Sleeve Gastrectomy in the High-Risk Patient

Hamoui, Nahid; Anthone, Gary J.; Kaufman, Howard S.; Crookes, Peter F.

doi:10.1381/096089206778870157

Cited by 193 publications

(117 citation statements)

References 15 publications

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“…Laparoscopic sleeve gastrectomy is associated with a significant improvement of T2DM and other obesity-associated comorbidities such as hypertension and hyperlipidemia (13,14). Postoperative improvement of diabetes starts even before significant weight loss has occurred.…”

Section: Discussionmentioning

confidence: 99%

Impact of preoperative body mass index on the final outcome after laparoscopic sleeve gastrectomy for morbid obesity

Elbanna

Ghnnam

Negm

et al. 2016

UCD

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Section: Discussionmentioning

confidence: 99%

Impact of preoperative body mass index on the final outcome after laparoscopic sleeve gastrectomy for morbid obesity

Elbanna

Ghnnam

Negm

et al. 2016

UCD

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“…LSG has demonstrated weight-loss results comparable to LRYGB and LBPD-DS but with a lower morbidity profile, associated with improvement of health status and resolution of co-morbidities such as diabetes, hypertension, OSA and dyslipidemia [16,18,38,41,44,45,47,48]. Silecchia et al [44] showed that in 41 super-obese patients (9 patients with BMI > 60 kg/m ) following LSG, 60% of major comorbidities were resolved and 24% improved, 57.8% of patients were co-morbidity-free and 31.5% had only one major co-morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Leaks and bleeding represent the most feared complications and the most frequently reported causes of death after LSG. Reported leak rates range from 0.7 to 5.3% [24,41,[44][45][46]50]. Esophageal stenting (endoluminal technique) is an effective and new strategy for treatment of gastric fistula, and may be performed safely in a patient with leak of the staple line following sleeve or re-sleeve gastrectomy (for weight regain) with or without BPD-DS [53,54].…”

Section: Discussionmentioning

confidence: 99%

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Updated Review of Sleeve Gastrectomy

Trelles¹,

Gautier²

2008

TOGASJ

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There is a bariatric explosion worldwide to deal with the rising prevalence of morbid obesity. In 1988, Hess and Hess first added the sleeve gastrectomy (SG) and the duodenal switch (DS) as a modification to the biliopancreatic diversion (BPD) to improve clinical outcomes. But the increased morbidity and mortality observed in super-super-obese patients (BMI > 60 kg/m ) who underwent BPD with DS (BPD-DS) made Gagner and co-workers propose SG as a bridge to gastric bypass or BPD-DS to reduce complications and mortality. The excellent short-term weight-loss outcomes after SG have increased the enthusiasm among surgeons to use it as a definitive treatment for morbidly obese and super-obese patients (BMI > 50 kg/m ). Neurohormonal and gastric emptying changes may account for its superiority over other restrictive procedures. Recent reports on mid-term weight-loss outcomes make this procedure a viable option for bariatric surgeons; nonetheless, long-term studies are still required.

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“…This procedure was previously the first part of a more complex mixed operation called the duodenal switch, 80 and it involves the removal of the greater curvature and gastric fundus and a consequent reduction of ghrelin production. [81][82] Vertical gastrectomy is an emergent restrictive bariatric surgery; 83,84 it causes satiety and can be used as an initial stage in a two-stage operation for high-risk surgical patients, [85][86][87] or as an isolated and final surgery. 88 Vertical gastrectomy alone has demonstrated satisfactory results in weight loss, 89 glycemic control 90 and early satiety, even in long-term assessments.…”

Section: Introductionmentioning

confidence: 99%

Organic consequences of ileal transposition in rats with diet-induced obesity

et al. 2011

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INTRODUCTION:The clinical management of metabolic syndrome -especially diabetes mellitus type 2 -is notoriously complex due to the progressive nature of this disease. At present, there is a need for a surgical procedure that is effective for the treatment of diabetes mellitus type 2, even in non-obese individuals. The isolated ileal transposition theory could lead to an effective alternative therapy. This intervention has not yet been performed in humans, and there are no reports of its use in an experimental model of diet-induced metabolic syndrome. OBJECTIVES:The objective of this study is to evaluate the physiological effects of ileal transposition in rats with diet-induced metabolic syndrome. The effects of this procedure on glucose and lipid metabolism will be assessed. METHODS:Forty 12-week-old male rats (albino Rattus norvegicus, Wistar, 2BAW, heterogeneous) will be divided into four groups of 10 animals each: the ileal transposition group (TG) comprising animals on a hypercaloric-hyperlipidic diet; the sham group (SG) containing animals that receive the same diet and undergo the sham surgery; control group 1 (CG1), which will receive a hypercaloric-hyperlipidic diet and will not undergo surgery; and control group 2 (CG2), which will consume standard feed and will not undergo surgery. The surgeries will be performed in 20-week-old animals.Blood samples for laboratory testing will be collected from 12-week-old animals on the day of surgery and after eight postoperative weeks, following determination of the weights of the animals and the administration of anesthesia. The levels of serum glucose, insulin, triglycerides, total cholesterol and fractions, glucagon-like peptide-1, C-peptide and glycated hemoglobin will be assessed in all of the animals. The insulin tolerance test will be performed using PRISMA software, and insulin resistance will be calculated by the HOMA-IR indirect test. On specific days, two 20-week-old rats will be separated and randomly distributed in TG and SG. These animals will be followed until the eighth postoperative week. Subsequently, they will be euthanized, and the retroperitoneal and periepididymal fat deposits will be collected and weighed using a precision scale. In addition, the pancreas, liver and intestinal segments will be sent for pathological and immunohistochemical studies.

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Sleeve Gastrectomy in the High-Risk Patient

Abstract: Although the sleeve gastrectomy does not result in as much weight loss as the duodenal switch or gastric bypass, it can be used as a stand-alone operation or as a bridge to more complex procedures in the high-risk super-obese patient.

Cited by 193 publications

References 15 publications

Impact of preoperative body mass index on the final outcome after laparoscopic sleeve gastrectomy for morbid obesity

Impact of preoperative body mass index on the final outcome after laparoscopic sleeve gastrectomy for morbid obesity

Updated Review of Sleeve Gastrectomy

Organic consequences of ileal transposition in rats with diet-induced obesity

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