Obesity surgery
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Randomized Controlled Trial Comparative Study
Comparison of volume-controlled and pressure-controlled ventilation during laparoscopic gastric banding in morbidly obese patients.
There are no guidelines on ventilation modes in morbidly obese patients. We investigated the effects of volume-controlled (VCV) and pressure-controlled ventilation (PCV) on gas exchange, respiratory mechanics, and cardiovascular responses in laparoscopic gastric banding procedures. ⋯ VCV and PCV appear to be an equally suited ventilatory technique for laparoscopic procedures in morbidly obese patients. Carbon dioxide elimination is more efficient when using VCV.
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Biography Historical Article
Management of obesity in the writings of Soranus of Ephesus and Caelius Aurelianus.
Caelius Aurelianus (5th century AD) is famous for translating the writings of Soranus of Ephesus (2nd century AD) into Latin. In his book On acute and chronic diseases, Caelius gives an almost complete edition of the works of Soranus, while adding some of his own and other writers' material. ⋯ The nature, etiology, the clinical manifestations of obesity are described, although treatment covers the greatest part of the material. Infliction of perspiration, very low caloric intake diet, exercise, and diuresis are proposed, and one cannot overlook the strong similarities of some of the treatments with those used nowadays as secondary aids for weight loss.
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The American Society of Bariatric Surgery has initiated a Bariatric Surgery Center of Excellence Program and the American College of Surgeons has followed with their Bariatric Surgery Center Network Accreditation Program. These programs postulate that concentration of weight loss operations in high-volume centers will decrease surgical mortality and improve outcomes. ⋯ Surgeons at Hackensack University Medical Center, a high volume, accredited 1A American College of Surgeons Bariatric Surgery Center, achieved a 0.13% mortality among 5,365 patients undergoing weight loss operations between 1998 and June, 2006. This study supports the concept that high-volume centers perform bariatric operations with low mortalities.
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Conflicting data exist regarding the effect of body mass index (BMI) on postoperative mortality from critical illness. Few studies have examined this issue in surgical patients specifically. We tested the hypothesis that BMI is associated with mortality from surgical critical illness. ⋯ BMI is not related to mortality of surgical critical illness. Several factors, including modern ICU care, may mitigate the risks of obesity in the SICU.
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Practice Guideline
IFSO guidelines for safety, quality, and excellence in bariatric surgery.