Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Apr 2017
Multicenter StudyEvaluating the effect of operative technique on leaks after laparoscopic sleeve gastrectomy: a case-control study.
To assess the effect of operative technique on staple line leaks after laparoscopic sleeve gastrectomy (LSG). ⋯ Despite considerable variation in operative technique, leak rates with laparoscopic sleeve gastrectomy have decreased over time as operative volume has increased. Oversewing of the staple line was associated with fewer leaks, but specific suturing technique was not uniform and oversewing was performed routinely by more experienced surgeons with higher case volumes and less complication rates overall. Before standardizing surgical technique one must take into account variations in surgeon skill and experience.
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Surg Obes Relat Dis · Apr 2017
Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication.
Morbidly obese patients are affected by gastroesophageal reflux disease (GERD) and hiatal hernia (HH) more frequently than lean patients. Because of conflicting results, the indication to sleeve gastrectomy (SG) in patients with GERD is still debated. ⋯ In the present series the incidence of EE and of BE in SG patients was considerably higher than that reported in the current literature, and it was not related to GERD symptoms. Endoscopic surveillance after SG should be advocated irrespective of the presence of GERD symptoms.
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Surg Obes Relat Dis · Mar 2017
Randomized Controlled TrialMelatonin premedication improves quality of recovery following bariatric surgery - a double blind placebo controlled prospective study.
Melatonin has hypnotic, sedative, analgesic, anti-inflammatory, and antioxidant properties, and is a widely used sleep agent. ⋯ Use of melatonin premedication improved the quality of recovery 1 day after bariatric surgery as measured by the QoR-15, specifically the quality of sleep and pain levels. Melatonin may serve as a premedication, especially when other options, like benzodiazepines are not recommended.
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Surg Obes Relat Dis · Mar 2017
Hypocalcemia after thyroidectomy in patients with a history of bariatric surgery.
Hypocalcemia is a common complication after total thyroidectomy. Previous bariatric surgery could be a higher factor risk for hypocalcemia due to alterations in calcium absorption and vitamin D deficiency. ⋯ Patients with previous bariatric surgery have an increased risk for hypocalcemia after total thyroidectomy, especially after Roux-en-Y gastric bypass. Careful and prolonged follow-up of calcium, vitamin D, and parathyroid hormone levels should be suggested for these patients.
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Surg Obes Relat Dis · Feb 2017
Perioperative outcome of laparoscopic sleeve gastrectomy for high-risk patients.
Morbidly obese patients with excessive concomitant disease carry a significantly increased perioperative risk. Although they may benefit most from a bariatric intervention, they are often denied surgery. Laparoscopic sleeve gastrectomy (LSG), as it is less complication-prone than other bariatric procedures, suits the needs of those patients. ⋯ "High-risk"-patients identified using a combination of established obesity- and co-morbidity-related risk scores profit from LSG as part of a uniform treatment pathway. Given the severity of co-morbidities, LSG can be performed safely. (Surg Obes Relat Dis 2016;X:XXX-XXX.) © 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.