Although rare, PCI should be considered in the differential diagnosis of acute abdomen. Diagnostic laparoscopy and preoperative radiological tests, including computed tomography, play an important role in confirming the diagnosis.
Background: Laparoscopic sleeve gastrectomy (LSG) is currently the most frequently
performed bariatric procedure in Turkey. The goal of weight reduction
surgery is not only to decrease excess weight, but also to improve obesity
related comorbidities and quality of life (QoL). Aim: To evaluate the impact of LSG on patient quality of life, weight loss, and
comorbidities associated with morbid obesity according to the updated BAROS
criteria. Methods: Eleven hundred thirty-eight adult patients were undergone to LSG by our
bariatric surgery team between January 2013 and January 2016. A
questionnaire (The Bariatric Analysis and Reporting Outcome System - BAROS)
was published on social media. The data on postoperative complications were
collected from hospital database. Results: Number of respondants was 562 (49.4%). Six of 1138 patients(0.5%) had
leakage. All patients who had leakage were respondants. The overall
complication rate was 7.7%. After a mean period of 7.4±5.3 months(1-30),
mean excess weight loss was 71.3±27.1% (10.2-155.4). The respondants
reported 772 comorbidities. Of these, 162 (30%) were improved, and 420
(54.4%) were resolved. The mean scores for QoL were significantly increased
after LSG (range, p<0.05 to <0.001). Of the 562 patients, 26 (4.6%)
were classified as failures; 86 (15.3%) fair; 196 (34.9%) good; 144 (25.6%)
very good, and 110 (19.6%) excellent results according to the updated BAROS
scoring system. Conclusion: LSG is a highly effective bariatric procedure in the manner of weight
control, improvement in comorbidities and increasing of QoL in short- and
mid-term.
Background
There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates.
Methods
We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020.
Results
Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country.
Conclusions
BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak.
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