Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
-
Surg Obes Relat Dis · Mar 2014
Comparative StudyComparison of laparoscopic sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass for morbid obesity in a military institution.
Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance in the bariatric community as a definitive weight loss procedure; however, longitudinal data remain limited. The objective of this study was to compare weight loss results of LSG with laparoscopic Roux-en-Y gastric bypass (LRYGB) up to 5 years postoperatively using anthropometric measurements. ⋯ Our study provides similar long-term weight loss between LSG and LRYGB, and therefore, LSG is a viable option as a definitive bariatric procedure.
-
Surg Obes Relat Dis · Mar 2014
Comparative StudyCross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study.
Nutritional deficiencies are highly prevalent in obese patients. Bariatric surgery has been associated with adverse effects on homeostasis of significant vitamins and micronutrients, mainly after gastric bypass. The aim of the present study was to compare the extent of long-term postsurgical nutritional deficiencies between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). ⋯ During a mean follow up period of 4 years postRYGB or SG, patients were identified with several micronutrient deficiencies, including vitamin D, folate, and vitamin B12. SG may have a more favorable effect on the metabolism of vitamin B12 compared with RYGB, being associated with less malabsorption. Adherence to supplemental iron and vitamin intake is of primary significance in all cases of bariatric surgery.
-
Surg Obes Relat Dis · Mar 2014
High prevalence of vitamin D insufficiency in a United Kingdom urban morbidly obese population: implications for testing and treatment.
Current recommendations suggest universal screening of vitamin D status before bariatric surgery to identify individuals at risk for postoperative deficiency. However little is known about the magnitude or severity of vitamin D insufficiency in the morbidly obese population awaiting bariatric surgery in the United Kingdom. The purpose of this prospective observational study was to assess the prevalence and determinants of vitamin D insufficiency in an urban multiethnic U.K. population awaiting bariatric surgery. ⋯ Regardless of ethnicity, vitamin D insufficiency appears to be typical among this clinic population; therefore, routine vitamin D supplementation is suggested for all individuals awaiting bariatric surgery rather than testing vitamin D status in an attempt to identify high-risk individuals.
-
Surg Obes Relat Dis · Mar 2014
Simultaneous laparoscopic paraesophageal hernia repair and sleeve gastrectomy in the morbidly obese.
Morbid obesity is associated with increased rates of hiatal and paraesophageal hernias. Although laparoscopic sleeve gastrectomy is gaining popularity as the procedure of choice for morbid obesity, there is little data regarding the management of paraesophageal hernias found intraoperatively. The aim of this study was to evaluate the feasibility and benefits of a combined sleeve gastrectomy and paraesophageal hernia repair in morbidly obese patients. ⋯ Laparoscopic sleeve gastrectomy combined with a paraesophageal hernia repair is well-tolerated and feasible in morbidly obese patients. Surgeons should be aware that preoperative EGD is not effective at diagnosing large hiatal or paraesophageal hernias. Surgeons with the skill set to repair paraesophageal hernias should do a combined procedure because it is well-tolerated, feasible, and can reduce the cost of multiple hospital admissions.