Obesity surgery
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Randomized Controlled Trial Clinical Trial
Influence of a forced air warming system on morbidly obese patients undergoing Roux-en-Y gastric bypass.
Hypothermia during and after major abdominal surgery decreases host defenses, increases the incidence of coagulopathy and may alter blood pressure, cardiac contractility and myocardial stability. ⋯ The forced air warming system is safe, cost effective and beneficial in minimizing the undesirable consequences of hypothermia in morbidly obese patients undergoing Roux-en-Y gastric bypass.
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Comparative Study
Outcome following bariatric surgery in super versus morbidly obese patients: does weight matter?
Numerous investigators have attempted to identify prognostic indicators for successful outcome following bariatric surgery. The purpose of this study was to determine whether degree of obesity affects outcome in super obese [>225% ideal body weight (IBW)] versus morbidly obese patients (160-225% IBW) undergoing gastric restrictive/bypass procedures. ⋯ Super obese patients have a greater absolute weight loss after bariatric surgery than do morbidly obese patients. Using commonly utilized measures of success based on weight, morbidly obese patients tend to have better outcomes following bariatric surgery.
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In nonobese patients, peritoneal insufflation has consistently been shown to influence parameters of preload and afterload as well as cardiac output. Obese patients have an abnormal and particular cardiovascular status. The aim of this study was to investigate the hemodynamic changes induced by an increase of intra-abdominal pressure in morbidly obese patients (MOP). ⋯ When compared to nonobese patients our obese patients tolerated the pneumoperitoneum surprisingly well, without experiencing fall in cardiac output. The hemodynamic consequences of peritoneal insufflation seem to be different in obese and nonobese patients.
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Different surgical alternatives for the treatment of severe obesity have been described. The two most common surgical procedures are the Vertical Banded Gastroplasty (VBG) and the Roux-en-Y Gastric Bypass (GBP). ⋯ The procedure was fairly easy to perform. The results were excellent in terms of weight loss and postoperative complications. It is an early experience and the long-term results are still inconclusive; regular check-ups should indicate the procedure's long-term effectiveness.