Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
-
Surg Obes Relat Dis · Sep 2009
Continuous positive airway pressure in immediate postoperative period after laparoscopic Roux-en-Y gastric bypass: is it safe?
Obstructive sleep apnea is a common condition in the morbidly obese population. Many patients undergoing bariatric surgery require postoperative continuous positive airway pressure (CPAP) therapy. Few data have been published evaluating gastrointestinal anastomotic morbidity in patients receiving CPAP therapy immediately after laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of the present study was to examine the short-term morbidity of postoperative CPAP in patients after LRYGB in a research setting. ⋯ The use of CPAP after LRYGB did not result in increased the morbidity in our patient series.
-
Surg Obes Relat Dis · Sep 2009
Comparative StudyDepression is associated with increased severity of co-morbidities in bariatric surgical candidates.
Depression is prevalent among bariatric surgical patients, and previous studies have suggested a link between depression and quality of life. Our objective was to examine the relationship between depression and other co-morbidities of obesity at a university hospital in the United States. ⋯ This report has characterized a link between depression and other co-morbidities in bariatric surgical patients. This association was independent of the body mass index. Although a causal relationship could not yet be identified, our findings indicate that depression, in this patient population, is associated with a greater prevalence and increased severity of medical co-morbidities that express distinct physical symptoms.
-
Surg Obes Relat Dis · Jul 2009
Patterns of readmission and reoperation within 90 days after Roux-en-Y gastric bypass.
Health insurance payors harbor concerns regarding the cost of bariatric procedures that are chiefly related to early readmissions and reoperations. We have attempted to identify the avoidable causes of readmission. ⋯ A considerable number of patients are affected by nausea, vomiting, and dehydration, abdominal pain, and wound issues <90 days postoperatively. Socioeconomic and functional status might have an effect on the rate of ED visits and readmissions. By ensuring that the appropriate outpatient mechanisms for management of these problems are available, early ED visits and readmission rates should significantly decrease.
-
Surg Obes Relat Dis · Jul 2009
Expanded Occupational Safety and Health Administration 300 log as metric for bariatric patient-handling staff injuries.
Mobilization of morbidly obese patients poses significant physical challenges to healthcare providers. The purpose of this study was to examine the staff injuries associated with the patient handling of the obese, to describe a process for identifying injuries associated with their mobilization, and to report on the need for safer bariatric patient handling. ⋯ Manual mobilization of morbidly obese patients increases the risk of caregiver injury. A tracking indicator on the OSHA 300 logs for staff injury linked to a bariatric patient would provide the ability to compare obese and nonobese patient handling injuries. The E-OSHA 300 log provides a method to identify the frequency, severity, and nature of caregiver injury during mobilization of the obese. Understanding the heightened risk of injury associated with manual bariatric patient handling should help healthcare institutions identify deficiencies in their current injury prevention program and focus resources more precisely for safer, systems-based bariatric patient-handling solutions. Effective patient handling systems should also reduce the aura of fear that might be present in some caregivers when mobilizing a bariatric patient.
-
Surg Obes Relat Dis · May 2009
Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass.
Previous outcome research in bariatric surgery has been unable to document quantitative changes in co-morbidities associated with obesity owing to a lack of a standardized instrument to grade the severity. We report a detailed description of the early resolution of the metabolic syndrome using our novel scheme for assessing co-morbidities. This study was performed at a tertiary care university hospital. ⋯ We have demonstrated a new and novel approach to categorize and more accurately define the magnitude of improvement in co-morbidities after laparoscopic Roux-en-Y gastric bypass. This improvement preceded the weight loss effects on the metabolic syndrome.