Obesity surgery
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Anastomotic leaks and bleeding are the two most feared major complications in patients undergoing laparoscopic gastric bypass (LRYGB). This study was designed to evaluate if there is a clinical correlation between abnormal vital signs and postoperative leaks and bleeding. After IRB approval and adherence to HIPAA guidelines, a retrospective review of medical records was performed on 518 patients who underwent LRYGB between October 2002 and October 2006. ⋯ Tachycardia less than 120 bpm that has occurred in a cyclical pattern strongly pointed toward postoperative bleeding. Anastomotic leaks and bleeding are the two most feared major complications in patients undergoing LRYGB. This study was designed to evaluate if there is a clinical correlation between abnormal vital signs and postoperative leaks and bleeding.
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Obesity may cause adverse effects on the respiratory system. The main purpose of this study was to investigate how various measures of obesity are related to arterial blood gases and pulmonary function. ⋯ Both central and overall obesity were associated with unfavorable blood gases and low ERV.
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Comparative Study
Perioperative outcomes of laparoscopic adjustable gastric banding in mildly obese (BMI < 35 kg/m2) compared to severely obese.
Laparoscopic adjustable gastric banding (LAGB) has become a standard restrictive procedure in the USA for the treatment of severe obesity (body mass index, BMI > 35 kg/m(2)). Mildly obese individuals (BMI < 35 kg/m(2)) are also at increased risk from obesity-related conditions. Recently, an FDA panel supported its use in this subgroup. ⋯ In mildly obese, LAGB is as safe as in the severely obese with no perioperative morbidity. The perioperative outcomes and hospital resource utilization are comparable between BMI groups. Lower BMI is associated with lower operative times and blood loss.
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Comparative Study
A comparative study of the transversus abdominis plane (TAP) block efficacy on post-bariatric vs aesthetic abdominoplasty with flank liposuction.
The transversus abdominis plane (TAP) block acts on the nerves localised in the anterior abdominal wall muscles. We evaluated the efficacy on post-bariatric (PB) patients undergoing body-contouring abdominoplasty. We retrospectively evaluated PB patients undergoing abdominoplasty with flank liposuction and compared results to a matched group of TAP aesthetic patients. ⋯ Patients with greater flap resected and higher pre-abdominoplasty BMI had greater morphine consumptions. In PB patients, the larger amount of tissues resected corresponded to a greater stimulation of pain fibres that cannot be paralleled by a concomitant increase of the local anesthetic administered. This partially invalidates TAP's efficacy on PB patients.
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The aim of this study was to determine the relationship between gastric wall thickness and BMI. ⋯ There was no significant correlation between gastric wall thickness and BMI. Mean gastric wall thickness of endoscopically normal stomachs was in the range of 3-4 mm.