standardization of the laparoscopic technique used were the main factors contributing to the low rates of postoperative complications, mortality, and conversion.
-
Surg Obes Relat Dis · Nov 2013
Comparative StudyIs selection bias toward super obese patients in the rationing of metabolic surgery justified?--A pilot study from the United Kingdom.
Recent evidence suggests that National Health Service (NHS) rationing of bariatric surgery is biased toward super-obese patients without scientific basis. The aim of this study was to compare health, quality of life, and employment outcomes in morbidly obese (MO) versus super-obese (SO) patients after laparoscopic Roux-en-Y gastric bypass (LRYGB) to provide a basis for rationing. ⋯ These results suggest that MO patients appear to benefit more than SO patients from LRYGB and yet seem to be disadvantaged in some NHS Trusts in the United Kingdom for access to bariatric surgery. This study provides a baseline framework for further research to generate evidence for more scientific rationing of bariatric surgery.