Obesity surgery
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In bariatric surgery patients, weight loss and long-term weight maintenance are related to food intake and eating patterns. To improve the diet orientation in the bariatric surgery postoperative period, we assessed the postoperative eating patterns and related them to weight loss. ⋯ Postoperative eating pattern influenced postbariatric surgery weight loss. In the present study, the snack-eating pattern was associated with the worst weight loss outcome, followed by the sweet-eating and normal-eating patterns. A screening and a differential approach to patients according to their eating patterns may lead to better results of weight loss.
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Clinical Trial
Surgery for nonobese type 2 diabetic patients: an interventional study with duodenal-jejunal exclusion.
A 24-week interventional prospective trial was performed to compare the benefits of open duodenal-jejunal exclusion surgery (GJB) with a matched control group on standard medical care. ⋯ In conclusion, duodenal-jejunal exclusion was an effective treatment for nonobese T2DM subjects. GJB was superior to standard care in achieving better glycemic control along with reduction in insulin requirements.
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Comparative Study
Video-assisted versus conventional tracheal intubation in morbidly obese patients.
We compared tracheal intubation characteristics and arterial oxygenation quality during airway management of morbidly obese patients whose trachea was intubated under video assistance with the LMA CTrach (SEBAC, Pantin, France) or the Airtraq laryngoscope (VYGON, Ecouen, France) with that of the conventional Macintosh laryngoscope. ⋯ Because LMA CTrach promoted short apnea time and the Airtraq laryngoscope allowed early definitive airway, both video-assisted tracheal intubation devices prevented most serious arterial oxygenation desaturation evidenced during tracheal intubation of morbidly obese patients with the conventional Macintosh laryngoscope.
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The intragastric balloon system is licensed for temporary use in moderately obese patients who have significant health risks related to their obesity and have failed to achieve and maintain significant weight loss with a supervised weight control program alone. Although intragastric balloons are advocated as safe devices, major complications have been described. We report a case of a gastric perforation during the removal of an intragastric balloon. This is the first case reported in the literature.
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Accidental ingestion of foreign bodies is common in the general population. Most foreign bodies pass through the entire digestive tract without incidents. ⋯ Bowel perforation may not be more common in the massively obese than in the normal-weight population but may be more problematic. We describe a super-obese female (body mass index, 52.3 kg/m2) who underwent emergency surgery for small-bowel perforation caused by an ingested foreign body (fish bone); the patient died despite segmental intestinal resection and intensive care.