Relative Outcome Measures for Bariatric Surgery. Evidence Against Excess Weight Loss and Excess Body Mass Index Loss from a Series of Laparoscopic Roux-en-Y Gastric Bypass Patients

2011 ◽  
Vol 21 (6) ◽  
pp. 763-767 ◽  
Author(s):  
Arnold van de Laar ◽  
Laura de Caluwé ◽  
Bruno Dillemans
2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mohsen Mahmoudieh ◽  
Behrouz Keleidari ◽  
Naser Afshin ◽  
Masoud Sayadi Shahraki ◽  
Shahab Shahabi Shahmiri ◽  
...  

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods. 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients’ BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results. Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007). Six-month follow-up showed statistically significant reduction in total cholesterol, total triglyceride, Fe, and vitamin B12 among patients with higher BMI level (P value <0.05). Conclusion. Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.


2015 ◽  
Vol 26 (5) ◽  
pp. 1041-1047 ◽  
Author(s):  
Filipe M. Cunha ◽  
Joana Oliveira ◽  
John Preto ◽  
Ana Saavedra ◽  
Maria M. Costa ◽  
...  

2011 ◽  
Vol 7 (3) ◽  
pp. 388-389
Author(s):  
Hugo Sánchez ◽  
Rocío Durán ◽  
Florencia Vargas ◽  
Vianey Anduaga ◽  
Maureen Mosti ◽  
...  

2019 ◽  
Vol 69 (12) ◽  
pp. 490-498 ◽  
Author(s):  
Yvonne Mühlig ◽  
Miriam Remy ◽  
Rolf Holle ◽  
André Scherag ◽  
Martin Wabitsch ◽  
...  

Zusammenfassung Einleitung Soziale Benachteiligung stellt eine Behandlungsbarriere für Jugendliche mit (extremer) Adipositas dar. Mit der Implementierung einer Spezialambulanz in Kooperation mit fünf Job-Centern sollte geprüft werden, ob arbeitslose Jugendliche mit Adipositas Interesse an einer Behandlung ihrer Adipositas haben und welche Teilnahmeraten sie in einem mehrstufigen Behandlungsprogramm aufweisen. Material und Methoden Jugendliche (15,0–24,9 Jahre) mit einem Body-Mass-Index (BMI) ≥30 kg/m2 erhielten das Angebot zur Beratung bzgl. Behandlungsmöglichkeiten der Adipositas im Job-Center. Interessierte Jugendliche wurden nach einer psychologischen Diagnostik in ein multimodales Behandlungsprogramm (6 Sitzungen) aufgenommen. Bei Interesse und bewiesener Adhärenz (Teilnahme an ≥5 Sitzungen) folgte ein Informationskurs (4 Sitzungen) und eine Indikationsprüfung für eine adipositaschirurgische Maßnahme. Ergebnisse Von 2012–2017 wurden 83 Jugendliche (im Mittel 21,1 Jahre, BMI 48,1 kg/m2, BMI 35,0–39,9 kg/m2: N=7, ≥ 40 kg/m2: N=71) eingeschlossen. 34 bewiesen ihre Adhärenz (≥5/6 Sitzungen in der multimodalen Adipositasintervention), 20 interessierten sich für einen adipositaschirurgischen Eingriff. Bisher wurden 11 Jugendliche operiert mit einer mittleren BMI-Reduktion von 14,3 kg/m2 3–36 Monate nach der Operation („Excess Weight Loss“ 27,3%) im Vergleich zu 3,8 kg/m2 6–48 Monate nach Behandlungsbeginn bei den nicht-operierten Jugendlichen. 13 Teilnehmer wurden auf dem ersten Arbeitsmarkt integriert. Diskussion Einige arbeitslose Jugendliche nahmen das Behandlungsangebot gut an und zeigten eine positive gesundheitliche und berufliche Entwicklung im Verlauf ihrer Teilnahme. Schlussfolgerung Die Implementierung einer Spezialambulanz für arbeitslose Jugendliche mit Adipositas in deutschen Job-Centern erweist sich als eine erfolgreiche Strategie, um diese oft unbehandelte Hochrisikogruppe zu charakterisieren und den individuellen Behandlungsbedarf zu ermitteln. Dieser Befund muss an einer größeren Stichprobe im Langzeitverlauf bestätigt werden.


2020 ◽  
Author(s):  
Marko Kraljević ◽  
Romano Schneider ◽  
Bettina Wölnerhanssen ◽  
Marco Bueter ◽  
Tarik Delko ◽  
...  

Abstract Background Obesity and type 2 diabetes mellitus (T2DM) are reaching epidemic proportions. In morbidly obese patients, bariatric operations lead to sustained weight loss and relief of comorbidities in the majority of patients. Laparoscopic Roux-Y-gastric bypass (RYGB) is one of the most frequently performed operations, but it is still unknown why some patients respond better than others. Therefore, a number of variations of this operation have been introduced. Recent evidence suggests that a longer bypassed biliopancreatic limb (BPL) has the potential to be more effective compared to the standard RYGB with a shorter BPL length. This article describes the design and protocol of a randomized controlled trial comparing the outcome of a RYGB operation with a long versus short BPL.Methods/Design The trial is designed as a multicenter, randomized, patient and observer blinded trial. The relevant ethics committee has approved the trial protocol. To demonstrate that long BPL RYGB is superior compared to short BPL RYGB in terms of weight loss and resolution of T2DM the study is conducted as a superiority trial. Postoperative percent excess body mass index loss (%EBMIL) is the primary endpoint, whereas morbidity, mortality, remission of obesity related comorbidities and quality of life are secondary endpoints. Eight hundred patients, between 18 and 65 years and with a body mass index (BMI) from 35 to 60 kg/m2 who meet the regulatory rules for bariatric surgery in Switzerland will be randomized. The endpoints and baseline measurements will be assessed pre-, intra- and postoperatively.Discussion With its high number of patients and a 5-year follow-up this study will answer questions about effectiveness and safety of long BPL RYGB and provide level I evidence for improvement of the standard RYGB. These findings might therefore potentially influence global bariatric surgery guidelines.Trial registration This trial was registered on ClinicalTrials.gov under the identifier NCT04219787, on January 7th, 2020.


2012 ◽  
Vol 78 (6) ◽  
pp. 698-701 ◽  
Author(s):  
Franziska Huettner ◽  
Charalambos K. Rammos ◽  
Danuta I. Dynda ◽  
Melinda L. Lange ◽  
J. Stephen Marshall ◽  
...  

Body weight, body mass index (BMI), and percent excess weight loss are used to assess patient outcomes after bariatric surgery; however, they provide little insight into the true nature of the patient's weight loss. Body composition measurements monitor fat versus lean mass losses to permit interventions to reduce or avoid lean body mass loss after bariatric surgery. A retrospective review of patients who underwent bariatric surgery between 2002 and 2008 was performed. Patients underwent body composition testing via air displacement plethysmography before and after surgery (6 and 12 months). Body composition changes were assessed and compared with the BMI. Results include 330 patients (54 male, 276 female). Average preoperative weight was 139 kg, BMI was 50 kg/m2, fat percentage was 55 per cent, and lean mass percent was 45 per cent. Twelve months after surgery average weight was 90 kg, mean BMI was 32 kg/m2, fat percentage was 38 per cent, and lean mass percent was 62 per cent. Body composition measurements help monitor fat losses versus lean mass gains after bariatric surgery. This may give a better assessment of the patient's health and metabolic state than either BMI or excess weight loss and permits intervention if weight loss results in lean mass losses.


2021 ◽  
pp. 000313482199198
Author(s):  
Imad El Moussaoui ◽  
Etienne Van Vyve ◽  
Hubert Johanet ◽  
André Dabrowski ◽  
Arnaud Piquard ◽  
...  

Background Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in the world. Our purpose was to evaluate the percentage of excess weight loss (%EWL), resolution of obesity-related comorbidities after SG, and identify predictive factors of weight loss failure. Methods A prospective cohort study of adults who underwent SG during 2014 in 7 Belgian-French centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically. Results Overall, 529 patients underwent SG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m2, respectively. Body mass index significantly decreased to 32.2 kg/m2 at 5 years ( P < .001). The mean %EWL was 63.6% at 5 years. A significant reduction in dyslipidemia (28.0%-18.2%), obstructive sleep apnea (OSAS) (34.6%-25.1%), and arterial hypertension (HTN) (30.4%-21.5%) was observed after 5 years, but not for diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age >50 years old, BMI >50 kg/m2, and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure. Conclusions Five years after SG, weight loss was satisfactory; the reduction of comorbidities was significant for dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age >50 years old, BMI >50 kg/m2, and previous LAGB were independent predictors of weight loss failure.


2014 ◽  
Vol 6 (1) ◽  
pp. 1 ◽  
Author(s):  
Mário Nora ◽  
Marta Guimarães ◽  
Rui Almeida ◽  
Paulo Martins ◽  
Gil Gonçalves ◽  
...  

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 43-46 ◽  
Author(s):  
Silvia Leite FARIA ◽  
Orlando Pereira FARIA ◽  
Mariane de Almeida CARDEAL

BACKGROUND: After Roux-en-Y gastric bypass to avoid rapid gastric emptying, dumping syndrome and regained weight due to possible dilation of the gastric pouch, was proposed to place a ring around the gastric pouch. AIM: To compare weight loss, consumption of macronutrients and the frequency of vomiting among patients who underwent Roux-en-Y gastric bypass with and without the placement of a constriction ring around the pouch. METHOD: A retrospective study, in which an analysis of medical records was carried out, collecting data of two groups of patients: those who underwent the operation with the placement of a constriction ring (Ring Group) and those who underwent without the placement of a ring (No-Ring Group). The food intake data were analyzed using three 24-hour recalls collected randomly in postoperative nutritional accompaniment. Data on the percentage of excess weight loss and the occurrence of vomiting were collected using the weight corresponding to the most recent report at the time of data collection. RESULTS: Medical records of 60 patients were analyzed: 30 from the Ring Group (women: 80%) and 30 from the No-Ring Group (women: 87%). The average time since the Ring Group underwent the operation was 88±17.50 months, and for the No-Ring Group 51±15.3 months. The percentage of excess weight loss did not differ between the groups. The consumption of protein (g), protein/kg of weight, %protein and fiber (g) were higher in the No-Ring Group. The consumption of lipids (g) was statistically higher in the Ring Group. The percentage of patients who never reported any occurrence was statistically higher in the No-Ring Group (80%vs.46%). The percentage who frequently reported the occurrence was statistically higher in the Ring Group (25%vs.0%). CONCLUSION: The placement of a ring seems to have no advantages in weight loss, favoring a lower intake of protein and fiber and a higher incidence of vomiting, factors that have definite influence in the health of the bariatric patient.


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