Obesity surgery
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Randomized Controlled Trial
The Effect of Intraoperative Dexmedetomidine Versus Morphine on Postoperative Morphine Requirements After Laparoscopic Bariatric Surgery.
Dexmedetomidine is an α2 receptor agonist with sedative and analgesic properties. During bariatric surgery, its use may reduce postoperative opioid requirements, reduce their side effects, and improve quality of recovery. The aim of this prospective randomized controlled trial was to compare the effect of dexmedetomidine bolus and infusion versus morphine bolus given prior to the end of laparoscopic bariatric surgery. ⋯ Dexmedetomidine given prior to end of laparoscopic sleeve gastrectomy provides the same level of postoperative analgesia as morphine with better hemodynamic profile.
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Comparative Study Observational Study
Comparison of Repeat Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Case of Weight Loss Failure After Sleeve Gastrectomy.
Few series are available on the results of repeat sleeve gastrectomy (re-SG) and Roux-en-Y gastric bypass (RYGB) performed to manage the failure of primary sleeve gastrectomy (SG). The objective of this study was to compare the short- and medium-term outcomes of re-SG and RYGB after SG. ⋯ Re-SG and RYGB as revisional surgery for SG are feasible with acceptable outcomes and similar results on weight loss on the first postoperative year.
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Bariatric surgery reduces atherosclerotic cardiovascular disease (ASCVD) risk. However, the comparative effect of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on 10-year and lifetime ASCVD risk, as defined by the American College of Cardiology/American Heart Association (ACC/AHA), remains unknown. ⋯ Although RYGB and SG significantly lower 10-year and lifetime cardiovascular disease risks by 1 year after surgery, patients who undergo RYGB may experience greater cardiovascular risk reduction relative to counterparts who undergo SG.
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To compare non-fatal cardiovascular (CV) events and metabolic outcomes, among obese patients with insulin-treated type 2 diabetes who underwent bariatric surgery compared with a propensity-matched non-bariatric cohort. ⋯ Among obese insulin-treated patients with type 2 diabetes, bariatric surgery is associated with significant reductions in non-fatal CHD and PAD events, lower body weight, HbA1c, BP and a greater likelihood of insulin independency during 10 years of follow-up.
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Internal hernia is a rare but a potentially fatal complication of laparoscopic Roux-En-Y gastric bypass (LRYGB). The aims of this study are to determine the impact of mesenteric defects closure on the incidence of internal hernia after LRYGB and to determine the symptoms, characteristics, and management of internal hernias after LRYGB. ⋯ The closure of mesenteric defects during LRYGB is recommended because it is associated with a significant reduction in the incidence of internal hernia.