Obesity surgery
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Randomized Controlled Trial Comparative Study
Sugammadex allows fast-track bariatric surgery.
Morbidly obese (MO) patients are at increased risk for postoperative anesthesia-related complications. We evaluated the role of sugammadex versus neostigmine in the quality of recovery from profound rocuronium-induced neuromuscular blockade (NMB) in patients with morbid obesity. ⋯ Sugammadex allowed a safer and faster recovery from profound rocuronium-induced NMB than neostigmine did in patients with MO. Sugammadex may play an important role in fast-track bariatric anesthesia.
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Non-Hispanic blacks bear a disproportionate burden of the growing obesity epidemic. Bariatric surgery is an effective treatment for morbid obesity. We sought to assess for racial disparities in short-term outcomes following bariatric surgery. ⋯ Non-Hispanic blacks undergoing bariatric surgery demonstrate higher in-hospital mortality than their racial counterparts. It is unclear if this disparity is due to susceptibility to obesity-related mortality or suboptimal delivery of healthcare in the perioperative setting.
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Laparoscopic sleeve gastrectomy (LSG) has become a common surgical procedure, yet there is no consensus on what bougie size is best for LSG. We reviewed the literature and assessed the relationship between the size of bougie used and the incidence of leak as well as weight loss parameters. We wanted to determine if there is an ideal bougie size for LSG. ⋯ Larger sizing bougies are associated with a significant decrease in incidence of leak with no change in weight loss. Further studies are needed before an unequivocal decision on the optimal bougie size is made. A recommendation to use the smallest bougie possible should be avoided because the risks may outweigh the benefits.
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Comparative Study
Diagnosis of diabetes remission after bariatic surgery may be jeopardized by remission criteria and previous hypoglycemic treatment.
Controversy exists regarding type 2 diabetes (T2D) remission rates after bariatric surgery (BS) due to heterogeneity in its definition and patients' baseline features. We evaluate T2D remission using recent criteria, according to preoperative characteristics and insulin therapy (IT). ⋯ Consensus criteria reveal lower T2D remission rates after BS than previously reported. Prior insulin use is a main setback for remission.