Bariatric and metabolic outcomes in the super-obese elderly

Daigle, Christopher R.; Andalib, Amin; Corcelles, Ricard; Cetin, Derrick; Schauer, Philip R.; Brethauer, Stacy A.

doi:10.1016/j.soard.2015.04.006

Cited by 32 publications

(17 citation statements)

References 36 publications

(54 reference statements)

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“…Compared with other studies in patients with super obesity (BMI ≥50 kg/m 2 ), the %EWL after LMGB in the present study is higher than that after laparoscopic sleeve gastrectomy (mean 40.2%, 49.5%, and 35.6%), whereas the weight loss effect is similar to or slightly less than that of LRYGB (mean 55.0%, 55.8%, and 51.0%) [18][19][20].…”

Section: Discussioncontrasting

confidence: 81%

Initial Experience with Laparoscopic Mini-gastric Bypass in Korean Obese Patients

Lim

Kim

Kim³

2019

J Metab Bariatr Surg

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Purpose: To report our initial experience with laparoscopic mini-gastric bypass (LMGB) in Korean obese patients. Materials and Methods: From July 2016 to February 2018, 14 male patients underwent LMGB for morbid obesity at a single institution. Five trocars were placed in a U-shape formation and 1 trocar was placed at the epigastrium as a liver retractor; a window was created between the vagal nerve and lesser curvature at the gastric angle for entering the lesser sac; a narrow gastric tube (∼100-120 ml volume) was made; a linear-stapled gastrojejunostomy was created after bypassing the jejunum 200 cm from the Treitz' ligament; and the Petersen defect was closed to prevent internal hernia. Patient demographics, operative time, estimated blood loss, postoperative hospital stay, complications, weight loss, and resolution of comorbidities were evaluated during 1 year of follow-up. Results: All procedures were successful by laparoscopy. The average age was 29 (19-49) years; weight, 164.9 (127-250) kg; and body mass index, 51.0 (42.4-81.6) kg/m 2. In 1 case, nephrectomy was simultaneously performed for early renal cell carcinoma. The mean operative time was 148.8 (120-175) min. The mean postoperative hospital stay was 1.9 (1-4) days. The percentage excess weight loss at 1, 3, 6, 9, and 12 months was 16.6%, 31.0%, 41.4%, 45.4%, and 50.4%, respectively. The resolution rate of type 2 diabetes mellitus, hypertension, and dyslipidemia was 75%, 40%, and 66.7%, respectively. There was no major complication including mortality during the follow-up. Conclusion: LMGB is a technically simple, safe, and effective procedure in Korean obese patients.

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Section: Discussioncontrasting

confidence: 81%

Initial Experience with Laparoscopic Mini-gastric Bypass in Korean Obese Patients

Lim

Kim

Kim³

2019

J Metab Bariatr Surg

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“…Seventeen studies showed results on diabetes resolution, ranging from 33% 42 to 83%, 33 , 40 with a pooled mean of 54.5% (95% CI 39.1–69.1; Figure 5 ).…”

Section: Resultsmentioning

confidence: 99%

Bariatric surgery in elderly patients: a systematic review

Giordano¹,

Victorzon²

2015

CIA

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Controversy exists regarding the effectiveness and safety of bariatric/metabolic surgery in elderly patients. We performed a systematic review on this issue in patients aged 60 years or older. MEDLINE, Cochrane Library, Embase, Scopus, and Google Scholar were searched until August 2015 for studies on outcomes of bariatric surgery in elderly patients. The results were expressed as pooled proportions (%) with 95% confidence intervals. Heterogeneity across the studies was evaluated by the I2 test, and a random-effects model was used. Twenty-six articles encompassing 8,149 patients were pertinent with this issue and included data on bariatric surgery outcomes in elderly population. Fourteen patients died during the 30-day postoperative period, with a pooled mortality of 0.01%. Pooled overall complication rate was 14.7%. At 1-year follow-up, pooled mean excess weight loss was 53.77%, pooled diabetes resolution was 54.5%, and pooled hypertension resolution was 42.5%, while pooled lipid disorder resolution was 41.2%. Outcomes and complication rates of bariatric surgery in patients older than 60 years are comparable to those in a younger population, independent of the type of procedure performed. Patients should not be denied bariatric surgery because of their age alone.

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“…27 For the comparison of different bariatric surgery types, data were available from one systematic review, 28 two RCTs, 29,30 and 18 retrospective cohorts. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] The majority of studies involved mostly women aged 35 to 45 years. We rated the systematic review as fair quality, 28 one RCT (in four studies) as low risk of bias, 29,[49][50][51] and one RCT as unclear risk of bias.…”

Section: Literature Flowmentioning

confidence: 99%