Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Jul 2007
Inferior vena cava filter placement for pulmonary embolism risk reduction in super morbidly obese undergoing bariatric surgery.
Pulmonary embolism (PE) is a leading cause of mortality after bariatric surgery. We evaluated inferior vena cava (IVC) filter use for PE risk reduction in high-risk super morbidly obese bariatric surgery patients. ⋯ IVC filter placement for PE risk reduction is safe and feasible in the super morbidly obese. Our data have shown that the filters can be placed expeditiously and with minimal morbidity concomitant with bariatric surgery. In this limited series, IVC filter placement was associated with no PE. Additional studies are needed to confirm the efficacy of IVC filter placement for PE risk reduction and related mortality in the super morbidly obese.
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Surg Obes Relat Dis · Mar 2007
Randomized Controlled TrialLaparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial.
To perform a prospective, randomized comparison of laparoscopic adjustable gastric banding (LAGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB). ⋯ The results of our study have shown that LRYGB results in better weight loss and a reduced number of failures compared with LAGB, despite the significantly longer operative time and life-threatening complications.
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Surg Obes Relat Dis · Mar 2007
Randomized Controlled Trial Multicenter StudyIncidence of gastroenterostomy stenosis in laparoscopic Roux-en-Y gastric bypass using 21- or 25-mm circular stapler: a randomized prospective blinded study.
Laparoscopic Roux-en-Y gastric bypass is the most common bariatric procedure performed in the United States today. The most common early complication after laparoscopic Roux-en-Y is stenosis. No randomized studies have compared the effect of the different staplers on the incidence of stenosis or on long-term weight loss. We compared the anastomoses performed with the two sizes of circular stapler in common use. ⋯ We found a significant difference in the stenosis rate between the 21-mm and 25-mm circular stapled anastomoses in laparoscopic Roux-en-Y gastric bypass. The 21-mm staplers led to significantly more endoscopies than did the 25-mm staplers. Symptoms leading to endoscopy occurred significantly later with use of a 25-mm stapler than after a 21-mm stapler.
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Surg Obes Relat Dis · Mar 2007
Multicenter StudyObesity surgery mortality risk score: proposal for a clinically useful score to predict mortality risk in patients undergoing gastric bypass.
Currently, no clinically useful scoring system is available to stratify the mortality risk for patients undergoing gastric bypass (GBP). We propose the obesity surgery mortality risk score as a clinically useful score system to predict the mortality risk for patients undergoing GBP. ⋯ The analysis reveals that mortality risk for gastric bypass can be stratified based upon independent variables that can be identified before surgery. The OS-MRS, a simple, clinically relevant scoring system, is proposed, which stratifies mortality risk into low (Class A), intermediate (Class B), and high (Class C) risk groups in the current study population. This risk assessment scoring system may contribute to surgical decision making in bariatric surgery if its ability to stratify risk is validated in subsequent studies.