The Surgical Management of Obesity

Neylan, Christopher J.; Kannan, Umashankkar; Dempsey, Daniel T.; Williams, Noel N.; Dumon, Kristoffel R.

doi:10.1016/j.gtc.2016.07.006

Cited by 26 publications

(22 citation statements)

References 68 publications

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“…The qualification was performed according to the current European and American recommendations: BMI greater than or equal to 40 kg/m 2 , or BMI greater than or equal to 35 kg/m 2 with at least one serious obesity-related comorbidity, such as heart disease, T2DM or severe OSA [8]. Every patient had the basic blood parameters measured, as well as endoscopy of the upper gastrointestinal tract and ultrasound examination of the abdominal cavity.…”

Section: Methodsmentioning

confidence: 99%

“…Every patient suffering from obesity with body mass index (BMI) over 40 kg/m 2 or with BMI over 35 kg/m 2 with comorbidities may be qualified for bariatric surgery. American and European bariatric federations are introducing the idea of lowering the qualifying level of BMI [8]. In 2013 over 450 000 bariatric procedures were performed worldwide, and these numbers are constantly increasing [9].…”

Section: Introductionmentioning

confidence: 99%

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Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Różańska-Walędziak

Kowalewski

Janik

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionObesity is one of the major lifestyle diseases and provokes various comorbidities, such as hypertension, type 2 diabetes mellitus, obstructive sleep apnea, and even neoplasms. Bariatric surgery is the most effective treatment of obesity. Since cost-effectiveness has become a major concern, there is a tendency to avoid general histological evaluation of surgical specimens during routine procedures.AimTo evaluate the necessity of histopathological investigation of tissue excised during bariatric surgery and to verify whether the operation should be continued in the case of suspicious macroscopic findings.Material and methodsFrom January 2013 to December 2016, 1252 patients with obesity were qualified for bariatric procedures. The qualification was performed according to the current European recommendations. Every operation started with an inspection of the peritoneal cavity performed once the abdomen was insufflated. If a macroscopic pathology was found, the specimen was secured for histopathological investigation.ResultsOut of 81 (6.47%) patients from whom histopathological samples were collected, 39% (n = 32) showed negative results, and 61% (n = 49) cases showed abnormalities.ConclusionsAs it is impossible to exclude the existence of gastric tumors only in preoperative gastroscopy and ultrasonography, especially as there is a higher risk in obese patients, routine histological examination of tissue excised during bariatric procedures should be considered. Since most of the neoplasms were found to be benign, there is no need to abandon the bariatric procedure if a pathology is found and resected. Bariatric surgeons should always focus on thorough examination of the abdominal and the pelvic cavity, especially in female patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Różańska-Walędziak

Kowalewski

Janik

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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“…Weight loss from the gastric band procedure is similar to that of gastroplasty procedures; however, the gastric band procedure is much simpler technically [13]. Though initially popular, there are many long-term band-related complications requiring removal in almost 50% of patients, including band slippage and pouch dilation [15]. …”

Section: Bariatric Surgerymentioning

confidence: 99%

“…Unlike the biliopancreatic diversion, in the distal RYGB procedure the distal stomach is not completely removed, but rather a small pouch is made. Though improved (with fewer malabsorption-related complications) compared with biliopancreatic diversion, this procedure is invasive and has severe complications, including diarrhea, vitamin deficiency, abdominal pain, and protein malnutrition [15]. Although RYGB can lead to vitamin and mineral deficiencies, it has been shown to be associated with endocrine changes, including a decrease in hunger-related hormones and changes in insulin sensitivity leading to an increased rate of remission of type-2 diabetes [16].…”

Section: Bariatric Surgerymentioning

confidence: 99%

Current and cutting-edge interventions for the treatment of obese patients

Vairavamurthy

Cheskin

Kraitchman

et al. 2017

European Journal of Radiology

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The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current “gold standard” therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band. Though effective, bariatric surgery can have severe short- and long-term complications. To fill the major gap in invasiveness between lifestyle modification and surgery, researchers have been developing pharmacotherapies and minimally invasive endoscopic techniques to treat obesity. Recently, interventional radiologists developed a percutaneous transarterial catheter-directed therapy targeting the hormonal function of the stomach. This review describes the current standard obesity treatments (including diet, exercise, and surgery), as well as newer endoscopic bariatric procedures and pharmacotherapies to help patients lose weight. We present data from two ongoing human trials of a new interventional radiology procedure for weight loss, bariatric embolization.

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“…However, currently, it has become the second most common bariatric surgical procedure (40,44). Effects of this procedure include a reduction in stomach capacity, decreased absorption by the digestive tract, and alterations in gut hormone levels (45).…”

Section: Mixed Procedures Roux-en-y Gastric Bypassmentioning

confidence: 99%

Summary of Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey

Sabuncu¹,

Kıyıcı²,

Eren³

et al. 2017

Turk J Endocrinol Metab

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Obesity, defined as a body mass index (BMI) ≥30 kg/m 2 , is a significant public health concern worldwide. In the United States and Turkey, more than 35% of the adults are obese (1-3). Obesity is a serious medical condition associated with several comorbidities including type 2 diabetes, cardiovascular and cerebrovascular diseases, digestive, locomotor and respiratory disorders, cancers S Su um mm ma ar ry y o of f B Ba ar ri ia at tr ri ic c S Su ur rg ge er ry y G Gu ui id de el li in ne e o of f t th he e S So oc ci ie et ty y o of f E En nd do oc cr ri in no ol lo og gy y a an nd d M Me et ta ab bo ol li is sm m o of f T Tu ur rk ke ey y T Tü ür rk ki iy ye e E En nd do ok kr ri in no ol lo oj ji i v ve e M Me et ta ab bo ol li iz zm ma a D De er rn ne eğ ği i B Ba ar ri ia at tr ri ik k C Ce er rr ra ah hi i K Kı ıl la av vu uz zu u Ö Öz ze et ti i Obesity is a common condition affecting approximately one-third of the adult population worldwide. Obesity results in a number of medical, psychosocial and economical problems, in many patients, it is usually difcult to achieve the desired weight loss with medical therapies, several surgical approaches for weight loss have been developed in the recent years and are described as bariatric or metabolic surgery. Though bariatric surgery promotes dramatic and reliable improvement in obesity and related complications, yet proper patient selection and careful selection of the bariatric method along with good pre-and post-operative management is very important for a successful therapy. Therefore, the authors aim to present a short review on the Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey. The indications and contraindications for bariatric surgery, description of commonly used bariatric surgical methods, preoperative preparation of obese patients prior to the surgery, early and late postoperative management and follow-up of the patients have been summarized in this review. This review has been written in accordance with the opinions and recommendations of the Hypertension, Lipid Metabolism and Obesity Study Group of the Society of Endocrinology and Metabolism of Turkey. Keywords: Obesity; bariatric surgery; metabolic surgery; indications; contraindications; preoperative evaluation; postoperative following Obezite, dünyadaki yetişkin nüfusun yaklaşık üçte birini etkileyen yaygın bir hastalık olup pek çok tıbbi, psikososyal ve ekonomik problemlere neden olmaktadır. Birçok hastada tıbbi tedaviler ile istenilen kilo kaybının sağlanamaması nedeniyle obezitenin tedavisi için günümüzde çeşitli cerrahi yaklaşımlar geliştirilmiş olup bunlar bariyatrik veya metabolik cerrahi olarak adlandırılmaktadır. Bariyatrik cerrahi sonuçları, obezite ve ilgili komplikasyonlarda çar-pıcı ve uzun süreli iyileşmeyi desteklese de, uygun hastanın ve bariyatrik yöntemin seçimi, ameliyat öncesi ve sonrası değerlendirme ile takip, bariyatrik cerrahinin başarısı için çok önemlidir. Bu nedenle, Türkiye Endokrinoloji ve Metabolizma Derneği Bariyatrik Cerrahi Kı...

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The Surgical Management of Obesity

Cited by 26 publications

References 68 publications

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Histopathological examination of tissue resected during bariatric procedures - to be done or not to be done?

Current and cutting-edge interventions for the treatment of obese patients

Summary of Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey

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