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Cost-Effectiveness Analysis of Bariatric Surgery for Morbid Obesity
ConclusionLRYGB is the optimal bariatric technique, being the most cost-effective compared to LSG, LAGB, and no surgery options for most subgroups. However, LSG was the most cost-effective choice when initial BMI ranged between 35 and 39.9  kg/m2. (Source: Obesity Surgery)
Source: Obesity Surgery - January 15, 2018 Category: Surgery Source Type: research

The Predictive Factors for Diabetic Remission in Chinese Patients with BMI & gt;  30 kg/m 2 and BMI & lt;  30 kg/m 2 Are Different
AbstractIntroductionRoux-en-Y gastric bypass has been proven to be beneficial for patients with obesity and type 2 diabetes mellitus (T2DM). In less-obese patient (BMI 30 –35 kg/m2), surgical treatment is indicated when medication fails to control the T2DM. Asian develops diabetes at a lower BMI. For lower-BMI patients, the rate of diabetes amelioration varies significantly with patients of higher BMI after surgical treatment. The factors that contribute to the post-operative diabetes response rate in lower-BMI patients have not been elucidated.MethodsBetween 2010 and 2014, a total of 144 patients who underwent ...
Source: Obesity Surgery - January 15, 2018 Category: Surgery Source Type: research

Implanted Closed-Loop Gastric Electrical Stimulation (CLGES) System with Sensor-Based Feedback Safely Limits Weight Regain at 24  Months
ConclusionDuring the 24  month follow-up, CLGES was shown to limit weight regain with strong safety outcomes, including no serious adverse events in the second year. We hypothesize that CLGES and objective sensor-based behavior data combined to produce behavior change. The study supports CLGES as a safe obesity treatment with potential for long-term health benefits.Trial registrationClinicalTrials.gov identifier: NCT01448785 (Source: Obesity Surgery)
Source: Obesity Surgery - January 15, 2018 Category: Surgery Source Type: research

Risk Prediction Model for Severe Postoperative Complication in Bariatric Surgery
This study aimed to identify preoperative risk factors and to construct a risk prediction model based on these.MethodsPatients who underwent a bariatric surgical procedure in Sweden between 2010 and 2014 were identified from the Scandinavian Obesity Surgery Registry (SOReg). Associations between preoperative potential risk factors and severe postoperative complications were analysed using a logistic regression model. A multivariate model for risk prediction was created and validated in the SOReg for patients who underwent bariatric surgery in Sweden, 2015.ResultsRevision surgery (standardized OR 1.19, 95% confidence interv...
Source: Obesity Surgery - January 12, 2018 Category: Surgery Source Type: research

Aurora D. Pryor, M.D.
(Source: Obesity Surgery)
Source: Obesity Surgery - January 12, 2018 Category: Surgery Source Type: research

Dietary Management in the Immediate Preoperative Period of Bariatric Surgery: a National Overview
ConclusionThis study identified the frequent practice of requesting preoperative weight loss and the diversity of diets used in the immediate preoperative period by Brazilian BS centers. Future guideline proposal is needed on preoperative BS diets. (Source: Obesity Surgery)
Source: Obesity Surgery - January 12, 2018 Category: Surgery Source Type: research

Efficacy of Forced-Air Warming to Prevent Perioperative Hypothermia in Morbidly-Obese Versus Non-obese Patients
AbstractBackgroundHypothermia is associated with an increased postoperative morbidity and mortality. Forced-air warming systems are the most effective methods for its prevention. When using a mattress, a reduction in the area of diffusion of warm air by crushing due to excess weight cannot be ruled out.MethodsWe designed a prospective study to compare the efficacy of a forced-air warming mattress (Bair Hugger ® 585) to prevent hypothermia (core temperature (CT°)
Source: Obesity Surgery - January 11, 2018 Category: Surgery Source Type: research

Changes in Iron Absorption After Roux-en-Y Gastric Bypass
AbstractIntroductionIron deficiency is one of the most common deficiencies that may occur after Roux-en-Y gastric bypass (RYGB). Little is known about the optimal treatment of post-RYGB iron deficiency.AimThe aim of this study is to evaluate the changes in iron absorption characteristics after RYGB for two oral iron formulations, one presented in tablet form and one as in the form of a solution.MethodIron absorption in 24 obese women was studied before and 1  month after RYGB. Twelve patients were tested with a single dose of 600 mg ferrous fumarate in tablet form (195 mg of elementary iron, group 1), and 12...
Source: Obesity Surgery - January 11, 2018 Category: Surgery Source Type: research

Bidirectional Jejunojejunal Anastomosis Prevents Early Small Bowel Obstruction Due to the Kinking After Closure of the Mesenteric Defect in the Laparoscopic Roux-en-Y Gastric Bypass
ConclusionEnlarging the JJS with a bidirectional linear stapling is associated with a reduced risk of early SBO due to the anastomosis kinking. However, it could be related to an increased risk of digestive bleedings. (Source: Obesity Surgery)
Source: Obesity Surgery - January 11, 2018 Category: Surgery Source Type: research

Serum Parathyroid Hormone and 25-Hydroxyvitamin D Concentrations Before and After Biliopancreatic Diversion
ConclusionsPrevalence of vitamin D deficiency and secondary hyperparathyroidism is high before BPD-DS. Despite a low prevalence of vitamin D deficiency after surgery, prevalence of hyperparathyroidism increased steadily 1  year after surgery, preceded by a decrease in serum calcium. Factors explaining the high prevalence of secondary hyperparathyroidism after BPD-DS and its long-term impact on bone health should be addressed. (Source: Obesity Surgery)
Source: Obesity Surgery - January 10, 2018 Category: Surgery Source Type: research

Predictors of Postoperative Urinary Tract Infection After Bariatric Surgery
ConclusionsOlder age, clindamycin prophylaxis, and revisional procedures are significantly associated with an increased rate of UTI following bariatric surgery. Several identified variables are modifiable risk factors and targets for a quality improvement initiative to decrease the rate of UTI in bariatric surgery patients. (Source: Obesity Surgery)
Source: Obesity Surgery - January 9, 2018 Category: Surgery Source Type: research

Single Session EUS-Guided Temporary Gastro-Gastrostomy and ERCP Following Gastric Bypass
(Source: Obesity Surgery)
Source: Obesity Surgery - January 9, 2018 Category: Surgery Source Type: research

Oral Vitamin B 12 Supplementation After Roux-en-Y Gastric Bypass: a Systematic Review
ConclusionThe review finds that oral supplementation doses of ≤ 15 μg vitamin B12 daily are inadequate for prophylaxis of vitamin B12 deficiency in adult RYGB patients but doses of 1000  μg vitamin B12 daily might be adequate. Future studies need to examine this and even higher oral doses for vitamin B12 supplementation for patients undergoing RYGB. (Source: Obesity Surgery)
Source: Obesity Surgery - January 9, 2018 Category: Surgery Source Type: research

Does Sleeve Shape Make a Difference in Outcomes?
ConclusionThis study showed no clear association between uniformity of sleeve shape and the type of calibration device used. The study showed a trend toward decreased reflux and improved weight loss with the lower pouch shape, regardless of calibration device. (Source: Obesity Surgery)
Source: Obesity Surgery - January 8, 2018 Category: Surgery Source Type: research

Mesenteric Panniculitis —First Case Series After Bariatric Surgery
We present two cases of young male patients who underwent laparoscopic sleeve gastrectomy and developed abdominal symptoms within 45 –60 days of surgery. Both were investigated for known post-bariatric complications. While first patient presented (5 months later) at an irreversible stage and died within 8–9 months of primary surgery, in second patient, the disease process could be reversed through early intervention, diagn osis, treatment, and compliance. Mesenteric panniculitis is a rapidly progressive entity, which can be adequately treated by early identification and long-term immune-suppressi...
Source: Obesity Surgery - January 8, 2018 Category: Surgery Source Type: research

General Practitioners and Bariatric Surgery in France: Are They Ready to Face the Challenge?
ConclusionAcademic institutions, scientific societies, and all physicians involved in obesity care should actively participate in the correction of the educational gap of GPs in order to obtain an effective help in the complex challenge of facing the obesity epidemic. (Source: Obesity Surgery)
Source: Obesity Surgery - January 8, 2018 Category: Surgery Source Type: research

Recommendations from Two Citizens ’ Juries on the Surgical Management of Obesity
ConclusionsCitizen ’s juries, even when shorter in duration, can be an effective tool to guide the development of health policy and priorities. However, our study has identified a range of variables that should be considered when designing and running a jury and when interpreting the verdict. (Source: Obesity Surgery)
Source: Obesity Surgery - January 7, 2018 Category: Surgery Source Type: research

Upregulation of Ghrelin Gene Expression in the Excluded Stomach of Obese Women with Type 2 Diabetes After Roux-en-Y Gastric Bypass in the SURMetaGIT Study
The objective of this study is to explore changes in ghrelin plasma levels and ghrelin gastrointestinal gene expression (GHRL) after RYGB, and their relationships to T2Dr.SettingIn 20 obese women with T2D, before and 3  months after RYGB, we assessed GHRL expression by microarray and quantitative RT-PCR in gastrointestinal biopsy samples and plasma levels of ghrelin.ResultsAfter RYGB, GHRL expression increased in the excluded stomach (p 
Source: Obesity Surgery - January 6, 2018 Category: Surgery Source Type: research

Effect of Employment Status on Physical Activity and Sedentary Behavior Long-Term Post-Bariatric Surgery
ConclusionEmployment status may be associated with meaningful improvements in activity post-bariatric surgery. (Source: Obesity Surgery)
Source: Obesity Surgery - January 6, 2018 Category: Surgery Source Type: research

Comparing Apples to Apples. Is it Fair to Compare Suboptimal Doses of Medications to Surgery?
(Source: Obesity Surgery)
Source: Obesity Surgery - January 6, 2018 Category: Surgery Source Type: research

Wernicke Encephalopathy Following Laparoscopic Sleeve Gastrectomy —a Call to Evaluate Thiamine Deficiencies After Restrictive Bariatric Procedures
(Source: Obesity Surgery)
Source: Obesity Surgery - January 6, 2018 Category: Surgery Source Type: research

Histopathology Findings in Patients Undergoing Laparoscopic Sleeve Gastrectomy
ConclusionMost of the findings are non-significant and can be predicted if UGIE plus multiple biopsies is routinely included in the bariatric work-up with significant cost reduction. In those patients who had a significant finding prior to the surgery or intraoperatively, the pathological examination of the specimen is recommended. (Source: Obesity Surgery)
Source: Obesity Surgery - January 5, 2018 Category: Surgery Source Type: research

Sleeve Gastrectomy after Renal Transplantation
ConclusionIn this specific group of high-risk patients, SG showed encouraging results in terms of weight loss and resolution/improvement of comorbidities, renal function, and quality of life. (Source: Obesity Surgery)
Source: Obesity Surgery - January 2, 2018 Category: Surgery Source Type: research

Major Gastric Haemorrhage After Intragastric Balloon Insertion: Case Report
We report a case of major upper gastrointestinal haemorrhage after insertion of an Orbera ® intragastric balloon. (Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes
This study seeks to identify if there is a disparity in payer status of patients undergoing bariatric surgery and what factors are associated with this disparity.MethodsWe performed a case-control analysis of National Inpatient Sample. We identified adults with body mass index (BMI) greater than or equal to 25  kg/m2 who underwent bariatric surgery and matched them with overweight inpatient adult controls not undergoing surgery. The sample was analyzed using multivariate logistic regression.ResultsWe identified 132,342 cases, in which the majority had private insurance (72.8%). Bariatric patients were significantly mo...
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Single Anastomosis Duodeno-Ileal Switch (SADIS): A Systematic Review of Efficacy and Safety
ConclusionAs a modified bariatric procedure, SADIS has promising outcomes for weight loss and comorbidity resolution in morbidly obese patients. When measured, there was a high prevalence of macro-nutrient deficiencies following SADIS. There is a high technical variability, and long-term data are required before any meaningful conclusion can be made. (Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Comparison of Banded Versus Non-banded Roux-en-Y Gastric Bypass: a Series of 1150 Patients at a Single Institution
ConclusionsBanded laparoscopic RYGB with a pericardial patch may not demonstrate a significant additional weight loss or prevent future weight regain. We were not able to demonstrate a clear advantage of banded RYGB over non-banded RYGB. (Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

How Can We Manage Long-Term Follow-up After Obesity and Metabolic Surgery?
(Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Analyses of Time to Recovery Including Time to Tracheal Extubation Need to Be Performed While Incorporating Their Probability Distribution
(Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Treatment of Vitamin and Mineral Deficiencies After Biliopancreatic Diversion With or Without Duodenal Switch: a Major Challenge
ConclusionExceptionally high supplementation doses are needed to prevent and treat vitamin and mineral deficiencies in patients after BPD or BPD/DS. Further refinement and simplification of treatment schedules is needed. Focus on improvement of compliance to treatment is recommended. (Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Long-Term Outcomes of Laparoscopic Sleeve Gastrectomy —a Single-Center, Retrospective Study
ConclusionsIsolated LSG provides fairly good effects in a long-term follow-up with mean %EWL at 51.1%. Sixteen percent of patients require additional surgery due to insufficient weight loss. More than half of the subjects observe improvement in AHT and T2DM. Over half of the patients complain of GERD symptoms, which in most of the cases is a de novo complaint. (Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A Survey of 210 Surgeons
ConclusionThis survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice. (Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Petersen ’s Hernia may be Commoner After OAGB/MGB Than Previously Reported
(Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Response to “The Forgotten Fundus—Obesity Treatment with Botulinum Toxin-A Is Not Effective: a Systematic Review and Meta-Analysis”
(Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Time to Extubation —What Causes the Variations?
(Source: Obesity Surgery)
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
AbstractIntroductionObesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool.Materials and MethodsThe present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underw...
Source: Obesity Surgery - December 18, 2017 Category: Surgery Source Type: research

Changes in Frequency Intake of Foods in Patients Undergoing Sleeve Gastrectomy and Following a Strict Dietary Control
ConclusionOne year after sleeve gastrectomy, calibrated with a 50-French bougie, there are not important problems in the intake of foods a priori difficult to digest. These problems mostly disappeared 5  years after surgery. The decrease intake of other unhealthy foods is mostly based on the dietary counseling. (Source: Obesity Surgery)
Source: Obesity Surgery - December 17, 2017 Category: Surgery Source Type: research

Remission of Sjogren ’s Syndrome after Roux-en-Y Gastric Bypass for Morbid Obesity
(Source: Obesity Surgery)
Source: Obesity Surgery - December 17, 2017 Category: Surgery Source Type: research

Delayed Intra Splenic Abscess: a Specific Complication Following Laparoscopic Sleeve Gastrectomy
ConclusionIntrasplenic abscess complicating laparoscopic sleeve gastrectomy is different from early extra splenic abscesses. The exact causes are still unclear; the role of partial splenic ischemia has to be rolled out. (Source: Obesity Surgery)
Source: Obesity Surgery - December 16, 2017 Category: Surgery Source Type: research

Greater Curvature Plication with Duodenal –Jejunal Bypass: a Novel Metabolic Surgery for Type 2 Diabetes Mellitus
AbstractObjectiveThe study investigated the use of great curvature plication with duodenal –jejunal bypass (GCP-DJB) in a type 2 diabetic with obesity rat model.MethodsTwenty-two Sprague-Dawley rats were given a high fat and sugar diet with subsequent intraperitoneal injection of a small dosage of streptozotocin (30  mg/kg) and randomly assigned to either GCP-DJB (n = 12) or Sham surgery (n = 10). Body weight, peripheral blood glucose, and fasting serum insulin were assayed, and insulin resistance index (IRI) was calculated, before and at 1, 2, 4, and 8 weeks after surgery.Result...
Source: Obesity Surgery - December 16, 2017 Category: Surgery Source Type: research

Correction to: Contraception, Menstruation, and Sexuality after Bariatric Surgery: a Prospective Cohort Study
AbstractThe spelling of author name Jill Shawe was incorrect in the original article. It is correct here. (Source: Obesity Surgery)
Source: Obesity Surgery - December 14, 2017 Category: Surgery Source Type: research

The First Consensus Statement on One Anastomosis/Mini Gastric Bypass (OAGB/MGB) Using a Modified Delphi Approach
ConclusionOAGB/MGB experts achieved consensus on a number of aspects concerning this procedure but several areas of disagreements persist emphasising the need for more studies in the future. (Source: Obesity Surgery)
Source: Obesity Surgery - December 14, 2017 Category: Surgery Source Type: research

Impact of Bariatric Surgical Intervention on Peripheral Blood Neutrophil (PBN) Function in Obesity
AbstractAimThe aim of this study was to investigate the impact of weight loss following gastric band surgery on multiple measures of peripheral blood neutrophil (PBN) function.Material and MethodsTwenty-three obese patients undergoing gastric band surgery were recruited to a longitudinal intervention study, alongside non-obese, healthy gender- and age-matched controls. Eighteen pairs of patients and controls completed all stages of the study. PBNs were isolated by density centrifugation and a comprehensive analysis of PBN function was undertaken at various stages of the patients ’ bariatric surgical care pathway.Resu...
Source: Obesity Surgery - December 14, 2017 Category: Surgery Source Type: research

Management of Slipped Gastric Bands via Creation of a De Novo Tunnel and Band Replacement: a Single-Centre Experience
ConclusionResiting of slipped LAGBs is safe and maintains weight loss. Although a significant risk of future operative intervention remains, this can be reduced via the creation of a de novo retrogastric tunnel for band resiting. (Source: Obesity Surgery)
Source: Obesity Surgery - December 13, 2017 Category: Surgery Source Type: research

Use of Self-Expandable Metal Stents in the Treatment of Leaks Complicating Laparoscopic Sleeve Gastrectomy: A Cohort Study
AbstractBackgroundUse of a self-expandable metal stent (SEMS) as an initial intervention for leaks after laparoscopic sleeve gastrectomy (LSG) has increased. We assessed the efficacy and safety of SEMS in the treatment of post-LSG leaks, and the determinants of repeated rounds of stenting.MethodsA retrospective chart review was conducted at a university hospital in Saudi Arabia. The study included patients who developed leaks after undergoing LSG between October 2011 and April 2016.ResultsSixty-four patients (mean age, 35.69  ± 10.71 years) were included; 55% were males. The mean estimated size of...
Source: Obesity Surgery - December 12, 2017 Category: Surgery Source Type: research

Duodenal Exclusion but Not Sleeve Gastrectomy Preserves Insulin Secretion, Making It the More Effective Metabolic Procedure
ConclusionThe effect of SG on glucose control was transient, whereas a duodenal exclusion was the more effective procedure in this model due to a sustained pancreatic function with a preserved insulin secretion. (Source: Obesity Surgery)
Source: Obesity Surgery - December 12, 2017 Category: Surgery Source Type: research

Increased Bile Acid Signals After Duodenal-Jejunal Bypass Improve Non-alcoholic Steatohepatitis (NASH) in a Rodent Model of Diet-Induced NASH
ConclusionsDJB has a direct effect on NASH improvement, and there is a possibility that an anti-inflammatory effect is functioning as a part of the mechanism. The increase of plasma bile acid level followed by the stimulation of FXR signaling may contribute to this phenomenon. (Source: Obesity Surgery)
Source: Obesity Surgery - December 12, 2017 Category: Surgery Source Type: research

Effects of Weight Loss on Acoustic Parameters After Bariatric Surgery
ConclusionObese individuals with post-surgery weight loss may present neck circumference, fundamental frequency, and maximum phonation time values closer to the mean values of normal weight individuals. In this study, weight loss was sufficient to adjust the acoustic parameter measurements. (Source: Obesity Surgery)
Source: Obesity Surgery - December 12, 2017 Category: Surgery Source Type: research

Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy on Morbidly Obese, Super-Obese, and Super-Super Obese Patients for the Treatment of Morbid Obesity
ConclusionAlthough %EWL was lower in the SSO group, LSG was a feasible and safe stand-alone bariatric surgical procedure for the resolution of comorbidities in MO, SO, and SSO patients. (Source: Obesity Surgery)
Source: Obesity Surgery - December 12, 2017 Category: Surgery Source Type: research

Implications of Celiac Disease Among Patients Undergoing Gastric Bypass
ConclusionThough many bariatric patients may carry a presumptive diagnosis of celiac disease, a small percentage of these meet AGA diagnostic criteria. RYGB appears safe in this population with comparable weight loss in non-celiac counterparts. Increased attention to vitamin D levels may be warranted post-operatively. (Source: Obesity Surgery)
Source: Obesity Surgery - December 12, 2017 Category: Surgery Source Type: research