Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Jan 2016
Review Meta AnalysisBowel obstruction rates in antecolic/antegastric versus retrocolic/retrogastric Roux limb gastric bypass: a meta-analysis.
Previous literature is varied with regard to rates of bowel obstruction after laparoscopic Roux-en-Y gastric bypass (LRYGB). Internal herniation through mesenteric defects is a common cause of bowel obstructions. There are advantages and disadvantages to routing the Roux limb via a retrocolic/retrogastric (RC/RG) versus an antecolic/antegastric (AC/AG) position. ⋯ Increased rates of bowel obstruction and internal hernia were observed in the RC/RG group compared with the AC/AG group. A prospective, randomized trial would be necessary to definitively determine the impact of Roux limb position and routine closure of mesenteric defects on bowel obstruction rates after gastric bypass.
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Surg Obes Relat Dis · Jan 2016
Multicenter StudyVariation in the use of minimally invasive bariatric surgery.
Obesity is a significant public health problem in the United States. Despite the known benefits of bariatric surgery, most patients eligible for bariatric surgery do not receive it. Access to minimally invasive bariatric surgery (MIS), the surgical gold standard, may be a limitation. ⋯ Variation in the performance of MIS bariatric surgical procedures exists. These differences can likely be attributed to physician preference or patient population. Obesity rates are elevated in rural areas. The implementation of MIS bariatric surgery programs in rural areas may improve the treatment of obesity and downstream co-morbidities in these populations.
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Surg Obes Relat Dis · Jan 2016
Laparoscopic sleeve gastrectomy in children and adolescents with Prader-Willi syndrome: a matched-control study.
Obesity is a leading cause of mortality and morbidity in Prader-Willi syndrome (PWS). ⋯ PWS children and adolescents underwent effective weight loss and resolution of co-morbidities after LSG, without mortality, significant morbidity, or slowing of growth. LSG should be offered to obese PWS patients with heightened mortality particularly because no other effective alternative therapy is available.
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Surg Obes Relat Dis · Jan 2016
Is there a role for enhanced recovery after laparoscopic bariatric surgery? Preliminary results from a specialist obesity treatment center.
There has been a relative lack of research on the effect of enhanced recovery in the context of morbid obesity surgery. ⋯ The implementation of an enhanced recovery program after bariatric surgery is feasible, well tolerated, and can significantly reduce the length of hospital stay without increasing readmission rates. Controlling for several possible confounders, implementation of the ERAS protocol remained the strongest predictor of discharge on the first postoperative day after laparoscopic bariatric surgery.
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Surg Obes Relat Dis · Jan 2016
Quality and safety in obesity surgery-15 years of Roux-en-Y gastric bypass outcomes from a longitudinal database.
Most population-based studies lack long-term data, making the reporting of true mortality and outcome rates difficult. An accurate estimate of these rates in a high-risk population is critical for obtaining informed consent, especially for an elective procedure such as Roux-en-Y gastric bypass (RYGB). ⋯ This longitudinal population study showed high rates of mortality following RYGB, with improved long-term outcomes when the laparoscopic approach was used.