Obesity Surgery最新文献

Obesity is a chronic disease that may require multiple interventions and escalation of therapy throughout the years. Until recently, no universal definition existed for recurrent weight gain and insufficient weight loss. Standardization of reporting is key so outcomes can be compared and data can be pooled. The recent IFSO consensus provided standard terminology and definitions that will likely resolve this in the future, and publishers will need to enforce for authors to use these definitions. This current IFSO position statement provides guidance for the management of recurrent weight gain after bariatric surgery.

Background: We aimed to compare the omentopexy and clipping reinforcement methods performed along the staple line during laparoscopic sleeve gastrectomy (LSG) in terms of the effectiveness on postoperative bleeding.

Methods: In this prospective randomized controlled study, patients were divided into two groups: clips group (CG) and omentopexy group (OG). The groups were compared in terms of postoperative bleeding, duration of surgery, length of hospital stay, hospital readmissions in the postoperative first 30-days.

Results: A total of 148 patients were included in the study. Postoperative bleeding was observed in 11 patients (14.9%) of CG and 2 patients (2.7%) of the OG, and the difference between the groups was found to be significant (p = 0.009). Similarly, the number of patients with bleeding that did not require intervention was 9 (12.2%) in CG and 2 (2.7%) in OG, and the difference between the groups was also significant (p = 0.028). The duration of surgery in the CG was 30 (27 to 36) minutes, whereas in the OG, it was 43 (39 to 45) minutes, with a significant difference noted (p < 0.001). Additionally, the rate of patients readmitted to the hospital within the first 30 days was 16 (21.6%) in the CG and 7 (9.5%) in the OG, with a significant difference observed (p = 0.041).

Conclusion: In terms of bleeding requiring intervention, there was no difference between omentopexy and clipping techniques. In addition, omentopexy showed more satisfactory results than clipping in terms of non-interventional bleeding, but its clinical significance is unclear.

Background: Roux-en-Y gastric bypass is one of the common bariatric surgery procedures performed worldwide. Necrosis of the biliopancreatic or Roux limbs in the late period after RYGB is a rarely observed condition, the most common causes of which are postoperative adhesion, inflammatory entities, volvulus, intussusception, and internal herniations. The goal of surgical treatment is the removal of the necrotic segment and the reconstruction of biliopancreatic or gastric drainage.

Case presentation: Here, we present a rare case in which a patient developed complete necrosis of the third and fourth segments of the duodenum and proximal jejunal limb in the postoperative seventh month after undergoing Roux-en-Y gastric bypass surgery.

Discussion: Necrosis occurring after RYGB surgery often affects the Roux limb, though necrosis of the biliopancreatic limb is extremely rare. The goal of surgery is to remove the necrotic segment and reconstruct the drainage. An area of ischemia is often observed in the jejunum, while a large ischemic area was noted in the present case that encompassed the third and fourth parts of the duodenum.

Conclusion: Although in general necrosis of the Roux limb occurs due to volvulus, intussusception, or internal herniation following RYGB surgery, it must be taken into account that necrosis of the jejunal, duodenal, or complete biliopancreatic segment may occur in cases in which the underlying etiology cannot be exactly revealed.

Background: Swallowable gastric balloons are available in the UK to treat severe obesity. Our hospital introduced this treatment in 2023, the first to do so in the National Health Service (NHS). The event was featured by the British Broadcasting Corporation (BBC) on regional television, in multiple radio interviews, and online by numerous news outlets in February 2024. Obesity and the treatment of obesity are often subject to stigma, prejudice and bias. The event gave an opportunity to observe public opinion in response to a new publicly available obesity treatment.

Methods: Qualitative review of public comments in articles responding to the BBC story about the introduction of swallowable gastric balloon therapy in the NHS. Comments were categorized as positive, neutral, or negative.

Results: Out of 2364 comments reviewed from all sources, 16.6% were positive, 48.9% were neutral and 34.8% were negative. Obesity stigma was highly prevalent in the responses and included many derogatory and abusive comments, including towards the patients featured in the BBC articles.

Conclusions: Obesity stigma is highly prevalent in those responding by social media and on news websites to a new treatment within the NHS. Negative stereotypes may be a barrier to obesity treatment within the NHS and need to be addressed.