It appears that hyperparathyroidism persists at 5-year follow-up after gastric bypass, despite most patients being supplemented with calcium and Vitamin D.

Long-term T2DM resolution rates are not well established following the laparoscopic sleeve gastrectomy (LSG). The aim of this paper was to systematically review the evidence on the efficacy of the LSG on long-term T2DM resolution. A comprehensive electronic literature search was conducted. Included studies reported 5-year follow-up of T2DM outcomes following the LSG. Eleven studies (n = 1354) were included in the systematic review. T2DM patients (n = 402) encompassed 29.7 % of patients. Diabetes prevalence decreased post-operatively to 20.5 % at 5 years, with diabetes resolution occurring in 60.8 % of patients. Mean plasma glucose levels and haemoglobin A1c values fell from 170.3 to 112.0 mg/dL and 8.3 to 6.7 % respectively at the 5-year mark. The LSG is an effective long-term metabolic surgery for patients with T2DM.

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Introduction: There is conflicting evidence with regard to the routine use of upper gastrointestinal contrast series in detecting early complications post paraesophageal hernia repair (PEHR).Methods: All cases booked for a PEHR between January 2007 and September 2015 were identified using hospital records. Standard demographic, operation, and imaging data were extracted.Results: We retrospectively identified 391 PEHR cases between January 2007 and September 2015. The mean age at the index operation was 66.7 years with a female predominance. The majority of index operations were elective and completed for a large paraesophageal hernia. Contrast studies were reported as normal in 70.6%, a leak in 0.3%, an obstruction in 27.9%, and early recurrence in 1.0%. Reoperation was required in 1.8% of cases. Conclusion:Routine upper gastrointestinal contrast studies post-PEHR changed management in 0.8% of cases and were unhelpful in determining the need for early reoperation in 57.1% of cases requiring reoperation.

Background: Australia has a low cadaver organ donor (CD) rate by international standards, leading to the increasing use of live donor (LD) renal grafts.Aims: To review the Australian experience with LD transplants from 1964 to 1999.Methods: Data were obtained from the Australian and New Zealand Dialysis and Transplant Registry. Survival was assessed by the Kaplan-Meier method.Results: A total of 1584 LD and 10 252 CD transplants was performed between 1964 and 1999. While the CD rate dropped over the last decade, the LD rate increased, maintaining the overall transplantation rate. Only 3.6% of grafts before 1980 were LD, increasing to 28.4% during 1995-1999. Patient and graft survival of LD grafts was superior to CD grafts. Most LD grafts were from live related donors (LRD), most commonly parents or siblings. The number of transplants from live unrelated donors (LURD) has risen (1980-1989, n = 6; 1990-1999, n = 143), primarily due to more spousal donation, with no difference in survival between LRD and LURD groups. Grafts from older donors (>50 years of age) increased, with no graft survival difference between donors <50 years and donors >50 years. LD transplants performed prior to commencement of dialysis increased, with survival similar to grafts performed after dialysis. Conclusion:The pattern of renal transplantation in Australia has changed, with increasing numbers of LD transplants, growing use of unrelated and older donors, and more transplants before dialysis commences. Long-term patient and graft survival advantages have been maintained, supporting the growing use of live donors to expand the donor pool. (Intern Med J 2002; 32: 569-574)