Comment on “Gastrointestinal symptoms before and after laparoscopic Roux-en-Y gastric bypass: a longitudinal assessment.”
The decision to pursue bariatric surgery can be difficult for patients. The driving force for many patients to seek bariatric surgical care is to improve their overall health, well-being, and general quality of life. There are multiple decisions that patients must make on their journey to the surgeon ’s office, though. Questions about financial concerns, employment issues, spousal support, child-care decisions, and psychological stressors are often made prior to their interactions with surgical practices.
Evidence remains contradictory for perioperative outcomes of super-obese (SO) and super-super-obese (SSO) patients undergoing bariatric surgery.
This study shed some light on the modification of postoperative gut microbial composition after bariatric surgery.MethodsA prospective longitudinal study on healthy lean subjects and patients who underwent bariatric surgery (Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) was carried out. Anthropometric and metabolic data, smoking, food preferences data, and stool samples were collected from lean subjects and from obese patients before and 3 and 6 months after surgery (T0, T3, and T6, respectively).ResultsWe collected stool samples from 25 obese patients before surgery and 3 and 6 months thereafte...
This study evaluated changes in serum high-density lipoprotein cholesterol (HDL-C) induced by laparoscopic bariatric surgery (BS) in non-diabetic obese subjects with low (L-HDL-C) or normal (N-HDL-C) levels of HDL-C. We assessed whether increased HDL-C is associated with weight loss, serum non-HDL cholesterol (non-HDL-C), serum triglycerides (TG), and physical activity (PA) before and 6 and 15 months after BS.MethodsIn this prospective cohort study, 71 subjects undergoing BS (42 by Roux-en-Y gastric bypass and 29 by sleeve gastrectomy) were evaluated for the % Excess Weight Loss (%EWL), waist circumference (WC), seru...
ConclusionsRevisional RYGB is a complex procedure but can be performed with the robotic approach with a low morbidity rate. Weight loss outcomes and resolution of complications of the index procedure are satisfactory.
Morbid obesity is considered a strong independent risk factor for chronic kidney disease (CKD), and bariatric surgery remains the most effective treatment for obesity-related comorbidities. Previous large database analyses have suggested that CKD does not independently increase the risk of adverse outcomes following bariatric surgery. The safety of elective bariatric surgery in this patient population remains unclear. To this end, we compared thirty day outcomes in this patient population after laparoscopic sleeve gastrectomy (SG) or gastric bypass (LRYGB).
Conclusions: Perforations of the excluded segment in RYGB patients are rare and represent a diagnostic challenge, as pneumoperitoneum is usually absent and the excluded segment is difficult to access. Despite negative diagnostic findings, laparoscopic exploration should always be considered. PMID: 31333071 [PubMed - as supplied by publisher]
Abstract BACKGROUND AND OBJECTIVES: Despite the potential for improving health status or increasing access to transplantation, national practice patterns for bariatric surgery in obese patients with ESKD are poorly understood. The purpose of this study was to describe current trends in surgical care for this population. DESIGN, SETTING, PARTICIPANTS, &MEASUREMENTS: Using 100% Medicare data, we identified all beneficiaries undergoing bariatric surgery in the United States between 2006 and 2016. We evaluated longitudinal practice patterns using linear regression models. We also estimated risk-adjusted compl...
CONCLUSIONSRYGB offers sustained, long-term weight loss with significant resolution of major comorbidities in older veterans, with acceptably low morbidity and mortality.
At first glance, many readers of Surgery for Obesity and Related Diseases may skim past this article and pay little attention. After all, laparoscopic sleeve gastrectomy has become the most common procedure, with Roux-en-Y gastric bypass (RYGB) numbers declining . Interest in best methods and limb lengths for distal RYGB may not seem pertinent. Furthermore, surgeons performing RYGB have strong feelings about their technique. However, a careful analysis of this paper may alter your practice and provide a different perspective.
At first glance, many readers of SOARD may skim past this article and pay little attention. After all, Laparoscopic Sleeve Gastrectomy(LSG) has become the most common procedure with Roux en Y Gastric Bypass (RYGB) numbers declining. (1) Interest in best methods and limb lengths for distal RYGB may seem impertinent. Furthermore, surgeons performing RYGB have strong feelings about their technique. However, a careful analysis of this paper may alter your practice and provide a different perspective.