Surgical treatment of morbid obesity

Pm, Sagar

doi:10.1002/bjs.1800820606

Cited by 66 publications

(32 citation statements)

References 62 publications

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“…The latter results from a significant increase in the sensitivity to insulin 15 -24 , with the clearcut improvement in glucose tolerance normalising hyperglycaemia in most previous non insulindependent diabetic subjects. Respiratory function is also improved, with significant regression or even disappearance of the sleep apnea syndrome 3 . There is also a rapid amelioration of abnormal cardiac function 25 .…”

Section: Long-term Benefits Of Gastric Surgerymentioning

confidence: 99%

“…Some surgeons are using an inflatable prosthetic device, allowing a variable calibration of the outlet to the lower part of the stomach 3 . This procedure may be relatively easily performed by laparoscopy, but it is, in general, considered as mechanically unreliable and gives rather disappointing results 3 * 5 .…”

Section: Gastroplastiesmentioning

confidence: 99%

“…The intake of protein is provided by dairy products and eggs and, later on, by poultry and fish. Patients are instructed to take frequent and small meals and, to prevent vomiting, to eat slowly and to avoid drinking during meals 3 .…”

Section: Long-term Benefits Of Gastric Surgerymentioning

confidence: 99%

“…The loss of weight during the first year after surgery is proportional to the degree of the pre-operative obesity, and depends largely on the frequency of the follow-up visits 3 . It may be considerably slower in obese subjects who consume large amounts of sweets and high-energy liquid foods rich in sugars and fat.…”

Section: Long-term Benefits Of Gastric Surgerymentioning

confidence: 99%

“…This complication rarely results from stenosis of the gastric pouch outlet, and is usually secondary to too rapid eating 3 . Another, relatively frequent, complication is disruption of the staple line 3 -8 ' 9 .…”

Section: Gastric Surgery -Related Risks and Complicationsmentioning

confidence: 99%

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Surgical treatment for morbid obesity

Kolanowski

1997

British Medical Bulletin

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Since severe obesity is frequently associated with serious metabolic, cardiovascular and psychological co-morbid conditions, and given the usually unsuccessful results of conservative therapeutic approaches, surgical treatment based on gastric restriction procedures is increasingly recognized as a treatment of choice for morbidly obese persons. Among several surgical approaches designed to promote a substantial loss of weight, two gastric restriction procedures, i.e. the vertical banded gastroplasty and the gastric bypass, have been increasingly used during the past years. Both techniques induce an impressive loss of weight, and are surprisingly well tolerated, even by severely obese persons.The usual 50-75% reduction of initial weight excess, is followed by a clear-cut reduction, or even disappearance of, obesity-related co-morbidity, such as hypertension, diabetes mellitus or sleep apnea syndrome.While serious peri-and postoperative risks are very limited, the intractable vomiting occurring after gastroplasty, and potential sequelae related to iron and calcium malabsorption after the gastric bypass, represent much more frequent complications of the surgical treatment of obesity. There is also a tendency towards a late regain of weight, but the benefit in terms of improvement in the obesity-associated co-morbidity is in general maintained despite this partial increase in weight.Gastric procedures are, therefore, an effective treatment of severe obesity and of its co-morbid conditions. However, careful medical and nutritional supervision is necessary during the follow-up after surgery, to prevent potential nutritional or digestive complications.

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Section: Long-term Benefits Of Gastric Surgerymentioning

confidence: 99%

Section: Gastroplastiesmentioning

confidence: 99%

Section: Long-term Benefits Of Gastric Surgerymentioning

confidence: 99%

Section: Long-term Benefits Of Gastric Surgerymentioning

confidence: 99%

Section: Gastric Surgery -Related Risks and Complicationsmentioning

confidence: 99%

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Surgical treatment for morbid obesity

Kolanowski

1997

British Medical Bulletin

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Band Erosion in Patients Who Have Undergone Vertical Banded Gastroplasty

Moreno

Alastrué²,

Rull³

et al. 1998

Arch Surg

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To study the incidence of band erosion in patients who have undergone vertical banded gastroplasty and to describe the reparative techniques used. Design: A retrospective review case series. Setting: A university hospital-based tertiary referral center. Patients: Two hundred fifty consecutive morbidly obese patients who underwent vertical banded gastroplasty between 1987 and 1995. Main Outcome Measures: The development of band erosion into the stomach, reparative surgical techniques, and long-term weight loss control. Results: Band erosion developed in 7 (2.8%) of the patients. Two patients had symptoms 1 month after undergoing forced endoscopy. Six patients required reoperation. The operative findings included 2 cases of "external" band erosion through the lesser curvature into the stomach and 4 cases of "internal" band erosion through the circular staple line. The surgical techniques used for repair depended on the radiological and endoscopic data and on the operative findings; the techniques included conversion into a gastric bypass, band replacement after the creation of a new stoma, and gastroplasty plus distal gastric bypass. There were no complications, and adequate longterm weight loss was achieved in all but 1 of the patients who underwent reoperation. Conclusion: Band erosion may be corrected using appropiate surgical techniques to allow for adequate longterm weight loss in patients who have undergone vertical banded gastroplasty.

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Relationships Between Changes in Body Composition and Changes in Cardiovascular Risk Factors: The SOS Intervention Study

1997

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Relationships between 2-year changes in body composition (estimated from computed tomography-validated anthropometry based on sagittal trunk diameter, weight, and height), adipose tissue (AT) distribution, and cardiovascular risk factors (blood pressure, lipids, glucose, insulin, uric acid) were examined in 842 treated adults with severe obesity with weight changes from -95.5 to +30.6 kg. Although the change (delta) of visceral AT mass (expressed in % total AT) for a given change in body mass index (delta BMI) was 6-fold larger in men than in women, delta waist and delta waist/hip were similar in both sexes. In men, risk factor changes were similarly related to delta waist, delta bodyweight, and delta BMI, whereas in women, delta bodyweight seemed to be the single independent variable with the highest explanatory power. In multivariate regressions adjusted for delta BMI and baseline conditions, delta visceral AT mass was more strongly associated with risk factor changes than were delta waist and delta waist/hip. When using a three-compartment model (lean body mass, subcutaneous and visceral AT masses) plus neck and thigh girths (indicators of subcutaneous AT distribution), risk factor changes were related both to delta subcutaneous and delta visceral AT masses but not to delta lean body mass. In agreement with cross-sectional findings, delta neck was positively and delta thigh was negatively related to some risk factor changes. Thus, the use of waist as a single risk factor indicator seems less effective for epidemiological studies than the simple anthropometric measures presented here, which are able to separate the effects of visceral AT mass, subcutaneous AT mass, and subcutaneous AT distribution on metabolic parameters under both cross-sectional and longitudinal conditions.

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Surgical treatment of morbid obesity

Cited by 66 publications

References 62 publications

Surgical treatment for morbid obesity

Surgical treatment for morbid obesity

Band Erosion in Patients Who Have Undergone Vertical Banded Gastroplasty

Relationships Between Changes in Body Composition and Changes in Cardiovascular Risk Factors: The SOS Intervention Study

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