Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Jan 2014
Outpatient laparoscopic sleeve gastrectomy in a free-standing ambulatory surgery center: first 250 cases.
A growing body of evidence supports the laparoscopic sleeve gastrectomy (LSG) as a safe and effective procedure for sustained weight loss and amelioration of weight-related co-morbidities. Procedures performed in ambulatory surgery centers (ASC) can provide several advantages over hospital-based surgery. We present our results of 250 consecutive patients undergoing LSG in an ASC. The objective of this study was to assess the safety and efficacy of outpatient LSG in a freestanding ASC. ⋯ LSG can be performed safely in a freestanding ASC in select patients with outcomes comparable to the inpatient standard. Additional studies are needed to formulate selection criteria and guidelines to maximize patient safety and outcomes.
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Surg Obes Relat Dis · Jan 2014
Comparative StudyChanges in post-prandial glucose and pancreatic hormones, and steady-state insulin and free fatty acids after gastric bypass surgery.
Changes in the multiple mechanisms that regulate glucose metabolism after gastric bypass (RYGB) are still being unveiled. The objective of this study was to compare the changes of glucose and pancreatic hormones [C-peptide, glucagon, and pancreatic polypeptide (PP)] during a meal tolerance test (MTT) and steady-state insulin and free fatty acid (FFA) concentrations during euglycemic-hyperinsulinemic clamp 14 days and 6 months after RYGB in morbidly obese nondiabetic patients. ⋯ In morbidly obese nondiabetic patients, RYGB produces early changes in postmeal glucose, C-peptide, glucagon, and PP responses, and it appears to enhance insulin clearance early after RYGB and improve insulin sensitivity in adipose tissue at 6 months postsurgery. The early changes cannot be explained by caloric restriction alone.
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Surg Obes Relat Dis · Jan 2014
ReviewA systematic review of musculoskeletal pain among bariatric surgery patients: implications for physical activity and exercise.
Physical activity (PA) can play an integral role in protecting the success of bariatric surgery by promoting weight loss and preventing weight regain. Although engagement in PA before surgery predicts postoperative PA levels, this may be undermined by weight-related co-morbidities. The importance of preoperative and postoperative musculoskeletal pain as a limitation to PA is unknown. The objective of this study was to review evidence on preoperative and postoperative pain in bariatric surgery patients, summarize the relationship between musculoskeletal pain and PA, and discuss areas of future research. ⋯ Gaps in knowledge regarding pain in bariatric surgery patients may present challenges for clinicians and exercise professionals on how to best advise patients about increasing their PA. Future research should include prospective evaluation of musculoskeletal pain via validated measures at multiple time points. This data will inform the time course of pain resolution, potential onset, and correlation with surgical weight loss.
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Surg Obes Relat Dis · Jan 2014
ReviewReview of long-term weight loss results after laparoscopic sleeve gastrectomy.
Sleeve gastrectomy (SG) has gained enormous popularity both as a first-stage procedure in high-risk super-obese patients and as a stand-alone procedure. The objective of this study was to evaluate the long-term weight loss results after SG published in the literature and compare them with the well-documented short-term and mid-term weight loss results. A detailed search in PubMed using the keywords "sleeve gastrectomy" and "long-term results" found 16 studies fulfilling the criteria of this study. ⋯ The overall attrition rate was 31.2% (13 studies). LSG seems to maintain its well-documented weight loss outcome at 5 or more years postoperatively, with the overall mean %EWL at 5 or more years after LSG still remaining>50%. The existing data support the role of LSG in the treatment of morbid obesity.