Impact of Laparoscopic Adjustable Gastric Banding on Obesity Co-morbidities in the Medium- and Long-Term

Korenkov, Michael; Sh, Shah; Sauerland, Stefan; Duenschede, Friedrich; Junginger, T

doi:10.1007/s11695-007-9118-y

Cited by 43 publications

(35 citation statements)

References 14 publications

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“…Baseline characteristics for patients with and without presurgery and postsurgery BMIs available are shown in eTable 7 (in Supplement). 12 or fewer years of education (n = 11 493); data available for individuals for median family income (n = 11 495) (Census 2000 data). d For BMI before surgery, n = 7366 and for BMI after surgery, n = 7136. e Quan comorbidity index was used to report available data (n = 11 685 patients) (Quan adaptation of the Elixhauser index, a comorbidity measurement tool with range from 0 to 31 clinical conditions; lower numbers reflect fewer comorbidities).…”

Section: Resultsmentioning

confidence: 99%

Chronic Use of Opioid Medications Before and After Bariatric Surgery

Raebel

Newcomer

Reifler

et al. 2013

JAMA

213

158

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IMPORTANCE Obesity is associated with chronic noncancer pain. It is not known if opioid use for chronic pain in obese individuals undergoing bariatric surgery is reduced.OBJECTIVES To determine opioid use following bariatric surgery in patients using opioids chronically for pain control prior to their surgery and to determine the effect of preoperative depression, chronic pain, or postoperative changes in body mass index (BMI) on changes in postoperative chronic opioid use. DESIGN, SETTING, AND PARTICIPANTSRetrospective cohort study in a distributed health network (10 demographically and geographically varied US health care systems) of 11 719 individuals aged 21 years and older, who had undergone bariatric surgery between 2005 and 2009, and were assessed 1 year before and after surgery, with latest follow-up by December 31, 2010.MAIN OUTCOMES AND MEASURES Opioid use, measured as morphine equivalents 1 year before and 1 year after surgery, excluding the first 30 postoperative days. Chronic opioid use is defined as 10 or more opioid dispensings over 90 or more days or as dispensings of at least a 120-day supply of opioids during the year prior to surgery. RESULTS Before surgery, 8% (95% CI, 7%-8%; n = 933) of bariatric patients were chronic opioid users. Of these individuals, 77% (95% CI, 75%-80%; n = 723) continued chronic opioid use in the year following surgery. Mean daily morphine equivalents for the 933 bariatric patients who were chronic opioid users before surgery were 45.0 mg (95% CI, 40.0-50.1) preoperatively and 51.9 mg (95% CI, 46.0-57.8) postoperatively (P < .001). For this group with chronic opiate use prior to surgery, change in morphine equivalents before vs after surgery did not differ between individuals with loss of more than 50% excess BMI vs those with 50% or less (>50% BMI loss: adjusted incidence rate ratio [adjusted IRR, 1.17; 95% CI, 1.07-1.28] vs Յ50% BMI loss [adjusted IRR, 1.03; 95% CI, 0.93-1.14] model interaction, P = .06). In other subgroup analyses of preoperative chronic opioid users, changes in morphine equivalents before vs after surgery did not differ between those with or without preoperative diagnosis of depression or chronic pain (depression only [n = 75; IRR, 1.08; 95% CI, 0.90-1.30]; chronic pain only [n = 440; IRR, 1.17; 95% CI, 1.08-1.27]; both depression and chronic pain [n = 226; IRR, 1.11; 95% CI, 0.96-1.28]; neither depression nor chronic pain [n = 192; IRR, 1.22; 95% CI, 0.98-1.51); and P values for model interactions when compared with neither were P = .42 for depression, P = .76 for pain, and P = .48 for both. CONCLUSIONS AND RELEVANCEIn this cohort of patients who underwent bariatric surgery, 77% of patients who were chronic opioid users before surgery continued chronic opioid use in the year following surgery, and the amount of chronic opioid use was greater postoperatively than preoperatively. These findings suggest the need for better pain management in these patients following surgery.

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Section: Resultsmentioning

confidence: 99%

Chronic Use of Opioid Medications Before and After Bariatric Surgery

Raebel

Newcomer

Reifler

et al. 2013

JAMA

213

158

View full text Add to dashboard Cite

show abstract

“…The procedure is quick, lasting an average of 35-95 min [10][11][12][13], which is important for obese patients with many coincidental pathologies, and it is associated with a low rate of serious complications as well as rare intra-and early postoperative complications.…”

Section: Resultsmentioning

confidence: 99%

“…Intraoperative complications (⊡ Table 17.2) include: ▬ Esophageal or gastric wall injury due to the use of coagulation or too "brutal" attempts at passage behind the stomach [11,14,15] ▬ Gastric bleeding, usually easy to control. The management of this complication is simpler, of course, if the source of bleeding is visible and much more difficult in the case of bleeding involving the adipose tissue or situated in the posterior gastric wall.…”

Section: Resultsmentioning

confidence: 99%

The Gastric Banding

Szewczyk¹,

Modzelewski²

2012

Principles of Metabolic Surgery

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“…Korenkov et al [26] followed 145 patients over 8 years who underwent adjustable gastric band. Despite a BMI drop from 48 to 34 and an improvement of other medical comorbidities, they only reported a drop in knee pain from 47% to 38%.…”

Section: Bariatric Surgery Link To Improved Osteoarthritismentioning

confidence: 99%

“…Although a statistically significant result, the clinical difference was quite minimal. It was postulated that there was a less than expected effect on knee pain because degeneration had already occurred and thus the damage was irreparable [26].…”

Section: Bariatric Surgery Link To Improved Osteoarthritismentioning

confidence: 99%