Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice

Background: Results of the laparoscopic Mini-Gastric Bypass (MGB) are reported. Methods: 1,274 MGB patients are continuously monitored as part of an online computer tracking data-base system. Results: Mean preoperative weight (± Standard Deviation) was 132 ± 21 kg, BMI 47 ± 7. Mean excess weight loss was 51% at 6 months, 68% at 12 months and 77% at 2 years. The mean operating-time was 36.9 ± 33.5 minutes. The shortest time was 19 minutes. Hospital stay was 1.5 ± 1.6 days. The overall complication rate has been 5.2%.The overall rate of deep vein thrombosis and pulmonary embolism was 0.08% and 0.16% respectively. The leak rate was 1.6%. There was one hospital death, 0.08%. Associated medical illnesses were either completely reversed or markedly improved. Conclusions: The MGB is safe, results in major weight loss, has a short operating-time, and has a short hospital stay.The MGB appears to meet many of the criteria of an "ideal" weight loss operation.

The mini-gastric bypass: experience with the first 1,274 cases.

Intragastric balloons have been used since 1985 to treat obesity, but an evidence-based systematic review had not been previously performed. The objective of this study is to determine the safety, efficacy, and effectiveness of the most widely used balloon, BioEnterics Intragastric Balloon (BIB®), to treat obesity. Systematic literature review of Medline, Embase, and other information sources from inception to March 2006. The quality of selected studies was assessed. Meta-analysis of weighted mean difference was made using the inverse variance method. We pooled 15 articles (3,608 patients) to estimate BIBs® effectiveness. The estimates for weight lost at balloon removal for BIB® were the following: 14.7 kg, 12.2% of initial weight, 5.7 kg/m2, and 32.1% of excess weight. However, data were scant after balloon removal. Yet, efficacy at balloon removal was estimated with a meta-analysis of two randomized controlled trials (75 patients) that compared balloon versus placebo, indicating the balloon group lost more weight than the placebo group. These differences in weight lost were 6.7 kg, 1.5% of initial weight, 3.2 kg/m2, and 17.6% of excess weight. Regarding BIB® safety, the majority of complications were mild and the early removal rate was 4.2%. The use of the BIB®, within a multidisciplinary weight management program, is a short-term effective treatment to lose weight, but it is not yet possible to verify its capacity to maintain the weight lost over a long period of time.

Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis.

The rising prevalence of morbid obesity and the increased incidence of super-obese patients (BMI >50 kg/m2) seeking surgical treatments has led to the search for surgical techniques that provide adequate EWL with the least possible morbidity. Sleeve gastrectomy (SG) was initially added as a modification to the biliopancreatic diversion (BPD) and then combined with a duodenal switch (DS) in 1988. It was first performed laparoscopically in 1999 as part of a DS and subsequently done alone as a staged procedure in 2000. With the revelation that patients experienced weight loss after SG, interest in using this procedure as a bridge to more definitive surgical treatment has risen. Benefits of SG include the low rate of complications, the avoidance of foreign material, the maintenance of normal gastro-intestinal continuity, the absence of malabsorption and the ability to convert to multiple other operations. Reduction of the ghrelin-producing stomach mass may account for its superiority to other gastric restrictive procedures. SG should be in the armamentarium of all bariatric surgeons. Nonetheless, long-term studies are necessary to see if it is a durable procedure in the treatment of morbid obesity.

/pdf/sleeve-gastrectomy-for-morbid-obesity-4asthbheah.pdf

Sleeve gastrectomy for morbid obesity.

https://www.soard.org/article/S1550-7289(14)00060-4/pdf

Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force.

Background: Roux-en-Y gastric bypass is an effective procedure for the long-term control of morbid obesity. An eventual revisionary operation, however, is necessary for some patients (0.8-29%). Redo procedures are required for pouch enlargement, stapleline dehiscence, or marginal ulceration. In 1994, the micropouch gastric bypass (MBG) was developed to eliminate the need for a repeat operation. Its design was based on two anatomical principles: 1) The fundus is elastic, aperistaltic, and may significantly dilate over time; 2) The proximal magenstrasse contains a high concentration of parietal cells, which potentiates the risk for marginal ulceration or gastroesophageal reflux after vertical pouch restriction. Construction of a micropouch limited to the gastric cardia avoids using the fundus and proximal lesser curvature, but requires a greater mobilization of the stomach and its peritoneal attachments. Methods: Between February 1994 and February 2000, 1,120 patients underwent the MGB as a primary or revisionary operation.The fundus was mobilized completely, including transection of the left phreno-esophageal and gastrophrenic ligaments. The transected pouch was limited to the gastric cardia with 1 cm of fundus incorporated into the gastrojejunostomy stoma (GJS). Results: There were 10 anastomotic leaks at the GJS (0.9%). All leaks sealed following surgical drainage or parenteral nutrition. One patient required re-operation (0.09%) for a dilated pouch and marginal ulceration. An additional patient (0.09%) developed a gastrogastric fistula secondary to a pharmacobezoar and stomal stenosis. Conclusion: With an appreciation for the finer anatomy of the proximal stomach and intra-abdominal esophagus, the micropouch can be constructed safely in both primary and redo procedures. The MGB, now in its seventh year, is durable and has, with rare exception, eliminated pouch enlargement, staple-line separation, reflux esophagitis, and marginal ulceration.

The micropouch gastric bypass: technical considerations in primary and revisionary operations.

Background: Marginal ulceration (MU) after Roux-en-Y gastric bypass (RYGB) is a well-recognized complication. Its incidence varies between 1% and 16%. Factors associated with the development of MU include pouch size, pouch orientation, staple line integrity, and mucosal ischemia. Nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori may also contribute to MU, but their mechanism of action in the RYGB patient has not been studied. Methods: In 1994 a prospective 3-year study was designed to document the incidence of MU after near-total gastric bypass (NTGB). In this procedure the transected pouch was limited to the cardia, and the gastrojejunostomy was made along the greater curvature. A total of 173 patients entered the study. All patients who experienced postoperative nausea, vomiting, or abdominal pain underwent endoscopic examination of the pouch, stoma, and proximal Roux-en-Y limb. Gastrograffin studies were used within the first 2 weeks of operation. Results: One year after operation, MU was not identified in any patient. At 3 years follow-up, MU was documented in one patient (0.6%) with a dilated gastric reservoir (60 cc). Conclusion: This study reviews the etiology, diagnosis, and treatment of MU in the RYGB patient and offers specific recommendations to reduce its occurrence. It also confirms a preliminary impression that NTGB is an effective operation in preventing MU formation.

Marginal ulcer after gastric bypass: a prospective 3-year study of 173 patients.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Flake Tm

Author Tools

Chat about Author

Papers

The micropouch gastric bypass: technical considerations in primary and revisionary operations.

Marginal ulcer after gastric bypass: a prospective 3-year study of 173 patients.