Risk factors for complications of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Major, Piotr; Wysocki, Michał; Pędziwiatr, Michał; Pisarska, Magdalena; Dworak, Jadwiga; Małczak, Piotr; Budzyński, Andrzej

doi:10.1016/j.ijsu.2016.12.012

Cited by 33 publications

(21 citation statements)

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“…No período estudado, a realização de ambos procedimentos foi semelhante, com 51,3% de bypass e 48,7% de sleeve. Além disso, com os avanços da cirurgia minimamente invasiva e o desenvolvimento da técnica videolaparoscópica, a cirurgia por vídeo passou a ser a mais utilizada mundialmente 5,16 . Dessa maneira, constata-se que foram realizadas, na presente amostra, mais cirurgias videolaparoscópicas em comparação com as convencionais/ abertas (84,3 versus 15,7%).…”

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“…Um estudo retrospectivo com 408 casos de cirurgias de bypass em Y de Roux e sleeve gástrico, apenas por técnica videolaparoscópica, evidenciou que as complicações acometeram 7,3% da amostra, com incremento significativo nos riscos para maiores IMC pré-operatórios e no dia da cirurgia, para maior tempo cirúrgico e menor número de grampos utilizados 16 . O tipo de cirurgia, no estudo citado, não apresentou diferença significativa quanto à incidência de complicações perioperatórias 16 .…”

Section: Discussionunclassified

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Pacientes submetidos a cirurgias bariátricas: fatores associados a complicações pós-operatórias de sítio cirúrgico

et al. 2018

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Objetivo: Verificar a prevalência e os fatores associados às complicações pós-operatórias de sítio cirúrgico em pacientes submetidos a cirurgiasbariátricas. Método: Estudo transversal, retrospectivo, analítico, com abordagem quantitativa. Foram analisados 197 casos de pacientes obesos submetidosà cirurgia bariátrica entre janeiro de 2013 e janeiro de 2016 em Pernambuco, Brasil. As variáveis relacionadas dicotomizadas foram analisadas porteste do χ2. O risco de complicações foi estimado pela odds ratio (OR). Assumiu-se significância de p<0,05. Resultados: Entre os 30 pacientes que compuserama amostra, foram observadas 45 complicações pós-operatórias de sítio cirúrgico. Houve maior incidência nos indivíduos acima de 45 anos (70,0%).Dos fatores que poderiam estar associados aos desfechos, destacaram-se abordagem cirúrgica aberta (OR=5,35), inserção de drenos (OR=4,48) e períodode tempo de pós-operatório superior a 3 dias de internação (OR=5,03). Conclusão: Comprovou-se maior prevalência de seroma como complicação desítio cirúrgico, além da técnica cirúrgica (bypass em Y de Roux), faixa etária maior de 45 anos, tipo de abordagem cirúrgica convencional/aberta, presençade inserção de dreno cavitário e tempo de internação superior a 3 dias como predisponentes a um maior desenvolvimento de complicações.

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Section: Discussionunclassified

Pacientes submetidos a cirurgias bariátricas: fatores associados a complicações pós-operatórias de sítio cirúrgico

et al. 2018

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“…The perioperative care protocol is described in detail in our previous publications [4][5][6]. The LSG and LRYGB surgical techniques used at our centers were also thoroughly described previously [7,12].…”

Section: Treatment Protocol and Surgical Techniquesmentioning

confidence: 99%

Influence of Preoperative Weight Loss on Outcomes of Bariatric Surgery for Patients Under the Enhanced Recovery After Surgery Protocol

et al. 2019

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Introduction The enhanced recovery after surgery (ERAS) protocol, which emphasizes preoperative interventions, is safely implemented in patients undergoing bariatric surgery. Patients are additionally encouraged to achieve weight loss preoperatively. We aimed to identify factors contributing to preoperative weight loss and assess their influence on outcomes of bariatric surgery among patients under the ERAS protocol. Materials and Methods We reviewed a prospectively created database in two bariatric centers with 909 bariatric patients treated in accordance with ERAS principles. The database included demographic characteristics, factors related to the surgery or perioperative period, and short-term outcomes. Our endpoints included analyses of (1) factors potentially contributing to preoperative weight loss and (2) the influence of preoperative weight loss on short-term outcomes of bariatric treatment. Results Diabetes mellitus (p = 0.007), obstructive sleep apnea (p < 0.001), and previous surgery (p = 0.012) were identified as predictors of preoperative weight loss. Steatohepatitis (p < 0.001) and respiratory disorder (p = 0.004) decreased the chance of achieving satisfactory preoperative body mass reduction. Except for operative time, early outcomes of bariatric surgery were not influenced by preoperative weight loss. Patients who achieved preoperative weight loss were less likely to be lost to follow-up (p = 0.023). Postoperative weight loss was better in patients who could lose ≥ 5% total weight preoperatively (p = 0.009).

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“…This group also included 1 patient with type 2 diabetes. In this group surgeons performed elective inguinal hernia repair using transabdominal preperitoneal approach (TAPP) [16,17]. Patients from both groups were treated in accordance with the principles of the multimodal Enhanced Recovery After Surgery (ERAS) pathway.…”

Section: Patient Tissue Samplesmentioning

confidence: 99%

Integrative genomics reveal a role for MCPIP1 in adipogenesis and adipocyte metabolism

Losko

Dolicka

Pydyn

et al. 2019

Cell. Mol. Life Sci.

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Obesity is considered a serious chronic disease, associated with an increased risk of developing cardiovascular diseases, non-alcoholic fatty liver disease and type 2 diabetes. Monocyte chemoattractant protein-1-induced protein-1 (MCPIP1) is an RNase decreasing stability of transcripts coding for inflammation-related proteins. In addition, MCPIP1 plays an important role in the regulation of adipogenesis in vitro by reducing the expression of key transcription factors, including C/EBPβ. To elucidate the role of MCPIP1 in adipocyte biology, we performed RNA-Seq and proteome analysis in 3T3-L1 adipocytes overexpressing wild-type ( WT MCPIP1) and the mutant form of MCPIP1 protein ( D141N MCPIP1). Our RNA-Seq analysis followed by confirmatory Q-RT-PCR revealed that elevated MCPIP1 levels in 3T3-L1 adipocytes upregulated transcripts encoding proteins involved in signal transmission and cellular remodeling and downregulated transcripts of factors involved in metabolism. These data are consistent with our proteomic analysis, which showed that MCPIP1 expressing adipocytes exhibit upregulation of proteins involved in cellular organization and movement and decreased levels of proteins involved in lipid and carbohydrate metabolism. Moreover, MCPIP1 adipocytes are characterized by decreased level of insulin receptor, reduced insulin-induced Akt phosphorylation, as well as depleted Glut4 level and impaired glucose uptake. Overexpression of Glut4 in 3T3-L1 cells expressed WT MCPIP1 rescued adipogenesis. Interestingly, we found decreased level of MCPIP1 along with an increase in body mass index in subcutaneous adipose tissue. The presented data show a novel role of MCPIP1 in modulating insulin sensitivity in adipocytes. Overall, our findings demonstrate that MCPIP1 is an important regulator of adipogenesis and adipocyte metabolism.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Risk factors for complications of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Abstract: Longer duration of LSG and the increase in the number of stapler firings used during LSG should alert a surgeon to an increased risk of postoperative complications. In patients submitted to LRYGB the risk of possible complications increases with BMI.

Cited by 33 publications

References 39 publications

Pacientes submetidos a cirurgias bariátricas: fatores associados a complicações pós-operatórias de sítio cirúrgico

Pacientes submetidos a cirurgias bariátricas: fatores associados a complicações pós-operatórias de sítio cirúrgico

Influence of Preoperative Weight Loss on Outcomes of Bariatric Surgery for Patients Under the Enhanced Recovery After Surgery Protocol

Integrative genomics reveal a role for MCPIP1 in adipogenesis and adipocyte metabolism

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