Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Sep 2014
Is glycosylated hemoglobin A1 c associated with increased risk for severe early postoperative complications in nondiabetics after laparoscopic gastric bypass?
Glycosylated hemoglobin A1 c (HbA1 c) has been described as a risk factor for adverse outcome after cardiovascular and colorectal surgery, but not for obese patients undergoing bariatric surgery. The objective of this study was to see if there is an association between HbA1 c and adverse outcome in laparoscopic gastric bypass surgery. ⋯ HbA1 c levels below 5.7 % were associated with a lower incidence of severe complications (2.7 %) than higher levels (HbA1 c 5.7-6.49% incidence 3.5%, P = .015; HbA1 c>6.5%, incidence 4.5%, P = .012). After multivariate analysis with patient-specific confounders the difference remained significant (HbA1 c 5.7-6.49% adjusted P = .046; HbA1 c>6.5% adjusted P = .023) CONCLUSION: Elevated HbA1 c levels in patients without pharmacologic treatment for diabetes undergoing laparoscopic gastric bypass surgery is associated with an increased risk for severe complications during the first 30 postoperative days. This is the case, even at levels not regarded as diagnostic for diabetes.
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Surg Obes Relat Dis · Sep 2014
Co-morbidity resolution in morbidly obese children and adolescents undergoing sleeve gastrectomy.
Bariatric surgery is becoming important for the reversal of co-morbidities in children and adolescents. We previously reported the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in the pediatric population. However, evidence pertaining to the effect of LSG on co-morbidities in this age group is scarce. The objective of this study was to assess the remission and improvement of co-morbidities (dyslipidemia, hypertension, diabetes, and obstructive sleep apnea) after LSG in children and adolescents. ⋯ LSG performed on children and adolescents results in remission or improvement of>90% of co-morbidities within 2 years after bariatric surgery with few complications, no mortality, and normal growth.
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Surg Obes Relat Dis · Sep 2014
Citation classics: top 50 cited articles in bariatric and metabolic surgery.
The number of times an article has been cited reflects its influence in a specific field. The aim of this study was to identify and characterize the most highly cited articles published on bariatric and metabolic surgery. ⋯ Extending from the early 1950s through the voluminous growth period of the early 2000s, the field of bariatric and metabolic surgery led to the emergence of many top-cited scientific articles. These articles have provided the scientific basis for the only currently effective treatment for severe obesity. Articles published in high-impact journals, innovative observational studies, meta-analyses, survival analyses, and research on postoperative metabolic changes are most likely to be cited in the field of bariatric surgery.