Obesity surgery
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Multicenter Study Comparative Study
Comparative review of the safety and efficacy of ferric carboxymaltose versus standard medical care for the treatment of iron deficiency anemia in bariatric and gastric surgery patients.
Iron deficiency anemia (IDA) is a common finding in patients after bariatric surgery. The cause is multifactorial including reduced oral iron intake and malabsorption. While many patients can be managed with oral supplements, parenteral iron may be needed to restore and maintain iron stores. ⋯ These data in post-bariatric surgery IDA patients suggest that FCM is a safe and effective alternative to existing iron products permitting higher and thus less frequent individual doses.
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Randomized Controlled Trial Comparative Study
The combination of haloperidol, dexamethasone, and ondansetron for prevention of postoperative nausea and vomiting in laparoscopic sleeve gastrectomy: a randomized double-blind trial.
Many patients may experience postoperative nausea and vomiting (PONV) following laparoscopic sleeve gastrectomy (LSG). We evaluated the efficacy of the combination of haloperidol, dexamethasone, and ondansetron for prevention of PONV after LSG. ⋯ The combination of haloperidol, dexamethasone, and ondansetron reduced PONV and the necessity of rescue antiemetics and also reduced morphine consumption and the volume of fluids infused postoperatively.
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An increasing number of obese patients are undergoing surgery, particularly bariatric and orthopaedic surgery. The physiological differences between obese and normal-weight subjects may modify not only anaesthetic requirements during surgery but also post-operative analgesic management, raising a number of challenges in a critical period. ⋯ We discuss the genetic factors common to pain and obesity and the factors potentially modifying opioid pharmacokinetics and pharmacodynamics in obese patients, and we analyse the overall efficacy and safety of opioids for pain management during the post-operative period in obese patients. Both modifications to surgical methods and additional analgesic treatments to decrease the requirement for opioids may improve early rehabilitation and quality of care and reduce adverse effects in obese patients.
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Laparoscopic sleeve gastrectomy is a relatively new treatment modality implemented in the surgical management for morbid obesity. It has been well documented that obesity is not only associated with an increased risk of malignancies but is also consistent with a higher incidence of surgical complications related to its definitive management. In spite of the weight loss experienced by patients with malignancy due to a catabolic state, bariatric surgery might be considered as a step procedure allowing for a more efficient and suitable surgical approach to treat early stage malignancies, thereby decreasing the procedure-related morbidity and mortality. This study aims to examine the effectiveness of laparoscopic sleeve gastrectomy as a primary weight loss procedure in patients with untreated malignancy facilitating a definitive oncologic surgical approach. ⋯ Laparoscopic sleeve gastrectomy is a safe and reasonable approach to effectively reduce weight in order to allow morbidly obese patients with early stage malignancies to undergo a second oncologic procedure.
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Bariatric procedures excluding the proximal small intestine improve glycemic control in type 2 diabetes within days. To gain insight into the mediators involved, we investigated factors regulating glucose homeostasis in patients with type 2 diabetes treated with the novel endoscopic duodenal-jejunal bypass liner (DJBL). ⋯ The data indicate DJBL to be a promising treatment for obesity and type 2 diabetes, causing rapid improvement of glycemic control paralleled by changes in gut hormones.