Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Nov 2018
Options in bariatric surgery: modeled decision analysis supports Roux-en-Y gastric bypass and sleeve gastrectomy as the treatments of choice.
Obesity is a chronic disease associated with significant morbidity and mortality. Bariatric surgery has been shown to significantly reduce both morbidity and mortality. Numerous surgical strategies exist, but the most frequently used worldwide are adjustable gastric banding, sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB). It is not clear which of these strategies provides the optimal quality-of-life pay-off. ⋯ SG and RYGB offer similar outcomes in terms of QALY payoffs. Decision making should be in line with institutional and patient preference.
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Surg Obes Relat Dis · Nov 2018
Multicenter Study Comparative StudyRoux-en-Y gastric bypass, sleeve gastrectomy, or one anastomosis gastric bypass as rescue therapy after failed adjustable gastric banding: a multicenter comparative study.
To date, laparoscopic adjustable gastric banding remains the third most commonly performed surgical procedure for weight loss. Some patients fail to get acceptable outcomes and undergo revisional surgery at rates ranging from 7% to 60%. Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), and sleeve gastrectomy (SG) are among the most common salvage options for failed laparoscopic adjustable gastric banding. ⋯ Our data show that it is possible to achieve or maintain significant weight loss with an acceptable complication rate with all 3 surgical options.
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Surg Obes Relat Dis · Oct 2018
Controlled Clinical TrialSecond-stage duodenal switch for sleeve gastrectomy failure: A matched controlled trial.
Sleeve gastrectomy (SG) has become the predominant bariatric surgery worldwide. However, the surgical management in case of failure is still debated. ⋯ Second-stage DS is an effective option for the management of suboptimal outcomes of SG, with an additional 41% excess weight loss and 35% remission rate for type 2 diabetes. At 3 years, the global outcomes of staged approach did not significantly differ from single-stage BPD-DS; however, longer-term outcomes are still needed.
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Surg Obes Relat Dis · Oct 2018
Multicenter Study Comparative StudyHow safe is same-day discharge after laparoscopic sleeve gastrectomy?
Laparoscopic sleeve gastrectomy (LSG) is associated with low morbidity and mortality and a short length of stay. Studies on the safety of same-day discharge after LSG are limited. ⋯ Same-day discharge after LSG is associated with increased complications, readmissions, and reoperations compared with POD1 discharge. Further studies are needed to examine objective criteria for safe same-day discharge after LSG.
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Surg Obes Relat Dis · Oct 2018
Multicenter Study Observational StudyCurrent role of staple line reinforcement in 30-day outcomes of primary laparoscopic sleeve gastrectomy: an analysis of MBSAQIP data, 2015-2016 PUF.
Laparoscopic sleeve gastrectomy (LSG) has become a dominant bariatric procedure. In the past, significant leak rates prompted the search for staple line reinforcement (SLR) techniques. Previous analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for all LSG suggested a detrimental influence of SLR on leak rates and overall morbidity. ⋯ Primary LSG is a safe procedure with low morbidity and mortality rates. SLR is associated with decreased rates of bleeding and reoperations but does not affect leak rates. The selection of SLR technique should be left to the surgeon's discretion with an understanding of the associated risks, benefits, and costs.