Complications Following Surgery for Duodenal Ulcer in Obese Patients

Postlethwait, R. W.; Johnson, William D.

doi:10.1001/archsurg.1972.04180090043011

Cited by 128 publications

(46 citation statements)

References 6 publications

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“…58,59 However, with appropriate perioperative precautions and monitoring, the prevalence of serious complications can be minimized. 60,61 This seems to be the case with liver transplantation and obesity.…”

Section: Impact Of Obesity On the Outcome Of Liver Transplantationmentioning

confidence: 99%

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

Reuben

2001

Liver Transplantation

115

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Key Points 1. As long-term survival improves after liver transplantation, cardiovascular complications are emerging as a major cause of late morbidity and mortality. It seems reasonable to correct the potentially reversible cardiovascular risk factors of diabetes, hyperlipidemia, and obesity, in addition to hypertension. 2. The results of liver transplantation in diabetics are acceptable in terms of morbidity, mortality, and prevalence of posttransplant diabetes, but the poor outcomes described in some series suggest that more extensive testing for macro-and microvascular disease may become necessary. T he main aim of liver transplantation, besides the immediate goal of saving life, is to return the patient to productive community living with good quality of life. It is ironic, therefore, that many of the health problems that afflict successful liver transplant recipients long term are those of community living in the developed world, including diabetes mellitus, hyperlipidemia, and obesity. These three metabolic derangements, together with hypertension, constitute adverse cardiovascular risk factors for transplant recipients. The management of diabetes in liver transplant recipients is not substantially different from its management in

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Section: Impact Of Obesity On the Outcome Of Liver Transplantationmentioning

confidence: 99%

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

Reuben

2001

Liver Transplantation

115

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“…Obesity was found to be a significant risk factor with regard to surgical procedures in the 1970s [9,11,13]. At Helsinki University Hospital, where all renal tranplantations in Finland are performed, the outcome of transplantation in obese renal recipients was considered ferences in patient and graft survival rates and in the number of medical and surgical complications after renal transplantation between obese and non-obese patients [1,2,4,10].…”

Section: Introductionmentioning

confidence: 99%

Is obesity still a risk factor in renal transplantation?

et al. 1997

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At our center, since 1982, a body mass index (BMI) of less than 30 has been a prerequisite for placing a patient on the waiting list for renal transplantation. This decision was made because obese transplant recipients seemed to have a less than favorable post-transplant outcome. The aim of this study was to evaluate whether this requirement is still justified. Forty-six patients with a BMI above 30 underwent primary cadaveric renal transplantation between 1972 and 1993. For each of these obese patients, five consecutive nonobese (BMI 20-25) control patients were selected. Patient and graft survival, causes of graft loss, and acute rejection rate were evaluated for the two patient groups before and after the year 1982. Within the first 30 post-transplant days, one patient (2 Yo) and 11 grafts (24 Yo) were lost in the group of obese patients whereas seven patients (3 %) and 36 grafts (16 YO) were lost in the control group. Among the obese patients, renal circulatory complications were a major cause of graft loss. In the period 1973-1 981, the 1 -year patient survival rate was 65 O/O among obese patients versus 75 YO among controls from 1982 to 1993, this was 90 Yo versus 93 %. From 1973 to 1981, the 1-year graft survival rate was 25 YO among obese patients versus 53 YO among controls ( P < 0.05); from 1982 to 1993, it was 68 YO versus 84 YO ( P = NS). Multivariate analysis showed that the immunosuppressive regimen, age of the patient, BMI, and cold ischemia time of the graft had a significant influence on graft survival. The acute rejection rate within the first 30 days was 28 YO among obese patients and 35 YO among controls ( P = NS). We conclude that a BMI below or equal to 30 is still justified as a prerequisite for placement on the waiting list for renal transplantation, for despite an overall improvement, the outcome of renal transplantation in obese patients remains worse than that in non-obese patients.

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“…D Di is sc cu us ss si io on n The morbidity and mortality of morbidly obese patients following upper abdominal procedures is more than two and a half times higher than that of their non-obese counterparts. 14 In light of the well documented clinical advantages associated with neuraxial blockade in the non-obese patient undergoing surgery, we assumed that grossly obese patients undergoing bariatric surgery would benefit particularly from regional anesthesia techniques. 1-3 The results of our retrospective analysis do not confirm this assumption.…”

Section: Méthode : Nous Avons Comparé Rétrospectivement La Période mentioning

confidence: 99%

Patient controllediv analgesia is an acceptable pain management strategy in morbidly obese patients undergoing gastric bypass surgery. A retrospective comparison with epidural analgesia

Charghi

Backman

Christou

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To examine the hypothesis that pain treatment with patient controlled analgesia (PCA) using iv morphine is a suitable and safe alternative to epidural analgesia in morbidly obese patients undergoing gastric bypass surgery. We retrospectively compared the postoperative periods in all patients undergoing this procedure in our institution between November 1999 and November 2001.M Me et th ho od ds s: : According to their perioperative pain treatment, patients were assigned to a PCA group (with iv morphine) or an epidural analgesia group, in which patients received either intermittent doses of morphine or continuous infusions of bupivacaine/fentanyl. Study endpoints included quality of pain control, incidence of cardiovascular and respiratory complications, analgesia related side effects, time to ambulation and first flatus, length of hospital stay, and wound infections. R Re es su ul lt ts s: : Data from 86 patients were analyzed with 40 patients in the PCA group and 46 patients in the epidural group. Groups were similar with respect to age, body mass index, and gender. The type of analgesia did not affect the quality of pain control at rest, the frequency of nausea and pruritus, the time to ambulation and return of gastrointestinal function, and the length of hospital stay. Patients receiving epidural analgesia had a greater risk of wound infection than subjects with PCA (epidural group: 39%, PCA group: 15%, P = 0.01).

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Complications Following Surgery for Duodenal Ulcer in Obese Patients

Cited by 128 publications

References 6 publications

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

Is obesity still a risk factor in renal transplantation?

Patient controllediv analgesia is an acceptable pain management strategy in morbidly obese patients undergoing gastric bypass surgery. A retrospective comparison with epidural analgesia

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