Obesity surgery
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The interest in bariatric surgery has considerably increased in the scientific community in the last two decades. We present a bibliometric analysis of scientific publications in bariatric surgery focusing on the period 2010-2014. ⋯ Bariatric surgery has been a field of intense research in the last 20 years. We observed a growing interest of non-surgical journals and an increasing participation of new countries. Nevertheless, latest trends suggest a saturation of scientific production in this field.
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Prior studies have shown a relationship between surgeon volume and patient outcomes in Roux-en-Y gastric bypass (RYGB) patients. Laparoscopic sleeve gastrectomy (SG) is now the most common bariatric procedure, but there is a little data on surgeon volume and outcomes after SG. We examined the relationship between annual surgeon bariatric volume and 30-day complication rate after SG. ⋯ High SG volume is associated with improved 30-day readmission, reoperation, and complication rates. Concurrent RYGB volume impacts the 30-day complication rate after SG, but does not affect the readmission or reoperation rate. Our findings suggest that SG-specific volume is important for optimal safety outcomes in SG patients.
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In bariatric surgery, there are no guidelines available for intraoperative fluid administration. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management that has been shown to improve the prognosis of patients undergoing abdominal surgery. The aim of our study is to assess the impact of the implementation of a GDFT protocol in morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG). ⋯ Implementation of GDFT protocols can prevent intraoperative fluid overload in patients undergoing bariatric surgery. It could improve outcomes, for example decreasing PONV or even hospital stay.
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Roux-en-Y gastric bypass (RYGB) has shown good diabetes remission in obese patients with type 2 diabetes mellitus (T2DM), but long-term complications were observed. We developed loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) to achieve diabetes remission and avoid the drawbacks of RYGB. We compare 1-year results between LDJB-SG and RYGB with body mass index (BMI) <35 kg/m(2) of T2DM patients. ⋯ LDJB-SG was comparable to RYGB in terms of weight loss, glycemic control, and comorbidity resolution in BMI <35 kg/m(2) T2DM patients in the short-term.
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Comparative Study
Approach to Poor Weight Loss After Laparoscopic Sleeve Gastrectomy: Re-sleeve Vs. Gastric Bypass.
Laparoscopic sleeve gastrectomy (LSG) is increasing worldwide; however, long-term follow-up results included insufficient weight loss and weight regain. This study aims at assessing the outcomes of converting LSG to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic re-sleeve gastrectomy (LRSG). ⋯ Following our algorithm, revising an LSG with an LRSG or LRYGB for poor weight loss is feasible with good outcomes. Larger and longer follow-up studies are needed to verify our results.