Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
-
Surg Obes Relat Dis · Jan 2015
The role of capnography during upper endoscopy in morbidly obese patients: a prospective study.
Pulmonary depression remains a major concern when performing upper endoscopy in the morbidly obese patient. The aim of this prospective study is to determine the effects of sedation and role of capnography during preoperative upper endoscopy in obese patients. ⋯ Capnography provided a real time assessment of changes in ventilation and can detect early phases of respiratory depression. Utilization of propofol as a means for sedation, with extended advanced monitoring technique, can allow for reduced adverse outcomes in morbidly obese patients undergoing upper endoscopy.
-
Surg Obes Relat Dis · Jan 2015
Laparoscopic sleeve gastrectomy in morbidly obese patients with end-stage heart failure and left ventricular assist device: medium-term results.
Morbid obesity precludes patients with end-stage heart failure from becoming cardiac transplant candidates. This study evaluates the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) as a means to transplant candidacy in such patients. ⋯ LSG appears to be a safe, technically feasible, and effective method for obtaining adequate weight loss in morbidly obese patients with end-stage heart failure and mechanical circulatory support, subsequently improving their access to cardiac transplantation. This is the largest case series to date of this high-risk group of patients undergoing LSG.
-
Surg Obes Relat Dis · Jan 2015
Influence of median surgeon operative duration on adverse outcomes in bariatric surgery.
Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. ⋯ Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery.
-
Surg Obes Relat Dis · Jan 2015
Five-year weight loss in primary gastric bypass and revisional gastric bypass for failed adjustable gastric banding: results of a case-matched study.
Despite their now frequent use, the long-term results for adjustable gastric bands are variable and often less than gastric bypass. Laparoscopic Roux-en-Y gastric bypass (LRYGB) provides good early results and seems to be the revisional procedure of choice. Nevertheless, the long-term outcomes following revisional LRYGB (rLRYGB) for failed adjustable gastric banding have not been compared with those for primary LRYGB (pLRYGB). ⋯ After 5 years of follow-up, pLRYGB provides greater weight loss than rLRYGB with similar rates of improvement and remission of coexisting conditions. Patients and surgeons should be aware of such results before primary and revisional bariatric surgery.
-
Surg Obes Relat Dis · Jan 2015
Five-year outcomes of gastric bypass for super-super-obesity (BMI≥60 kg/m²): a case matched study.
Laparoscopic gastric bypass (LRYGB) is feasible for patients with body mass index (BMI)≥60 kg/m² (super-super-obesity [SSO]) but long-term data are lacking. The objective of this study was to compare the 5-year weight loss and changes in obesity-related co-morbidities after LRYGB for SSO and non-SSO patients. ⋯ According to %IWL and rate of partial or complete remission of diabetes and hypertension, our study shows similar outcomes for LRYGB in SSO and non-SSO patients 5 years after surgery. The %EWL does not seem to be an adequate indicator for evaluation of LRYGB outcomes in patients with extreme obesity, such as SSO.