Obesity surgery
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Clinical Trial
Impact of Laparoscopic Sleeve Gastrectomy on Gut Permeability in Morbidly Obese Subjects.
Recent studies have suggested that obesity is associated with an increased intestinal permeability as well as an altered microbiota profile. These conditions can promote the translocation of lipopolysaccharide into the circulation and, subsequently, contribute to the observed systemic inflammation. Our aim was to assess gut permeability in patients with obesity compared to non-obese subjects as well as after excessive weight loss following laparoscopic sleeve gastrectomy (LSG). ⋯ The trials were registered at https://www.drks.de/drks_web/ with the number DRKS00009008 and DRKS00006210.
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Although enhanced recovery after bariatric surgery (ERABS) has proven to be safe and cost-effective, this concept is relatively new in the Middle East. ⋯ Implementation of a standardized ERABS program in the Middle East is feasible and safe and leads to reduced LOS and OR times.
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Early discharge after laparoscopic sleeve gastrectomy (SG) is common and safe, but two-thirds of patients are still hospitalized longer than 1 day. The purpose of this study was to evaluate factors associated with early discharge at a single institution with intention to discharge on postoperative day 1. ⋯ LOS after SG is affected by multiple factors, including patient health, socioeconomic status, case order, and postoperative management. Optimization of these may allow for improvement in preoperative education and streamlined postoperative pathways, resulting in reduced LOS.
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Comparative Study
Comparison of the Bile Reflux Frequency in One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass: a Cohort Study.
One of the most acceptable procedures in bariatric surgery is laparoscopic gastric bypass. Laparoscopic Roux-en-Y gastric bypass (RYGB) is a common technique used in bariatric surgery. Recently, one anastomosis gastric bypass (OAGB) has been suggested as a simple, fast, and effective technique for obesity treatment. This study aims to compare the frequency of histologically proven bile reflux in OAGB and RYGB among patients with morbid obesity. ⋯ OAGB and RYGB appear to be equal with respect to postoperative complications, bile reflux frequency, bile reflux index, and the Sydney system score.
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Randomized Controlled Trial
Impact of Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative Pain and Early Outcome After Laparoscopic Bariatric Surgery: a Randomized Double-Blinded Controlled Trial.
Based on the promising results of transversus abdominis plane (TAP) block in various abdominal procedures, this study aimed to investigate its effect on postoperative pain and early outcome after laparoscopic bariatric procedures. ⋯ Using US-guided TAP block in adjunct with laparoscopic bariatric surgery managed to achieve lower pain scores, lower opioid requirements, lower PONV scores, earlier ambulation, shorter time to pass flatus, and comparable hospital stay and complication rate to the control group.