Obesity surgery
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Durability is a key requirement for the broad acceptance of bariatric surgery. We report on durability at and beyond 10 years with a systematic review and meta-analysis of all reports providing data at 10 or more years and a single-centre study of laparoscopic adjustable gastric banding (LAGB) with 20 years of follow-up. ⋯ All current procedures are associated with substantial and durable weight loss. More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy. Reoperation is likely to remain common across all procedures.
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Meta Analysis
Impact of Bariatric Surgery on Male Sex Hormones and Sperm Quality: a Systematic Review and Meta-Analysis.
This systematic review and meta-analysis aims to establish the effects of bariatric surgery on male sex hormones, sperm parameters, and sexual function. We searched MEDLINE, EMBASE, Web of Science, and Scopus from database inception through June 2018. Articles were eligible for inclusion if they examined the effect of bariatric surgery on male sex hormones and sperm parameters in patients with obesity. ⋯ However, bariatric surgery did not affect sperm quality, DHEA, androstenedione, and inhibin B levels. Sustained weight-loss induced by bariatric surgery had a significant effect on increasing male sex hormones and decreasing female sex hormones in male patients with obesity. However, sperm quality and function were not improved after surgery.
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Many respectable guidelines recommend lifelong vitamin B12 injections for Roux-en-Y gastric bypass (RYGB) patients in the absence of lack of consensus on the efficacy of oral route of prophylaxis and the appropriate doses needed for this purpose. The purpose of this review was to examine the published English language scientific literature in accordance with PRISMA principles to find out if orally given vitamin B12 is adequate for prophylactic purposes in RYGB patients and the appropriate dosages needed for this purpose if it is. ⋯ The review finds that oral supplementation doses of ≤ 15 μg vitamin B12 daily are inadequate for prophylaxis of vitamin B12 deficiency in adult RYGB patients but doses of 1000 μg vitamin B12 daily might be adequate. Future studies need to examine this and even higher oral doses for vitamin B12 supplementation for patients undergoing RYGB.
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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.
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Review
Gastrobronchial Fistula in Sleeve Gastrectomy and Roux-en-Y Gastric Bypass--A Systematic Review.
Gastrobronchial fistula (GBF) is a rare surgical complication after bariatric surgery. We aimed to identify the clinical aspects of GBF and establish diagnostic and treatment strategies. A literature search was conducted in December 2013, in the PubMed electronic database. ⋯ Endoscopic treatment was successful in 18 out of 20 patients, with minimal complication. Surgical treatment was successful in 17 cases with significant complications. GBF can be effectively treated with both endoscopic and surgical approach; however, surgical treatment can be associated with more complication.