Background
Single anastomosis sleeve ileal (SASI) bypass is a new bariatric and metabolic procedure that has both restrictive and malabsorptive effects. This study was conducted to assess both the ...efficacy and safety of this procedure in a short-term follow-up.
Methods
This retrospective cohort study examined weight loss- and obesity-related comorbidities and complications in patients who had undergone SASI bypass from October 2017 to March 2018 at a center of excellence for bariatric/metabolic surgery.
Results
Twenty-four patients had undergone SASI bypass due to some existing risk factors of gastric cancer or premalignant lesions in the esophagogastroduodenoscopy. The mean BMI of the patients was 44.2 (median 43.7, range 37.0–54.8) kg/m
2
. Six and 12 months after surgery, the mean (median) excessive weight loss (EWL) was 67.8% (63.3) and 86.2% (82.9) and total weight loss (TWL) was 28.5% (27.6) and 36.46% (35.8), respectively. Most patients had complete remission in type 2 diabetes mellitus (89%), arterial hypertension (86%), dyslipidemia (100%), obstructive sleep apnea (100%), and non-alcoholic fatty liver disease (73%) during the 1 year after surgery. One case of extra-luminal bleeding and one case of trocar site hernia occurred after surgery. Moreover, two patients converted to sleeve gastrectomy because of hypoalbuminemia and EWL about 1 year after SASI.
Conclusion
SASI bypass is a newly introduced investigational procedure for improving weight loss and comorbidities; however, it may result in EWL and protein malnutrition and should only be performed for select patients and by well-experienced bariatric surgeons.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
We aimed to assess the weight loss trend following Roux en Y Gastric Bypass (RYGB), One Anastomosis Gastric Bypass (OAGB), and Sleeve Gastrectomy (SG), utilizing a change-point analysis. A ...retrospective cohort study was conducted on 8640 patients, from 2009 to 2023. The follow-up period extended to 7 years, with a median follow-up of 3 years (interquartile range: 1.4–5). Following metabolic bariatric surgery, four weight loss phases (three change points) were observed. The primary, secondary, and tertiary phases, transitioned at 12.64–13.73 days, 4.2–4.8 months, and 11.3–13.1 months post-operation, respectively, varying based on the type of procedure. The weight loss rate decreased following each phase and plateaued after the tertiary phase. The nadir weight was achieved 11.3–13.1 months post-procedure. There was no significant difference in the %TWL between males and females, however, males achieved their nadir weight significantly earlier. Half of the maximum %TWL was achieved within the first 5 months, with the greatest reduction rate in the first 2 weeks. Our findings inform healthcare providers of the optimal timing for maximum weight loss following each surgical method and underscore the importance of close patient monitoring in the early postoperative period.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Aim
The aim of this study was to find independent perioperative factors predicting unsuccessful weight loss following one anastomosis gastric bypass-mini gastric bypass (OAGB-MGB), a recently ...developed technique of bariatric surgery.
Methods
Using regression analysis, this prospective cohort study assessed the role of demographic and socioeconomic factors, clinical features, body composition, length of biliopancreatic limb (LBL), nutritional habits, comorbidities, and early post-operative weight reduction values, in predicting 1-year weight loss after OAGB-MGB. All patients at the center who underwent laparoscopic OAGB-MGB between October 2010 and May 2017 were included. The dependent variable was the percent of excess weight loss (%EWL) after 12-month follow-up. Weight loss outcome was defined as successful EWL (≥ 50%) or unsuccessful EWL (< 50%).
Results
Follow-up data at 1 year was available for 1309 (77%) patients. Mean EWL and BMI reduction were 81.63% and 16.82 ± 4.37 kg/m
2
at 1 year. In addition, 48 (3.7%) patients had unsuccessful weight loss. Pre-operative higher BMI (OR, 1.34;
p
= 0.001), type 2 diabetes (OR, 4.26;
p
= 0.039), pre-surgery volume eating habit (OR, 0.12;
p
= 0.003), weight reduction value in the first month after surgery (OR, 0.80;
p
= 0.002), and length of biliopancreatic limb (LBL) (OR, 1.05;
p
= 0.017) were independently associated with unsuccessful weight loss at 1-year follow-up.
Conclusions
OAGB-MGB provides considerable weight loss for most patients. Initial lower BMI, absence of diabetes, being volume eater, and higher first month weight loss are independently associated with successful weight loss after 1 year.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
There is no data on patients with severe obesity who developed coronavirus disease 2019 (COVID-19) after bariatric surgery. Four gastric bypass operations, performed in a 2-week period between Feb 24 ...and March 4, 2020, in Tehran, Iran, were complicated with COVID-19. The mean age and body mass index were 46 ± 12 years and 49 ± 3 kg/m
2
. Patients developed their symptoms (fever, cough, dyspnea, and fatigue) 1, 2, 4, and 14 days after surgery. One patient had unnoticed anosmia 2 days before surgery. Three patients were readmitted in hospital. All 4 patients were treated with hydroxychloroquine. In two patients who required admission in intensive care unit, other off-label therapies including antiretroviral and immunosuppressive agents were also administered. All patients survived. In conclusion, COVID-19 can complicate the postoperative course of patients after bariatric surgery. Correct diagnosis and management in the postoperative setting would be challenging. Timing of infection after surgery in our series would raise the possibility of hospital transmission of COVID-19: from asymptomatic patients at the time of bariatric surgery to the healthcare workers versus acquiring the COVID-19 infection by non-infected patients in the perioperative period.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Purpose
With the global increase in life expectancy and the subsequent impaired quality of life in older obese adults, modalities such as bariatric surgery become crucial to help lose excess weight. ...This study was conducted to evaluate the effectiveness and safety of one anastomosis gastric bypass (OAGB) in patients 65 years old and above.
Materials and Methods
This retrospective cohort study was conducted on 61 patients with severe obesity aged ≥ 65 years through Iran National Obesity Surgery Database. The patients had undergone OAGB and were followed up for 12 to 60 months. The required data was extracted through national database.
Results
Mean age and BMI of the patients were 67.62 ± 2.03 years and 46.42 ± 5.46 kg/m
2
, respectively. Regarding gender, 90.1% of the participants were female. Mean operative time and length of hospital stay were 41.37 ± 13.91 min and 1.16 ± 0.61 days, respectively. Five patients (8.19%) required ICU admission. The changes in %TWL after 3, 6, 12, 24, 36, 48, and 60 month follow-up was 18.62%, 25.51%, 32.84%, 35.86%, 38.49%, 31.41%, and 29.52%, respectively. The resolution of gastroesophageal reflux disease, diabetes mellitus, dyslipidemia, obstructive sleep apnea, and hypertension after 24 month was about 100%, 65%, 73.33%, 100%, and 76%, respectively. The postoperative early and late complications were 6.53% and 11.46%, respectively. We did not find significant difference in above results between two age groups of 65–70 and > 70 years.
Conclusions
OAGB can be a good choice in older obese adults because of its shorter operative time, higher potency, and low complication rate.
Graphical abstract
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background/Aim
Little data is available on body composition and biochemical parameter changes after one anastomosis gastric bypass (OAGB) surgery. This study was therefore conducted to assess body ...composition and biochemical parameter changes in patients who underwent OAGB. The relationship between the percentage of total weight loss (%TWL) with percentage changes in body composition and biochemical parameters was measured in the first year after surgery.
Materials and Methods
This retrospective study was carried out on 363 patients (mean age 39.93 ± 9.98 years) who underwent OAGB between January 2011 and November 2018. Anthropometric, body composition and biochemical measurements were recorded before and 1 year after surgery. For paired data, a paired sample
t
test or Wilcoxon test was used. Spearman or Pearson correlation test was used to evaluate the relationship between % TWL and changes in body composition and biochemical parameters.
Results
The average %TWL at 1 year following surgery was 35.72 ± 6.85. Fat and muscle tissue and also serum levels of glycemic parameters, low density lipoprotein, triglycerides (TG), total cholesterol, zinc, albumin, hemoglobin, hematocrit, and platelet had decreased a year after OAGB (
P
< 0.05). The postoperative levels of HDL-c, vitamins D, B12, and folic acid were dramatically higher than the preoperative values. Higher %TWL significantly correlated to greater decreases in body fat, muscle mass, and serum TG at 1 year post-surgery, compared to preoperative values.
Conclusion
OAGB may be effective over a follow-up period of 1 year in achieving weight, fat mass reduction, and improved serum levels of glycemic parameters and lipid profiles.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background
De novo gastroesophageal reflux disease (GERD) is one of the complications that may occur after laparoscopic sleeve gastrectomy (LSG). This study was conducted to examine whether ...omentopexy can be effective in reducing the incidence of GERD after LSG.
Methods
A total of 201 patients (145 females) were compared in this retrospective cohort study, including Group A (
n
= 100) and Group B (
n
= 101), consisting of patients undergoing LSG with omentopexy and LSG without omentopexy, respectively. One year after surgery, the patients were evaluated by GERD-Q; those obtaining a score of eight or above also underwent upper endoscopy to confirm their de novo GERD.
Results
Thirty-seven patients had a GERD-Q score ≥ 8 and therefore underwent upper endoscopy. Seventeen patients had fully normal endoscopy results, and no significant differences was observed between the two groups in terms of the incidence of de novo GERD (
P
= 0.966). There were also no significant differences between the groups in terms of age (
P
= 0.517), sex (
P
= 0.193), diabetes (
P
= 0.979), and GERD-Q score (
P
= 0.880). The pre-operative mean weight (
P
= 0.003) and total weight loss (TWL) showed significant intergroup differences (
P
= 0.001). The mean body mass index (BMI) showed significant differences between the groups before the operation (
P
= 0.001) and 1 year after the surgery (
P
= 0.009). Excess BMI loss (EBMIL) was also significantly higher in Group A 1 year after the surgery (
P
= 0.004). Even after omitting confounder effect of BMI between two groups with and without omentopexy, GerdQ was not significantly different.
Conclusion
Omentopexy does not have a significant effect on reducing the incidence of de novo GERD after LSG, even in individuals with higher BMI and weight.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background
Body mass index, an estimate of body fat percentage, has been previously shown to be associated with metabolic disorders. However, there is little data on the associations between a body ...shape index (ABSI) or modified body adiposity index (MBAI), which provide valuable definitions of body fat, with serum biochemical parameter levels. Therefore, this study was conducted to find either ABSI or MBAI associations with serum biochemical parameter levels in bariatric surgery candidates.
Methods
This cross-sectional study was conducted on 776 bariatric surgery candidates (age range 18–69 years) between November 2010 and September 2017. Demographic data, anthropometric indices, biochemical parameters, and body composition analysis data were drawn from the National Obesity Surgery Database, Iran. ABSI and MBAI were calculated using related equations. A stepwise multivariate linear regression was used to evaluate whether ABSI or MBAI was associated with each serum biochemical parameter.
Results
ABSI, age, and multivitamin/mineral supplementation (MVMS) were independently associated with serum vitamin D (
β
= 24.374, SE 10.756,
P
value 0.026;
β
= 0.022, SE 0.007,
P
value 0.002;
β
= 0.639, SE 0.235,
P
value 0.008). However, a negative association was observed between MBAI and vitamin D (
β
= − 0.037, SE 0.016,
P
value 0.025) in a model adjusted for age and MVMS. Additionally, MBAI and age showed a significant positive association with serum HDL-c (
β
= 0.185, SE 0.085,
P
value 0.028;
β
= 0.171, SE 0.033,
P
value < 0.001), although there was a negative association between male sex and HDL-c (
β
= − 4.004, SE 0.891,
P
value < 0.001).
Conclusion
ABSI and MBAI may be appropriate indices in predicting serum vitamin D and HDL-c levels.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Author Affiliation: (1) Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran (2) Department of Surgery, Aleris Hospital, Fredrik Stangs gate 11-13, 0264, ...Oslo, Norway (3) Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (4) Iran National Center of Excellence for Minimally Invasive Surgery Education, Iran University of Medical Sciences, Tehran, Iran (d) mkermansaravi@yahoo.com Article History: Registration Date: 10/16/2020 Received Date: 10/11/2020 Accepted Date: 10/15/2020 Online Date: 10/21/2020 Byline:
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
PDF