Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Sep 2020
Review Meta AnalysisTransversus abdominis plane block using a short-acting local anesthetic reduces pain and opioid consumption after laparoscopic bariatric surgery: a meta-analysis.
Transversus abdominis plane (TAP) block is a form of regional anesthesia that has been increasingly employed in minimally invasive surgery. The data regarding its use in laparoscopic bariatric surgery, however, are still limited and at times controversial. ⋯ Given the significant effect on early and late postoperative pain, opioid consumption, and postoperative recovery and the low risk profile, TAP block using a short-acting anesthetic should be encouraged in routine practice in patients undergoing laparoscopic bariatric surgery.
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Surg Obes Relat Dis · Dec 2018
Meta AnalysisPredictors of glycemic control after sleeve gastrectomy versus Roux-en-Y gastric bypass: A meta-analysis, meta-regression, and systematic review.
Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most commonly performed bariatric procedures globally. However, it remains controversial which procedure provides better glycemic control. To identify predictors of glycemic control after SG versus RYGB, a systematic search of PubMed, EMBASE, and the Cochrane Library was conducted up to January 2017 for comparative studies with both SG and RYGB arms for the treatment of type 2 diabetes (T2D). ⋯ The baseline body mass index, duration of T2D, preoperative fasting plasma glucose, and preoperative A1C had predictive value for glycemic control after SG, but only duration of T2D and preoperative A1C were correlated with that after RYGB. These findings showed that the choice of procedure between SG and RYGB predicts no better glycemic control. However, more factors should be considered when SG is recommended to a given patient with diabetes.
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Surg Obes Relat Dis · Aug 2018
Meta AnalysisRelationship between bariatric surgery and periodontal status: a systematic review and meta-analysis.
The effects of bariatric surgery can reflect in the oral cavity and can cause alterations in oral health. This high prevalence of oral alterations in the pre and post-operative periods has been highlighted in different studies. ⋯ Plaque index can be improved after bariatric surgery. The present systematic review investigated the association between bariatric surgery and periodontal status from cross-sectional and longitudinal studies. A systematic search strategy was developed until May 2017. The results of this systematic review allowed the conclusion that the plaque index can be improved after bariatric surgery.
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Surg Obes Relat Dis · Jun 2018
Review Meta AnalysisAntral resection versus antral preservation during laparoscopic sleeve gastrectomy for severe obesity: Systematic review and meta-analysis.
Although laparoscopic sleeve gastrectomy is an established operation for severe obesity, there is controversy regarding the extent to which the antrum is excised. The objective of this systematic review was to investigate the effect on perioperative complications and medium-term outcomes of antral resecting versus antral preserving sleeve gastrectomy. MEDLINE, EMBASE, and Cochrane databases were searched from 1946 to April 2017. ⋯ There was no difference in incidence of perioperative bleeding, leak, or de novo gastroesophageal reflux disease. According to the available evidence, antral resection is associated with better medium-term weight loss compared with antral preservation, without increased risk of surgical complications. Further randomized clinical trials are indicated to confirm this finding.
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Surg Obes Relat Dis · Aug 2017
Review Meta AnalysisPerioperative analgesic profile of dexmedetomidine infusions in morbidly obese undergoing bariatric surgery: a meta-analysis and trial sequential analysis.
Opioid-sparing analgesia for bariatric surgery in morbidly obese can potentially prevent catastrophic airway complications. Our meta-analysis attempts to consolidate the evidence on dexmedetomidine evaluating its analgesic and safety profile. ⋯ Perioperative dexmedetomidine infusion in obese patients undergoing bariatric surgery is a promising and safe alternative. Both intraoperative or postoperative infusions lead to significant opioid sparing in early and extend postoperative recovery phase. Morbidly obese patients receiving perioperative dexmedetomidine infusions have overall better pain control and lower incidence of postoperative nausea-vomiting. All the aforementioned merits come with a stable hemodynamic profile and without any reported major adverse events.