Perioperative outcomes of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in super-obese and super-super-obese patients: a national database analysis

Nasser, Hassan; Ivanics, Tommy; Leonard-Murali, Shravan; Shakaroun, Dania; Genaw, Jeffrey A.

doi:10.1016/j.soard.2019.07.026

Cited by 34 publications

(24 citation statements)

References 36 publications

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“…Among bariatric surgeries performed as a stand-alone procedure, data have been published on SG, RYGB, OAGB, BPD-DS, and SADI in the setting of severe obesity with BMI > 50 kg/m 2 . The study by Nasser et al [ 28 ] analyzed the data of 356, 621 patients who received SG or RYGB (65, 565 with BMI > 50, 18, 861 with BMI > 60). Patients with BMI > 50 kg/m 2 had increased morbidity and mortality compared to those with morbid obesity.…”

Section: Discussionmentioning

confidence: 99%

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

et al. 2021

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Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

et al. 2021

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“…LRYGB bariatric surgery is the most popular operation at present for treating patients with obesity and metabolic diseases [10]. Although LRYGB surgery can guarantee weight loss and has a lower perioperative mortality rate, patients with the higher BMI tend to have increased incidence of complications and increased surgical difficulty [11]. In addition, as one of the more common stressors in clinical practice, most patients will have different degrees of worry, fear and tension before surgery.…”

Section: Discussionmentioning

confidence: 99%

Application of Medical Nursing Integrated Nursing Mode in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass Bariatric Surgery

Zhang¹,

Yu²,

Wei³

et al. 2020

AJNS

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Purpose: To explore the effect of medical nursing integrated nursing mode on the quality of care of patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) bariatric surgery. Methods: A total of 60 patients from January 2018 to December 2018 were enrolled as the control group, and 60 patients from January 2019 to December 2019 were enrolled as the intervention group. In the control group, patients were cared by the routine nursing mode. In the intervention group, medical nursing integrated nursing mode was adopted in addition to the routine LRYGB nursing process. The waiting time of preoperative examination, preoperative HAMA and SDS scores, postoperative complication rates, time indicators of nursing quality and patient satisfaction in the two groups were collected and compared. Results: The waiting time of preoperative examination was shortened (P<0.05), preoperative anxiety and depression were reduced (P<0.05), the complication rates of postoperative bleeding, infection, wound pain and abdominal distension were reduced (P<0.05), the time indicators of nursing quality were shortened (P<0.05) and patient satisfaction was improved in the intervention group compared to the control group (P<0.05). Conclusions: Application of medical nursing integrated nursing mode in patients undergoing LRYGB bariatric surgery can alleviate the negative emotions of anxiety and depression before surgery, reduce the postoperative complication rates, improve the quality of care and patient satisfaction.

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“…Conditions such as diabetes, obstructive sleep apnoea and hypoventilation syndrome and cardiac risk factors increase operative risk. These patients are often relatively sarcopaenic and have reduced capacity to manage the stress of surgery (5,7). Surgical complications are likely to have greater morbidity impact.…”

Section: Review Articlementioning

confidence: 99%

“…Surgical complications are likely to have greater morbidity impact. Surgical wound complications tend to be more severe, respiratory complications more difficult to recover from and sepsis more difficult to reverse (7). Assessment and treatment of complications may also be more difficult due to body habitus leading to late diagnosis and treatment.…”

Section: Review Articlementioning

confidence: 99%

Laparoscopic Roux en Y gastric bypass in the super obese

Aly¹,

Mori²

2020

Ann Transl Med

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Bariatric surgery in super obese patients presents technical, metabolic and risk related challenges.Moreover, there is concern that weight loss and health outcomes of surgery, including gastric bypass, may be lesser than in non super obese (morbidly obese) patients. This may drive clinicians toward more aggressive forms of surgery at the risk of greater morbidity. This review examines outcomes pertaining to laparoscopic Roux en Y gastric bypass (LRYGB) in the super obese and determines the role of such surgery in the current day. Whilst a minor increase in morbidity and mortality risk exists, weight loss outcomes when measured as percentage total body weight loss are equivalent to non super obese patients. Final BMI is not an appropriate indicator of benefit in such patients and may lead to escalation surgery inappropriately. Surgeons employing the use of LRYGB in the super obese should have adequate training and expertise in the technique and operating upon super obese patients should be avoided during the learning curve phase to minimise morbidity risk.

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Perioperative outcomes of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in super-obese and super-super-obese patients: a national database analysis

Cited by 34 publications

References 36 publications

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

Application of Medical Nursing Integrated Nursing Mode in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass Bariatric Surgery

Laparoscopic Roux en Y gastric bypass in the super obese

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