Obesity surgery
-
Review Meta Analysis
Systematic Review and Meta-Analysis of Occupational Outcomes after Bariatric Surgery.
Obesity has been linked with reduced productivity in the workplace and is associated with higher levels of unemployment and absenteeism. Studies have shown improvement in functioning and enhanced activity levels in patients after bariatric surgery. ⋯ There is limited evidence in the literature regarding occupational outcomes following bariatric surgery, and further studies are required before firm conclusions can be drawn. However, the existing evidence does suggest that bariatric surgery has a generally positive impact on occupational outcomes. This suggests that surgery may have wider economic, social and psychological benefits above and beyond its immediate health benefits.
-
Review Meta Analysis
Long-term effects of bariatric surgery on type II diabetes, hypertension and hyperlipidemia: a meta-analysis and meta-regression study with 5-year follow-up.
The first aim of the study was to estimate weight loss and major modifiable risk factors after bariatric surgery. The second aim was to investigate the relationship between the reduction in cardiovascular risk and weight loss over time. ⋯ The reduction in arterial hypertension reached a nadir earlier than the risk of diabetes and hyperlipidemia, thus indicating a possible link between weight reduction and positive hemodynamic effects.
-
Meta Analysis Comparative Study
Laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass for morbid obesity and related comorbidities: a meta-analysis of 21 studies.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are two most common weight loss procedures; our meta-analysis aims to compare these two in the treatment of morbid obesity and its related comorbidities. An electronic literature research of published studies concerning LRYGB and LSG was performed from inception to October 2013. Percentage of excess weight loss (%EWL), resolution or improvement rate of comorbidities, and adverse events were all pooled and compared by the software Review Manager 5.1. ⋯ Except for type 2 diabetes mellitus (T2DM) (P < 0.001), the difference between these two procedures in the resolution or improvement rate of other comorbidities did not reach a statistical significance (P > 0.05). There were more adverse events in LRYGB compared with LSG (P < 0.01). In conclusion, LRYGB is superior to LSG in efficacy but inferior to LSG in safety.
-
Review Meta Analysis
Diabetes and weight in comparative studies of bariatric surgery vs conventional medical therapy: a systematic review and meta-analysis.
We performed a meta-analysis of weight loss and remission of type 2 diabetes mellitus (T2DM) evaluated in randomized controlled trials (RCTs) and observational studies of bariatric surgery vs conventional medical therapy. English articles published through June 10, 2013 that compared bariatric surgery with conventional therapy and included T2DM endpoints with ≥12-month follow-up were systematically reviewed. Body mass index (BMI, in kilogram per square meter), glycated hemoglobin (HbA1C, in degree), and fasting plasma glucose (FPG, in milligram per deciliter) were analyzed by calculating weighted mean differences (WMDs) and pooled standardized mean differences and associated 95 % confidence intervals (95 % CI). ⋯ Of the included studies, 94.0 % demonstrated a significant statistical advantage favoring surgery. In a meta-analysis of 16 studies (5 RCTs) with 6,131 patients and mean 17.3-month follow-up, bariatric surgery was significantly more effective than conventional medical therapy in achieving weight loss, HbA(1C) and FPG reduction, and diabetes remission. The odds of bariatric surgery patients reaching T2DM remission ranged from 9.8 to 15.8 times the odds of patients treated with conventional therapy.
-
Review Meta Analysis
Bariatric surgery is effective and safe in patients over 55: a systematic review and meta-analysis.
Effective weight loss and reduction in comorbidities has been convincingly demonstrated with bariatric surgery. Concerns regarding increased perioperative complications and poor results have led to a reluctance to offer such surgery to older patients. We performed a systematic review and meta-analysis of the published evidence for those in the ≥55-year age group. ⋯ Meta-analysis of old versus young patients revealed better comorbidity and mortality outcomes for younger patients. Bariatric surgery for patients ≥55 years achieves weight loss and reduction in comorbidities and mortality comparable to the general bariatric surgery population. Based on the above findings, patients should not be denied bariatric surgery on the basis of age alone.