Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Jul 2011
ReviewEffect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review.
Sleeve gastrectomy (SG) has increased in popularity as both a definitive and a staged procedure for morbid obesity. Gastroesophageal reflux disease (GERD) is a common co-morbid disease in bariatric patients. The effect of SG on GERD has not been well studied; thus, the goal of the present systematic data review was to analyze the effect of SG on GERD. ⋯ The evidence of the effect of SG on GERD did not consolidate to a consensus. The studies showed differing outcomes. Hence, dedicated studies that objectively evaluate GERD after SG are needed to more clearly define the effect of SG on GERD in bariatric patients.
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The short-term benefits of bariatric surgery are well documented; however, few reports with data beyond 10 years exist. Those that have been published have described only open procedures. We present our 10-year follow-up results with laparoscopic Roux-en-Y gastric bypass with hand-sewn gastrojejunal anastomosis in a group private practice. ⋯ The obstacles to follow-up have continued to impede the collection of accurate long-term data. Of the 26% of patients with data, laparoscopic Roux-en-Y gastric bypass provided sustainable weight loss and resolution of co-morbidities. However, nutritional deficiencies presented sporadically over time and underscore the importance of routine testing.
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Surg Obes Relat Dis · Jul 2011
Are laparoscopic bariatric procedures safe in superobese (BMI ≥50 kg/m2) patients? An NSQIP data analysis.
The safety of laparoscopic bariatric procedures in superobese patients is still debatable. ⋯ Laparoscopic bariatric procedures in superobese patients have been associated with significantly increased complications, including 30-day mortality, compared with morbidly obese patients. However, overall, the procedures appear to be safe, with low complication and 30-day mortality rates.
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Surg Obes Relat Dis · May 2011
Multicenter Study Comparative StudyDifferences in outcomes of laparoscopic gastric bypass.
Although several risk factors affecting weight loss outcomes with bariatric procedures have been identified, the effect of age, gender, race, and illness severity on postoperative outcomes of laparoscopic gastric bypass has not been extensively examined. ⋯ The present study identified gender, race, age, and illness severity as risk factors affecting postoperative outcomes after laparoscopic gastric bypass. Male gender and increasing age were overall associated with an increased risk of complications. Significant racial disparities in the outcome measures were observed with blacks having an increased risk of adverse events. Illness severity was shown to adversely affect the surgical outcomes in laparoscopic gastric bypass.
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Surg Obes Relat Dis · May 2011
Comparative StudyImplementation of designated bariatric surgery program leads to improved clinical outcomes.
Emphasis on the development of designated programs for bariatric surgery as a method of quality improvement has increased; however, the data on the effect of these programs on the clinical outcome are insufficient. The aim of the present study was to consider the effect of the implementation of a bariatric clinical program on patient outcomes in a high-volume academic setting. ⋯ We observed a significant improvement in patient outcomes with the introduction of a designated bariatric surgery program. Additional studies of the validity of these quality indicators are needed to determine the true effect of these quality improvement programs.