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Background: 20% of patients with chronic kidney disease (CKD) in the United States have a body-mass index (BMI) ≥35 kg/m2. Bariatric surgery reduces progression of CKD to end-stage kidney disease (ESKD), but the risk of perioperative complications remains a concern. Methods: 24-month data spanning 2017-2018 were obtained from the Metabolic and Bariatric Surgery Quality Improvement Program (MBSAQIP) database and analyzed. Surgical complications were assessed based on the length of hospital stay, mortality, reoperation, readmission, surgical site infection (SSI), and worsening of kidney function during the first 30 days after surgery. Results: The 277,948 patients who had primary bariatric procedures were 44±11.9 (mean±SD) years old, 79.6% female, and 71.2% Caucasian. Mean BMI was 45.7±7.6 kg/m2. Compared with patients with an eGFR ≥90 mL/min/BSA, those with stage 5 CKD/ESKD were 1.91 times more likely to be readmitted within 30 days of a bariatric procedure (95% CI, 1.37-2.67; p<0.001). Similarly, length of hospital stay beyond 2 days was 2.05-fold (95% CI, 1.64-2.56; p<0.001) higher and risk of deep incisional surgical site infection was 6.92-fold (95% CI, 1.62-29.52; p=0.009) higher for those with stage 5 CKD/ESKD. Risk of early postoperative mortality increased with declining preoperative eGFR, such that patients with CKD stage 3b were 3.27 (95% CI, 1.82-5.89; p<0.001) times more likely to die compared with those with normal kidney function. However, absolute mortality rates remained relatively low at 0.53% in those with CKD stage 3b. Furthermore, absolute mortality rates were less than 0.5% in those with CKD stages 4 and 5, and these advanced CKD stages were not independently associated with an increased risk of early postoperative mortality. Conclusion: Increased severity of kidney disease was associated with increased complications after bariatric surgery. However, even for the population with advanced CKD, the absolute rates of postoperative complications were low. The mounting evidence for bariatric surgery as a renoprotective intervention in people with and without established kidney disease suggests that bariatric surgery should be considered a safe and effective option for patients with CKD.

Background Laparoscopic adjustable gastric banding (LAGB) continues to be a valid surgical treatment option to address severe obesity. However, outcomes are varied and can be difficult to predict. Early prediction of suboptimal weight loss following LAGB may enable adjustments to postoperative care and consequently improve surgical outcomes. Therefore, our aim is to investigate the prognostic utility of using early weight loss following LAGB to predict long‐term weight outcomes. Methods Clinical data from patients undergoing LAGB between 2001 and 2007 at a single institution were retrospectively collected and analysed. The data was used to inform a model for predicting long‐term weight loss after LAGB surgery. Percent total weight loss (%TWL) greater than 20% 1 year after surgery was considered a measurement of success since it has been associated with the improvement of comorbidities and increased patient satisfaction. Results The average %TWL 1 year after LAGB surgery was 23.73% (n = 1524, SD = 8.68%). Weight loss of less than 10% in 1 year was a negative predictor of weight loss >20% in 8–12 years (OR = 0.449; p = 0.002; 95% CI = 0.272–0.742). Moreover, weight loss >20% in 1 year was a strong predictor of weight loss >20% in 8–12 years (OR = 5.33; p < 0.001; 95% CI = 3.17–8.97). Conclusion Total body weight reduction of less than 10% 1 year after LAGB surgery suggests a lesser weight loss at 8–12 years. For these patients, targeted interventions would be appropriate to increase the chances of long‐term success.

Pl astic surgery is based on improving esthetic for the patient. In most services, the surgery outcome is evaluated in a subjective manner.Aim: to objectively assess the degree of patient satisfaction one year after rhinoplasty using the Rhinoplasty Outcome Evaluation questionnaire at a referral academic center. Materials and Methods:69 patients operated in the otorhinolaryngology service were selected. The patients were operated upon by third year residents during the period from January to December 2007 and answered the questionnaire translated by the authors of this study.Results: we obtained a mean value of 73.25% of satisfaction for primary rhinoplasty and a mean value of 72.02% of satisfaction for secondary rhinoplasty.Conclusion: the level of satisfaction presented by the patients was considered to be very good. Braz J Otorhinolaryngol. 2010;76(4):437-41. ORIGINAL ARTICLE BJORL