How to Choose and Use Bariatric Surgery in 2015

Piché, Marie-Ève; Auclair, Audrey; Harvey, Jany; Marceau, Simon; Poirier, Paul

doi:10.1016/j.cjca.2014.12.014

Cited by 100 publications

(66 citation statements)

References 167 publications

(154 reference statements)

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“…The mortality rate associated with diabetes has also been significantly reduced. 10 A more recent study that assessed the long-term effects of bariatric surgery on diabetic patients observed that glucose control and remission from diabetes were possible in 89.2% and 64.7% of the patients, respectively. 30 Similar findings had already been reported previously.…”

Section: Antidiabetic Drugsmentioning

confidence: 99%

“…45,46 Regarding the reduction in the number of patients who were using antihypertensive drugs, our findings were similar to those reported by other authors. [26][27][28]47,48 Partial or complete improvement was shown within 12 months after undergoing bariatric surgery, especially among the patients who had undergone gastric bypass, 10,47 thus reducing the need for antihypertensive drugs. 49,50 It seems again that our results were somehow related to the technique used for the majority of our patients, i.e.…”

Section: Antihypertensive Drugsmentioning

confidence: 99%

“…10 This surgical procedure has been shown to enable control over glucose levels, even leading to remission of diabetes. 12 The quick and sustained improvement in glucose homeostasis that this procedure provides has made it the gold-standard metabolic procedure and treatment for diabetic patients with morbid obesity.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7][8] Most patients with high blood pressure are overweight, 9 and hypertension is six times more frequent among obese individuals than among those with normal weight. 10 The alternatives to clinic treatment for reducing weight among patients with morbid obesity are limited, and the longterm outcomes are relatively inefficient. 11 Bariatric surgery seems to be a viable option for treating morbid obesity, since it has been shown to be effective in maintaining the weight loss.…”

Section: Introductionmentioning

confidence: 99%

“…13 Comorbidity reductions are reflected in diminished drug use during the postoperative period, and discontinuation of drug therapy for some diseases, thus resulting in reduced expenditure on drugs and other healthcare services. 10,[14][15][16][17][18] In addition, bariatric surgery extends survival, decreases occurrences of cardiovascular events and is also associated with greater reduction of mortality due to cardiovascular diseases, myocardial infarction, stroke, diabetes and cancer, in comparison with obese individuals who do not undergo this surgery. 10,19,20 The reduction in the risk of myocardial infarction, stroke and adverse cardiovascular events is approximately 50% after this surgery, in comparison with individuals who did not undergo the procedure.…”

Section: Introductionmentioning

confidence: 99%

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Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction. RESUMO CONTEXTO E OBJETIVO:A cirurgia bariátrica tem sido uma alternativa efetiva de tratamento para a obesidade mórbida, resultando na diminuição da mortalidade, melhor controle das comorbidades e redução no uso de medicamentos. O objetivo deste estudo foi analisar o impacto da cirurgia bariátrica sobre a utilização de medicamentos e suplementos nutricionais. TIPO DE ESTUDO E LOCAL: Estudo longitudinal do tipo antes e depois com 69 pacientes obesos mórbi-dos em um hospital público de Porto Alegre. MÉTODOS: Nas entrevistas, foram avaliados a presença de comorbidades e o uso de medicamentos com e sem prescrição médica. RESULTADOS: De 69 pacientes entrevistados, 85,5% apresentaram comorbidades no período pré-cirúrgi-co, média de 2,3 (± 1,5) por paciente. As principais comorbidades relatadas foram hipertensão, diabetes e dislipidemias. 84,1% dos pacientes estavam em uso de medicamentos sob prescrição médica, no período pré-cirúrgico. A média de uso de medicamentos por paciente foi de 4,8, reduzindo para 4,4 após o procedimento. A cirurgia proporcionou diminuição significativa do uso da maioria dos antidiabéticos (84%), antilipêmicos (77%) e anti-hipertensivos (49,5%). Por outro lado, observou-se aumento significativo na utilização de multivitamínicos e medicamentos para desordens do trato gastrointestinal. A maior parte dos medicamentos que continuaram sendo prescritos após a cirurgia teve sua dose reduzida, no entanto, esta redução nã...

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Section: Antidiabetic Drugsmentioning

confidence: 99%

Section: Antihypertensive Drugsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

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Transradial left gastric artery embolization to treat severe obesity: A pilot study

Pirlet

Ruzsa

Costerousse

et al. 2018

Cathet Cardio Intervent

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Background Bariatric surgery is currently the only effective treatment with long‐lasting results to treat severe obesity. Objectives We performed a pilot study to evaluate the feasibility, safety and efficacy of percutaneous distal embolization of the left gastric artery (LGA) using a transradial approach. Methods and Results We recruited seven severely obese male patients (mean age 48 ± 7 years) referred for diagnostic coronary angiography. Mean baseline weight was 160 ± 27 kg and body mass index was of 52 ± 8 kg/m2. We successfully injected 300–500 μm polyvinyl alcohol particles using 5Fr catheters and all distal LGA were occluded at the end of procedures. Mean procedure duration was 24 ± 13 min and mean fluoroscopy time was 10 ± 5 min. Six patients reported mild transient epigastric discomfort, which resolved with proton pump inhibitors. At 2 months, the average weight loss was of 7 ± 6 kg (median loss: −10 kg [−2, −11]), 6 ± 12 kg (median loss: −9 kg [−16, +4]) at 6 months and 13 ± 17 kg (median loss: −11 kg [0, −25]) up to 12 months after index procedures. Conclusion Percutaneous transradial LGA embolization appears to be a promising technique to reduce the obesity burden. Randomized trials are required to further delineate the risk/benefit ratio, potential clinical indications and long term results.

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Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

Mechanick

Apovian

Brethauer

et al. 2020

Obesity

339

464

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Objective The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. Methods Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. Results New or updated topics in this CPG include: contextualization in an adiposity‐based chronic disease complications‐centric model, nuance‐based and algorithm/checklist‐assisted clinical decision‐making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). Conclusions Bariatric procedures remain a safe and effective intervention for higher‐risk patients with obesity. Clinical decision‐making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues.

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How to Choose and Use Bariatric Surgery in 2015

Cited by 100 publications

References 167 publications

Medication and nutritional supplement use before and after bariatric surgery

Medication and nutritional supplement use before and after bariatric surgery

Transradial left gastric artery embolization to treat severe obesity: A pilot study

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