Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Jun 2016
Comparative Study30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass.
Laparoscopic sleeve gastrectomy (SG) is gaining popularity over laparoscopic Roux-en-Y gastric bypass (LRYGB) within the United States. Data on readmissions after bariatric procedures are mostly based on LRYGB, with limited evidence regarding etiology of readmissions after SG. ⋯ Hospital readmissions are more common after LRYGB than SG. Reasons for readmission differ between procedures. Given the progressive increase in the proportion of bariatric patients undergoing SG, hospital programs that aim to decrease readmissions after bariatric surgery need to focus on prevention and control of postoperative nausea and dehydration.
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Surg Obes Relat Dis · May 2016
ReviewRecommendations for the presurgical psychosocial evaluation of bariatric surgery patients.
Psychosocial factors have significant potential to affect long-term outcomes of bariatric surgery, including emotional adjustment, adherence to the recommended postoperative lifestyle regimen, weight loss outcomes, and co-morbidity improvement and or resolution. Thus, it is recommended that bariatric behavioral health clinicians with specialized knowledge and experience be involved in the evaluation and care of patients both before and after surgery. ⋯ Central among these is the role of identifying factors that may pose challenges to optimal surgical outcome and providing recommendations to the patient and bariatric team on how to address these issues. This document outlines recommendations for the psychosocial evaluation of bariatric surgery patients, appropriate qualifications of those conducting these evaluations, communication of evaluation results and suggested treatment plan, and the extension of behavioral healthcare of the bariatric patient to the entire span of the surgical and postsurgical process.
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Surg Obes Relat Dis · May 2016
Randomized Controlled TrialRandomized trial of OFIRMEV versus placebo for pain management after laparoscopic sleeve gastrectomy.
OFIRMEV is an intravenous form of acetaminophen approved by the Food and Drug Administration for use as an antipyretic and treatment of mild to moderate pain alone or in conjunction with opioid medications. Intravenous APAP use in postsurgical pain management has been reported to decrease opioid usage, time to rescue dose, and subjective pain. ⋯ Intravenous OFIRMEV use caused a modest but statistically significant decrease in subjective pain without affecting narcotic use after laparoscopic sleeve gastrectomy. (Surg Obes Relat Dis 2015;0:000-00.) © 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.
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Surg Obes Relat Dis · Mar 2016
Review Meta AnalysisPerioperative noninvasive ventilation in obese patients: a qualitative review and meta-analysis.
Perioperative noninvasive ventilation (NIV) has been proposed to reduce postoperative morbidity and improve perioperative outcomes in patients undergoing general anesthesia. Whether it is advantageous to apply NIV just before and after general anesthesia in obese patients has not been yet established. ⋯ Results from this review and meta-analysis suggest that NIV is well tolerated and effective in improving perioperative care in obese patients. The application of NIV before and after general anesthesia should be considered and promoted in relevant cases.
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Surg Obes Relat Dis · Mar 2016
Review Practice GuidelineLipids and bariatric procedures Part 2 of 2: scientific statement from the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and Obesity Medicine Association (OMA).
Bariatric procedures generally improve dyslipidemia, sometimes substantially so. Bariatric procedures also improve other major cardiovascular risk factors. ⋯ Part 1 was published in the Journal of Clinical Lipidology, and reviewed the impact of bariatric procedures upon adipose tissue endocrine and immune factors, adipose tissue lipid metabolism, as well as the lipid effects of bariatric procedures relative to bile acids and intestinal microbiota. This Part 2 reviews: (1) the importance of nutrients (fats, carbohydrates, and proteins) and their absorption on lipid levels; (2) the effects of bariatric procedures on gut hormones and lipid levels; (3) the effects of bariatric procedures on nonlipid cardiovascular disease (CVD) risk factors; (4) the effects of bariatric procedures on lipid levels; (5) effects of bariatric procedures on CVD; and finally, (6) the potential lipid effects of vitamin, mineral, and trace element deficiencies, that may occur after bariatric procedures.