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[Not Available].
Biraima-Steinemann, M, Maurer, S, Angst, E
Therapeutische Umschau. Revue therapeutique. 2016;(11):651-657
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2.
Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre-post studies.
Opozda, M, Chur-Hansen, A, Wittert, G
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2016;(8):770-92
Abstract
Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours.
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3.
Surgery for the treatment of obesity in children and adolescents.
Ells, LJ, Mead, E, Atkinson, G, Corpeleijn, E, Roberts, K, Viner, R, Baur, L, Metzendorf, MI, Richter, B
The Cochrane database of systematic reviews. 2015;(6):CD011740
Abstract
BACKGROUND Child and adolescent overweight and obesity have increased globally, and are associated with significant short and long term health consequences. OBJECTIVES To assess the effects of surgical interventions for treating obesity in childhood and adolescence. SEARCH METHODS We searched the Cochrane Library, MEDLINE, PubMed, EMBASE as well as LILACS, ICTRP Search Portal and ClinicalTrials.gov (all from database inception to March 2015). References of identified studies and systematic reviews were checked. No language restrictions were applied. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of surgical interventions for treating obesity in children and adolescents (age < 18 years) with a minimum of six months follow-up. Interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity were excluded. Pregnant females were also excluded. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and extracted data. Where necessary authors were contacted for additional information. MAIN RESULTS We included one RCT (a total of 50 participants, 25 in both the intervention and comparator group). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi component lifestyle programme. The participating population consisted of Australian adolescents (a higher proportion of girls than boys) aged 14 to 18 years, with a mean age of 16.5 and 16.6 years in the gastric banding and lifestyle group, respectively which was conducted in a private hospital, receiving funding from the gastric banding manufacturer. The study authors were unable to blind participants, personnel and outcome assessors which may have resulted in a high risk of performance and detection bias. Attrition bias was noted as well. The study authors reported a mean reduction in weight of 34.6 kg (95% confidence interval (CI) 30.2 to 39.0) at two years, representing a change in body mass index (BMI) of 12.7 (95% CI 11.3 to 14.2) for the surgery intervention; and a mean reduction in weight of 3.0 kg (95% CI 2.1 to 8.1) representing a change in BMI of 1.3 (95% CI 0.4 to 2.9) for the lifestyle intervention. The differences between groups were statistically significant for all weight measures at 24 months (P < 0.001). The overall quality of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was low. Adverse events were reported in 12/25 (48%) participants in the intervention group compared to 11/25 (44%) in the control group (low quality evidence). A total of 28% of the adolescents undergoing gastric banding required revisional surgery. No data were reported for all-cause mortality, behaviour change, participants views of the intervention and socioeconomic effects. At two years, the gastric banding group performed better than the lifestyle group in two of eight health-related quality of life concepts (very low quality evidence) as measured by the Child Health Questionnaire (physical functioning score (94 versus 78, community norm 95) and change in health score (4.4 versus 3.6, community norm 3.5)). AUTHORS' CONCLUSIONS Laparoscopic gastric banding led to greater body weight loss compared to a multi component lifestyle program in one small study with 50 patients. These results do not provide enough data to assess efficacy across populations from different countries, socioeconomic and ethnic backgrounds, who may respond differently. This systematic review highlights the lack of RCTs in this field. Future studies should assess the impact of the surgical procedure and post operative care to minimise adverse events, including the need for post operative adjustments and revisional surgery. Long-term follow-up is also critical to comprehensively assess the impact of surgery as participants enter adulthood.
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Functional disorders and quality of life after esophagectomy and gastric tube reconstruction for cancer.
Poghosyan, T, Gaujoux, S, Chirica, M, Munoz-Bongrand, N, Sarfati, E, Cattan, P
Journal of visceral surgery. 2011;(5):e327-35
Abstract
Functional disorders such as delayed gastric emptying, dumping syndrome or duodeno-gastro-esophageal reflux occur in half of the patients who undergo esophagectomy and gastric tube reconstruction for cancer. The potential role for pyloroplasty in the prevention of functional disorders is still debated. Antireflux fundoplication during esophagectomy can apparently reduce the reflux but at the cost of increasing the complexity of the operation; it is not widely used. The treatment of functional disorders arising after esophagectomy and gastroplasty for cancer is based mainly on dietary measures. Proton pump inhibitors have well documented efficiency and should be given routinely to prevent reflux complications. Erythromycin may prevent delayed gastric emptying, but it should be used with caution in patients with cardiovascular disorders. In the event of anastomotic stricture, endoscopic dilatation is usually efficient. Problems related to gastrointestinal functional disorders after esophageal resection and gastric tube reconstruction do not significantly impair long-term quality of life, which is mainly influenced by tumor recurrence.
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A review of weight loss following Roux-en-Y gastric bypass vs restrictive bariatric surgery: impact on adiponectin and insulin.
Butner, KL, Nickols-Richardson, SM, Clark, SF, Ramp, WK, Herbert, WG
Obesity surgery. 2010;(5):559-68
Abstract
BACKGROUND Bariatric surgery is a common procedure often used to ameliorate comorbidities associated with obesity, including type 2 diabetes. Substantial weight loss leads to alterations in inflammation and insulin sensitivity as well as numerous metabolic and physiologic pathways. Several inflammatory markers have been evaluated, yet adiponectin, an anti-inflammatory adipokine, has not been fully investigated. Adiponectin may play a key role as a mediator between obesity and inflammation, as lower blood levels are more commonly associated with obesity and type 2 diabetes and because adiponectin lessens insulin resistance. This review evaluates outcome variables from patients who underwent Roux-en-Y gastric bypass (RYGB) or restrictive bariatric surgery to compare and contrast any differential surgical impacts on weight loss, adiponectin, and insulin. METHODS A systematic literature review was conducted using a PubMed search. Published studies from 1999 to 2009 that measured blood levels of adiponectin and insulin in bariatric surgery patients prior to and at least 6 months after surgery were included. RESULTS Eighteen studies met inclusion criteria for evaluation. RYGB surgery compared to restrictive surgery led to significantly greater weight loss and improvements in adiponectin and insulin sensitivity. Despite significant weight loss, many patients did not achieve "healthy" body mass index or normalization of inflammatory markers. CONCLUSIONS While RYGB surgery appears to more favorably influence body weight and inflammatory markers, data are insufficient to fully understand the impact of bariatric surgery on changes in adiponectin and insulin and related health implications. Long-term research is needed to more thoroughly evaluate inflammatory outcomes following these two bariatric surgery procedures.
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Successful pregnancy following partial pancreatectomy after complications from a laparoscopic adjustable gastric banding.
Fountain, RA, King, J, Blackwelder, L
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN. 2007;(5):457-63
Abstract
Each year, increasing numbers of bariatric surgeries are being performed to reduce health risks related to obesity. The improvement in health for these patients has promoted an increase in the possibility of pregnancy for some woman. Because there are lifelong adjustments and the possibility of unique complications from bariatric surgery, pregnancy presents special nursing concerns. Very few cases have been identified in nursing literature discussing pregnancy after complications following a bariatric surgery. This article presents a successful pregnancy after a partial pancreatectomy was performed secondary to acute pancreatitis and ischemic enterocolitis as a complication of laparoscopic gastric banding.
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7.
[Effect of gastric banding on pharmacotherapy: not much known].
Wilting, I, van den Bemt, PM, Brenninkmeijer, SJ, Spooren, PF, Siemons, AA, Egberts, AC
Nederlands tijdschrift voor geneeskunde. 2007;(20):1112-5
Abstract
Following placement of gastric banding, the time that medication remains in the proximal part of the stomach may increase variably. This can lead to problems with oral administration of enteric coated or controlled-release preparations. Problems can be avoided by changing over to another form ofa dministration or sometimes by changing to another active compound. The placement of a gastric band changes the size of the stomach opening and the volume of the functional part of the stomach. Other than oral tablets, alternative formulations of medication, such as liquid or rectal forms are not always available, sometimes the only solution for giving some medication is to ground the tablet finely into powder for oral administration. For tablets with enteric coating or controlled release changing to normal tablets is not always perceivable. Patients should receive adequate instructions for intake and information on their therapy so that they do not fail to comply with treatment if tablets have a nasty taste after being ground into powder. The fat and water balance of both obese patients and patients who are losing weight is not usually known. Patients who have gastric banding should have medication dosages especially for medication with a narrow therapeutic index followed under strict supervision and have regular blood tests so that any necessary dosage adjustments can be made. At present little data are available to provide a comprehensive overview of the effects of gastric banding on pharmacotherapy. The potential consequences ofgastric banding on pharmacotherapy, together with the increasing frequency of gastric banding surgery, emphasize the need for further research in this field.
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Therapy insight: weight-loss surgery and major cardiovascular risk factors.
Blackburn, GL, Mun, EC
Nature clinical practice. Cardiovascular medicine. 2005;(11):585-91
Abstract
Weight-loss surgery is an effective treatment for severe, medically complicated and refractory obesity. It reverses, eliminates or significantly ameliorates major cardiovascular risk factors related to obesity. In a large proportion of patients, the therapy produces significant weight loss, reduces the risk of disability and premature death, and improves quality of life. Surgical treatment by gastric-restrictive and malabsorptive procedures started several decades ago in the US. Since the 1970s, accrued clinical experience and advances in technology, particularly in minimally invasive surgical approaches, have changed this therapy. Some procedures have evolved, whereas others have become obsolete. Today's weight-loss operations are safe, effective and potentially life-saving options for severely obese cardiology patients. This review describes weight-loss surgery procedures and their effects on cardiovascular risk factors.
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Impact of bariatric surgery on cardiac structure, function and clinical manifestations in morbid obesity.
Poirier, P, Martin, J, Marceau, P, Biron, S, Marceau, S
Expert review of cardiovascular therapy. 2004;(2):193-201
Abstract
Obesity results from the excessive accumulation of fat. Risk of premature death is doubled compared to nonobese individuals, and risk of death from cardiovascular disease is increased fivefold. In patients with morbid obesity, a variety of adaptations and alterations in cardiac structure and function occur in the individual, as an excess amount of adipose tissue accumulates. The high long-term failure rate of diet intervention is well acknowledged by the clinician. Surgery for severe obesity has evolved during the last 40 years. Many surgical techniques have been described and abandoned. Nevertheless, numerous different techniques are still in use today. Weight loss has beneficial impacts on functional and structural cardiac status and will be reviewed in this report.
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10.
[Endoscopic treatment of gastroesophageal reflux disease--new possibilities].
Piotrowska-Staworko, G, Baniukiewicz, A, Ćaszewicz, W
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2004;(93):275-8
Abstract
Gastro-esophageal reflux disease (GERD) is one of the most important problems of gastroenterology at present. The symptoms of GERD have negative influence of patients' life on a daily basis. The principal aim of reflux disease treatment is to eliminate or alleviate the symptoms, to heal tissue damages and to reduce the frequency and duration of recurrences. Lifestyle and dietary modification are of only limited value in GERD treatment. Proton pump inhibitors (PPI) are the mainstay of GERD pharmacotherapy for both initial episode and long-term management. Surgical treatment is indicated in: complicated GERD, in patients who need high effective dose of medication, young patients who need lifelong PPI, patients with big hiatus hernia. Laparoscopic Nissen fundoplication has become the operation of choice. Nevertheless patients who have undergone fundoplication may experience adverse post operative complication. The useful alternatives in the management of GERD may indeed eventually prove the new endoscopic methods of minimally invasive treatment which are currently under thorough evaluation. The most promising methods of endoscopic treatment of GERD have been discussed: radiofrequency ablation (the Streett's procedure), endoscopic gastroplasty, endoscopic implantation of biopolymer hydrogel prosthesis.