Overweight and obesity lead to serious health consequences, so that many strategies were recommended for preventing or curing this emerging problem. Treatments are various: diet, physical activity, psychotherapy, drugs, and bariatric surgery. Moreover, during these years, the use of intragastric balloon (BIB) to treat obesity increased rapidly, aimed to (1) ...

BACKGROUND: Application of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) is still controversial because of scant evidence of long-term safety and feasibility. We evaluated the long-term outcome of LADG compared with conventional open distal gastrectomy (ODG) for EGC. METHODS: Between March 1999 and July 2006, 106 patients underwent ...

OBJECTIVE: To observe the relationship between treatment course and therapeutic effect of acupuncture on female obesity in different types. METHODS: The 83 cases of obesity were divided into two groups: abdominal obesity group (AO, 31 cases) and symmetrical obesity group (SO, 52 cases). All of them were treated by acupuncture ...

BACKGROUND: To evaluate the feasibility, safety, and short-term efficacy of the conversion of laparoscopic adjustable gastric banding (LAGB) to laparoscopic sleeve gastrectomy (LSG) because of inadequate weight loss. METHODS: The inclusion criteria were an inadequate percentage of excess weight loss (%EWL), defined as <30% at > or =1 year after ...

BACKGROUND: Limited data are available evaluating the effect of sleeve gastrectomy on the control of DM. Our objective was to evaluate the effectiveness of sleeve gastrectomy in improving glycemic control of obese patients with diabetes mellitus (DM) at a research clinic. METHODS: A retrospective review of a prospectively maintained database ...

BACKGROUND: The impact of intragastric balloon (IGB) on obesity-related illnesses and quality of life (QOL) has not been previously investigated. METHOD: One hundred and nineteen consecutive obese patients (86 females; mean age 37.8; mean body weight (BW) 103.7 +/- 24.1 kg; mean BMI 38.4 +/- 8.0 kg/m(2)) who underwent IGB ...

BACKGROUND: To determine the effect of different stoma sizes on the percent excess weight loss (%EWL) following laparoscopic Roux-en-Y gastric bypass surgery (LRYGBP). METHODS: Blinded randomized prospective controlled study in two American Society for Bariatric Surgeons-designated Centers of Excellence hospitals. Two hundred gastric bypass patients between January 2005 and September ...

BACKGROUND: Many techniques have excellent results at 2 years of follow-up but some matters regarding their long-term efficacy have arisen. This is why bariatric surgery results must be analyzed in long-term follow-up. The aim of this study was to extend the analysis over 5 years, evaluating weight loss, morbidity, and ...

The number of bariatric surgeries is progressively increasing in the USA and in Brazil. The number of post-bariatric plastic surgeries also increases as a response to this phenomenon. Abdominoplasties performed in former morbidly obese patients present a larger number of postoperative complications. Studies show that abdominoplasty caused postoperative skin hypesthesia. ...

OBJECTIVE: Many patients undergoing lumbar spine fusion are overweight or obese. The relationship between body habitus and outcome after lumbar spine fusion surgery is not well defined. METHODS: We analyzed a prospectively maintained database of self-reported pain and quality of life measures, including Visual Analog Scale pain score, Short Form ...

OBJECTIVES: To determine the impact of body mass index (BMI) on perioperative functional and oncological outcomes in patients undergoing robotic laparoscopic radical prostatectomy (RLRP) when stratified by BMI. METHODS: Data were collected prospectively for 945 consecutive patients undergoing RLRP. Patients were evaluated with the UCLA-PCI-SF36v2 validated-quality-of-life questionnaire preoperatively and postoperatively ...

BACKGROUND: There are limited data on appropriate dosing of low-molecular-weight heparins (LMWH) for venous thromboembolism (VTE) prophylaxis in bariatric surgery. The objective of this study was to describe the postoperative effects of LMWH dalteparin on anti-factor Xa (AFXa) level in morbidly obese patients undergoing bariatric surgery. METHODS: This was a ...

BACKGROUND: In obese patients, concomitant use of clonidine and ketamine might be suitable to reduce the doses and minimize the undesired side effects of anesthetic and analgesic drugs. In this study, we evaluated the perioperative effects of administration of clonidine and ketamine in morbidly obese patients undergoing weight loss surgery ...

BACKGROUND: It is estimated that 25% of Americans older than 60 years are obese. Male gender and advanced age are indicators of increased risk for bariatric surgery. Good results have been shown in patients older than 50, but nearly all published studies include a large majority of females, and few ...

BACKGROUND: To investigate the predictability and sustainability of weight loss in gastric bypass (GBP) surgery after the first year, we conducted a 3-year follow-up of patients who had already been comprehensively studied preoperatively and after 1 year. METHODS: Preoperative data had been obtained for 131 morbidly obese patients on a ...

BACKGROUND: Previous research has found that many patients with anorexia nervosa (AN) are unable to maintain normal weight after weight restoration. The objective of this study was to identify variables that predicted successful weight maintenance among weight-restored AN patients. METHOD: Ninety-three patients with AN treated at two sites (Toronto and ...

BACKGROUND: To determine the body mass index (BMI) located at the fulcrum of success and failure in a prospective study conducted at the University of Texas Health Science Center at Houston. On average, our patients whose percentage of excess weight loss (%EWL) was >50% at 1 year had a significantly ...

BACKGROUND: Obese patients with gastroesophageal reflux disease (GERD) refractory to medical therapy are a challenging patient population as obesity is a preoperative predictor of failure after antireflux surgery. We therefore sought to evaluate outcomes using one of two commercially available endoluminal therapies in this population. METHODS: Consecutive obese patients (body ...

BACKGROUND: Swedish adjustable gastric banding (SAGB) is an effective treatment for morbid obesity. The aim of this study was to assess the efficacy and safety of SAGB in older patients aged >or=50 years. METHODS: Between January 1996 and January 2006, 134 patients (102 women, 32 men) of 785 consecutive patients ...

A group of patients with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 20-34 kg/m(2) were submitted to laparoscopic interposition of a segment of ileum into the proximal jejunum or into the proximal duodenum associated to a sleeve gastrectomy. The objective of this study is to evaluate the ...

BACKGROUND: The objective of this study is to evaluate the clinical results of the laparoscopic interposition of a segment of ileum into the proximal duodenum associated to a sleeve gastrectomy (II-DSG) in order to treat patients with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 21-29 kg/m2. PATIENTS ...

Diabetes is a well-recognized and treatable risk factor for cardiac disease, and one of many comorbidities associated with obesity. The aim of this study was to evaluate the clinical outcome of a cohort of morbidly obese patients with documented diabetes who underwent laparoscopic Roux-en-Y gastric bypass. Fifty-nine patients with sufficient ...

OBJECTIVES: To compare the early complications with operative treatment of acetabular fractures in morbidly obese (body mass index >or=40) patients when compared with all other patients. DESIGN: Retrospective review. SETTING: University medical center. PATIENTS/PARTICIPANTS: Four hundred thirty-five consecutive patients with acetabular fractures operatively treated by a single surgeon. Forty-one of ...

AIMS: The curiosity that leanness is associated with poor survival in patients with chronic heart failure (CHF) needs further insight by investigating the impact of weight loss on prognosis in a large sample of patients across a broad spectrum of both reduced and preserved left ventricular (LV) systolic function. METHODS ...

BACKGROUND: To investigate the role of sleeve gastrectomy for patients with class I obesity (body mass index 30-35 kg/m(2)) at a private hospital with self-paying patients. Randomized trials have shown a benefit for bariatric surgery compared with conservative treatment in patients with class I obesity. Sleeve gastrectomy is a relatively ...

INTRODUCTION: Successful weight loss after laparoscopic Roux-Y gastric bypass (LRYGB) hinges on many elements including neurohormonal, anatomical, and postoperative behavioral changes. To date, the effects of socioeconomic factors have been inadequately studied. We examine several components of socioeconomic status and its relationship to weight loss after LRYGB. METHODS: Between August ...

INTRODUCTION: The utility of routine upper gastrointestinal (UGI) evaluations after laparoscopic Roux-Y gastric bypass (LRYGB) has yet to be determined, primarily being used to rule out a gastrojejunal leak. Additional information can be assessed with these studies, including the rate of contrast emptying from the pouch; some patients show no ...

BACKGROUND: In an attempt to potentiate the effect of laparoscopic gastric banding (LGB) on weight reduction and to reduce the risk of weight regain, we added laparoscopic truncal vagotomy (TV) to adjustable LGB. We report on our early interim results of a prospective 5-year randomized clinical trial comparing patients who ...

BACKGROUND: Although the published data have clearly related the size of the gastrojejunostomy anastomosis to the subsequent likelihood of a stricture, a correlation between the anastomosis size and postoperative weight loss has not previously been described. METHODS: A retrospective comparison was made of 124 anastomoses accomplished with the 21-mm circular ...

INTRODUCTION: Vertical banded gastroplasty (VBG) was initiated in 1980 as a weight loss operation that restricted oral intake. OBJECTIVE: The aim of our study was to determine the results of patients who presented with complications of the VBG and wanted reversal of the VBG, not a conversion to another gastric ...

OBJECTIVE: To investigate the feasibility of switching overweight schizophrenic patients to aripiprazole and to assess the impact of 12 months of aripiprazole treatment on weight in routine practice. METHOD: This was a non-controlled cohort study in overweight schizophrenic patients. Data were collected before treatment with aripiprazole was started and at ...

OBJECTIVE: To investigate the hypothesis that the peripheral actions of caffeine and ephedrine to increase sympathetic tone and metabolic rate and to preserve lean tissue will cause weight loss in patients with hypothalamic obesity. METHODS: We present 3 case studies of consecutive patients who presented with hypothalamic obesity and were ...

Gastric bypass (GBP) is the most common operation performed in the United States for morbid obesity. However, weight loss is poor in 10% to 15% of patients. We sought to determine the independent factors associated with poor weight loss after GBP. Prospective cohort study. We examined demographic, operative, and follow-up ...

It has been suggested that about 20% of subjects undergoing weight-loss programmes can achieve a certain degree of long-term success. At present, surgery remains the only method resulting in long-term sustained weight loss, but access remains restricted. Hence it is important to analyse, in addition to pharmacotherapy, the methods to ...

BACKGROUND: Medium and long-term efficacy of Roux-en-Y gastric bypass (RYGBP) has previously been demonstrated. However, weight-loss success criteria could be influenced by super-obesity prevalence at baseline. Here, we describe a 5-year follow-up concerning weight loss results, comorbidities, and mortality of a RYGBP Brazilian population with a high prevalence (60.6%) of ...

The only effective treatment for patients with morbid obesity is surgery. Laparoscopic bariatric surgery has become quite popular in attempts to decrease the morbidity associated with laparotomy. The aim of this study was to assess the safety and efficiency by using SurgASSIST(R) for performing the gastrojejunostomy in laparoscopic Roux-en-Y gastric ...

Bio-enteric intragastric balloon (BIB) insertion is gaining popularity for weight reduction in obese patients. We evaluated the efficacy, tolerability, and safety of BIB in the treatment of obesity. A total of 173 Saudi obese patients [mean+/-SD age 34.5 +/- 11.6 years, 58 (33.5%) were men] who underwent BIB (InaMed Corporation, ...

BACKGROUND: One of the perceived disadvantages of the biliopancreatic diversion with duodenal switch operation is diarrhea. The aim of this study was to compare the bowel habits of patients after duodenal switch operation or Roux-en-Y gastric bypass. METHODS: A prospective comparative case series design was used. Forty-six patients who underwent ...

Pulmonary complications following injury significantly contribute to subsequent mortality. Obese patients have preexisting risk factors for pulmonary complications, and are at risk for these complications following elective surgery. Whether or not obesity contributes to pulmonary complications after critical injury is poorly understood. A secondary analysis of a prospective cohort study ...

OBJECTIVES: To evaluate the impact of body mass index (BMI) on clinical outcomes and costs associated with percutaneous nephrostolithotomy (PCNL). METHODS: We reviewed charts of 200 consecutive patients who underwent PCNL between September 2005 and May 2007. We recorded patient and stone characteristics and perioperative outcomes. BMI was available for ...

BACKGROUND: Visceral fat, especially the greater omentum, seems to be an important factor in the development of some metabolic disturbances such as insulin resistance, hyperglycemia, and dyslipidemia. Therefore, we wanted to evaluate the influence of resecting or leaving in situ the greater omentum in a group of patients with morbid ...

BACKGROUND: The aim of this study is the prospective evaluation of the results of Bioenterics intragastric balloon (BIB) with sibutramine and BIB placement alone in the treatment of obesity. METHODS: The patients evaluated between March 2006 and January 2007 and enrolled in this study were assessed in two groups as ...

BACKGROUND: Surgical reports have indicated that longer Roux limbs (150 cm) have greater or no effect on long-term weight loss in super-obese patients (body mass index [BMI]>or=50 kg/m2) and little effect in less obese patients. METHODS: The weight loss outcomes through 5 years were compared in 3 sequential groups of ...

BACKGROUND: When gastric banding was introduced as a bariatric operation about 12 years previously, its early results were promising, with a low complication rate. Only a few long-term studies on this subject have been published. This study was performed to assess our results with laparoscopic gastric banding in young patients ...

BACKGROUND: In Roux-Y gastric bypass surgery pouch formation is the most demanding part of the operation. The vagal nerve is usually tempted to be preserved although results reporting beneficial effects are lacking. Dividing the perigastric tissue including the anterior vagal trunk may technically alleviate gastric pouch formation. We evaluated the ...

BACKGROUND: Gallstones have been frequently diagnosed after Roux-en-Y gastric bypass (RYGBP). Gallbladder stasis associated with duodenal exclusion may play a role in their pathogenesis. METHODS: Gallbladder emptying was studied before and on the 30th and 31st postoperative days (POD) after RYGBP in 20 morbidly obese patients. Gallbladder volume after fasting ...

BACKGROUND: Patients undergoing bariatric surgery with a gastric bypass lose about 66% of excess weight. Although this procedure induces weight loss, it is unknown whether it leads to protein malnutrition, which is studied here. METHODS: One hundred ten obese patients (body mass index, 47.9 +/- 8.6 kg/m(2)) undergoing gastric bypass ...

BACKGROUND: The purpose of this study was to investigate the clinical impact of radiological assessment on delivery of therapy in patients with laparoscopic adjustable gastric banding for morbid obesity who have developed gastroesophageal symptoms or have inadequate excess weight loss. METHODS: Institutional review board approval and informed consent were obtained ...

OBJECTIVE: To determine whether patients can accurately replicate and retain weight-bearing restrictions in both stationary (static) and dynamic conditions after autologous chondrocyte implantation (ACI). DESIGN: Case series. SETTING: Rehabilitation clinic. PARTICIPANTS: A consecutive sample of patients (N=48) who had undergone ACI to a medial or lateral femoral condylar defect in ...

BACKGROUND: Italy is the European country with the most obese and overweight children and teenagers. Most of them have a family history of obesity and this condition may increase the risk of many diseases. METHODS: This study involved 52 patients (32 females and 20 males) between 6 and 17 years ...