Role of Bariatric Surgery and Lung Transplant Eligibility in Setting of Pulmonary Hypertension(PHTN) and Systemic Sclerosis (SS)
Morbid obesity has been shown to increase risk of perioperative complications, delayed graft function, and mortality in kidney, liver, and lung/heart transplants. Both laparoscopic gastric bypass(LGBP) and laparoscopic sleeve gastrectomy(LSG) have been proven to be safe and efficacious in patients with end-stage kidney and liver disease of various etiologies, and are utilized to improve transplant candidacy by treating morbid obesity and associated co-morbidities, however the optimal bariatric operation for each transplant is not clear.
Conclusion. Patients with baseline liver disease, previously diagnosed fluid and electrolyte disorders, age older than 55 years, or drug use disorders are at higher risk for readmissions with fluid and electrolyte disorders following posterior lumbar fusion. Close monitoring of fluid and electrolyte balance in the perioperative period is essential to decrease complications and reduce unplanned readmissions. Level of Evidence: 3
Conclusion. Although intent-to-treat analysis failed to show significant differences in patients treated surgically, results of the as-treated analysis determined statically greater improvements in those patients with spondylolisthesis who were treated surgically as compared to those treated nonoperatively. Level of Evidence: 2
Conclusion. Ten years after its inception, SPORT has made strides in standardization and optimization of treatment for spinal pathologies. SPORT has provided clinicians with insight about outcomes of surgical and nonoperative treatment of spinal stenosis. Results showed significantly greater improvement through 4 year follow up in those patients that received surgical treatment, however the difference between the surgical and nonsurgical groups diminished at 8 year follow up. Level of Evidence: 3
Conclusion. In lumbar fusion, rhBMP-2 exhibited a higher fusion success rate and reduced the risk of re-operation. No difference in complication rate is between rhBMP (rhBMP-2 and rhBMP-7) and ICBG. We suggest rhBMP especially rhBMP-2 as an effective substitute for ICBG for lumbar fusion. Level of Evidence: 1
Purpose of review Advanced keratectasia often requires corneal transplantation for restoration of vision. This review discusses the surgical approach suitable for these cases including significant updates in the current literature. Recent findings With greater understanding of ectatic corneal disease and its associated operative challenges, several modifications in the surgical approach have been developed. Identified predictive factors for successful pneumatic dissection and intraoperative complications have informed surgical planning and decision-making. In the setting of failed pneumatic dissection, sequential use ...
Purpose of review Keratoconus can be surgically challenging, especially in advanced cases. Classic corneal transplantation techniques, may often be associated with complications. New alternative procedures like isolated Bowman layer transplantation (as a corneal stromal inlay or as a corneal onlay) and corneal allogenic intrastromal ring segments (CAIRS) have recently shown promising results. The aim of this review is to describe the main new surgical developments for treating keratoconus. Recent findings Intrastromal Bowman layer transplantation has recently shown to be effective in halting keratoconus progression an...
Purpose of review The management of peripheral corneal diseases, including Mooren's ulcer, Terrien's marginal degeneration, peripheral ulcerative keratitis and pellucid marginal degeneration is challenging. Circular grafts must either be very large, resulting in the excision of healthy tissue, or eccentric, leading to high levels of astigmatism. This review summarizes the range of noncircular keratoplasty procedures available to surgeons, in addition to their indications, and surgical techniques. Recent findings Noncircular grafts have been demonstrated to be useful in the management of peripheral corneal diseases. Th...
Publication date: Available online 5 June 2020Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Olivier Donnez, Jacques Donnez
No abstract available
Purpose of review To give an updated review on the underlying mechanisms and clinical effects of improved glucose control after bariatric surgery. Recent findings The basic principles of the mechanism for the metabolic effects of bariatric surgery can be categorized into calorie restriction, deviation of nutrients, and reduced amounts of adipose tissue. Recent findings suggest the importance of early changes following deviation of nutrients to more distal parts of the small bowel resulting in altered release of gastrointestinal hormones, altered gut microbiota, and weight-reduction. In the long-term, loss of adipose t...
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