Surgery for Obesity and Related Diseases (SURG OBES RELAT DIS )

Publisher: American Society for Bariatric Surgery, Elsevier


Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Bariatric Surgery and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities. The Editorial Board includes internationally prominent individuals who are devoted to the optimal treatment of the severely obese and include internists, psychiatrists, surgeons, and nutritional experts. Manuscripts are blindly reviewed without the reviewers knowledge of the authors, institution or country of origin.

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    Surgery for Obesity and Related Diseases website
  • Other titles
    Surgery for obesity and related diseases (Online)
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    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

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    • Voluntary deposit by author of pre-print allowed on Institutions open scholarly website and pre-print servers
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    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PMC after 12 months
    • Authors who are required to deposit in subject repositories may also use Sponsorship Option
    • Pre-print can not be deposited for The Lancet
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    ​ green

Publications in this journal

  • Surgery for Obesity and Related Diseases 02/2014;
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    ABSTRACT: Reoperative bariatric surgery has become a common practice in many bariatric surgery programs. There is currently little evidence-based guidance regarding specific indications and outcomes for reoperative bariatric surgery. A task force was convened to review the current evidence regarding reoperative bariatric surgery. The aim of the review was to identify procedure-specific indications and outcomes for reoperative procedures. Literature search was conducted to identify studies reporting indications for and outcomes after reoperative bariatric surgery. Specifically, operations to treat complications, failed weight loss, and weight regain were evaluated. Abstract and manuscript reviews were completed by the task force members to identify, grade, and categorize relevant studies. A total of 819 articles were identified in the initial search. After review for inclusion criteria and data quality, 175 articles were included in the systematic review and analysis. The majority of published studies are single center retrospective reviews. The evidence supporting reoperative surgery for acute and chronic complications is described. The evidence regarding reoperative surgery for failed weight loss and weight regain generally demonstrates improved weight loss and co-morbidity reduction after reintervention. Procedure-specific outcomes are described. Complication rates are generally reported to be higher after reoperative surgery compared to primary surgery. The indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, co-morbid disease, and complications.
    Surgery for Obesity and Related Diseases 02/2014;
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    ABSTRACT: The study compared laparoscopic sleeve gastrectomy (LSG) staple-line leak rates of 4 prevalent surgical options: no reinforcement, oversewing, nonabsorbable bovine pericardial strips (BPS), and absorbable polymer membrane (APM). LSG is a multipurpose bariatric/metabolic procedure with effectiveness proven through the intermediate term. Staple-line leak is a severe complication of LSG for which no definitive method of prevention has been identified. The systematic review study design was employed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement screening guidelines. Inclusion criteria centered on variables potentially relevant to LSG leak: leak rate, age, gender, calibrating bougie size, distance between pylorus and gastric transection line, overall complication rate, and mortality. Analysis of variance models were used to explore differences in select demographic and surgical technique variables characterizing each reinforcement group. An omnibus χ(2) test followed by independent Fisher's exact tests were used to compare leak rates. There were 659 articles identified; 41 duplicates removed. Of 618 remaining articles, 324 did not meet inclusion criteria. Of the 294 remaining articles, 206 were eliminated (kin studies, those not reporting staple-line or leak incidence, those reporting discontinued products). There were 88 papers included in the analysis. Statistically significant differences were found between groups across demographic and surgical variables studied (p<0.001). There were 191 leaks in 8,920 patients; overall leak rate 2.1%. Leak rates ranged from 1.09% (APM) to 3.3% (BPS); APM leak rate was significantly lower than other groups (p< 0.05). Systematic review of 88 included studies representing 8,920 patients found that the leak rate in LSG was significantly lower using APM staple-line reinforcement than oversewing, BPS reinforcement, or no reinforcement.
    Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
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    ABSTRACT: Background Laparoscopic adjustable gastric band (LAGB) insertion is a commonly performed bariatric procedure with low associated short-term risk. Given that a significant number of patients will require additional revision/removal procedures, overall morbidity may be underestimated. Objective To define the 30-day morbidity associated with LAGB removal and revision procedures. Setting ACS-NSQIP hospitals performing LAGB procedures 2006-2011. Methods Patients undergoing revision or removal of LAGB were identified within the ACS-NSQIP participant use file using CPT and ICD-9 coding. Patients having concurrent procedures were excluded. Primary outcomes included 30-day morbidity. The rate of complications in the removal/revision patients versus primary LAGB insertion was compared. We also analyzed trends over time. Results 3,236 patients underwent LAGB removal (n = 1,580), revision (n=1,111) or port site revision (n=545) from 2006-2011. The overall 30-day complication rate was 5.6% (95% CI: 4.8%, 6.4%) and was higher in patients undergoing LAGB removal with a 6.8% (95% CI: 5.6%, 8.1%) adverse event rate (2.5% infectious, 2.3% wound, 2.4% reoperation). 24,438 patients underwent primary LAGB insertion within the dataset with a 30-day complication rate of 2.6% (95% CI: 2.4%, 2.8%). Patients undergoing LABG removal had a significantly higher complication rate than those having primary LAGB insertion with an OR 2.72 (95% CI: 2.18, 3.37). The proportion of LAGB revision/removal compared to primary placement increased annually over the study period (P for trend <0.001). Conclusions The 30-day morbidity associated with LAGB revision is significant and higher than that associated with primary LAGB insertions. The potential need for future procedures and the associated additional morbidity should be considered when evaluating LAGB as a treatment option for morbid obesity.
    Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
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    ABSTRACT: Bariatric surgery has been associated with increased metabolic kidney stone risk and post-operative stone formation. A MEDLINE search, performed for articles published between January 2005 and November 2013, identified 24 pertinent studies containing 683 bariatric patients with 24-hour urine profiles, 6,777 bariatric patients with kidney stone incidence, and 7,089 non-stone forming controls. Of all procedures reviewed, only Roux-en-Y gastric bypass (RYGB) was linked to post-operative kidney stone development, increasing stone incidence two-fold in non-stone formers (8.5%) and four-fold in patients with previous stone history (16.7%). High quality evidence from 7 studies (n=277 patients) before and after RYGB identified the following post-RYGB urinary lithogenic risk factors: 30% reduction in urine volume (the main driver of urinary crystal saturation), 40% reduction in urinary citrate (a potent stone inhibitor), and 50% increase in urinary oxalate (a stone promotor). Based on this, a summary of strategies to reduce calcium oxalate stone risk following RYGB is provided. Furthermore, recent experimental RYGB studies are assessed for insights into the pathophysiology of oxalate handling, and the literature in gut anion (oxalate) transport is reviewed. Finally, as a potential probiotic therapy for hyperoxaluria, primary data from our laboratory is presented, demonstrating a 70% reduction in urinary oxalate levels in four experimental RYGB animals after colonization with Oxalobacter formigines, a non-pathogenic gut commensal that uses oxalate as an energy source. Overall, urine profiles and kidney stone risk following bariatric surgery appear modifiable by dietary adjustments, appropriate supplementation, and lifestyle changes. For hyperoxaluria resistant to dietary oxalate restriction and calcium binding, well-designed human investigations are needed to identify additional means of lowering urinary oxalate, such as Oxalobacter colonization or empiric pyridoxine therapy. Further investigations are also needed to determine tolerability and compliance of stone prevention strategies, such as citrate supplementation and hydration, in this population.
    Surgery for Obesity and Related Diseases 01/2014;
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    ABSTRACT: Background Several studies have shown improved outcomes associated with accredited bariatric centers. Objective The aim of our study was to examine the outcomes of bariatric surgery performed at accredited vs. non-accredited centers using a nationally representative database. Additionally, we aimed to determine if the presence of bariatric surgery accreditation can lead to improved outcomes for morbidly obese patients undergoing other general laparoscopic operations. Methods Using the Nationwide Inpatient Sample database, for data between 2008-2010, clinical data of morbidly obese patients who underwent bariatric surgery, laparoscopic antireflux surgery, cholecystectomy, and colectomy were analyzed according to the hospital’s bariatric accreditation status. Results A total of 277,068 bariatric operations were performed during the 3-year period, with 88.4% of cases performed at accredited centers. In-hospital mortality was significantly lower at accredited compared to non-accredited centers (0.08% vs. 0.19%, respectively). Multivariate analysis showed that non-accredited centers had higher risk-adjusted mortality for bariatric procedures compared to accredited centers (OR 3.1, p<0.01). Post-hoc analysis showed improved mortality for patients who underwent gastric bypass and sleeve gastrectomy at accredited centers compared to non-accredited centers (0.09% vs. 0.27%, respectively, p<0.01). Patients with a high severity of illness who underwent bariatric surgery also had lower mortality rates when the surgery was performed at accredited vs. non-accredited centers (0.17% vs. 0.45%, respectively, p<0.01). Multivariate analysis showed that morbidly obese patients who underwent laparoscopic cholecystectomy (OR 2.4, p<0.05) and antireflux surgery (OR 2.03, p<0.01) at non-accredited centers had higher rates of serious complications. Conclusion Accreditation in bariatric surgery was associated with more than a three-fold reduction in risk-adjusted in-hospital mortality. Resources established for bariatric surgery accreditation may have the secondary benefit of improving outcomes for morbidly obese patients undergoing general laparoscopic operations.
    Surgery for Obesity and Related Diseases 01/2014;
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    ABSTRACT: Background Recent research suggests that pre-intervention fMRI data may predict weight loss outcomes among patients who participate in a behavioral weight loss plan. No study has examined whether pre-surgical brain activation can predict outcomes following bariatric surgery. Objective The aim of the present study was to determine if brain activations during a pre-surgical fMRI food motivation paradigm are associated with weight loss 3 and 6 months following laparoscopic adjustable gastric banding (LAGB). Setting Medical university brain imaging center, two surgical weight loss centers in a major metropolitan area. Method 19 participants viewed food and non-food pictures from a well-established food motivation paradigm during an fMRI scanning session prior to LAGB surgery. Weight was assessed pre-surgery and three and six-months post-surgery; data for all participants was available at each time point. fMRI data were analyzed using BrainVoyager QX statistical package. Whole brain voxelwise correlations of presurgery (Food-NonFood) brain activation and weight, corrected for multiple comparisons, were performed to analyze the relationship between pre-surgical brain activation and subsequent weight loss. Results Increased activity in frontal regions associated with cognitive control (medial, middle, superior frontal gyrus) and posterior cingulate cortex (PCC) was associated with weight loss following LAGB. Conclusion We found that neural activity in previously established regions associated with cognitive and behavioral self-regulation predicts weight loss following bariatric surgery. These preliminary findings highlight the role of neural circuitry in the success and maintenance of weight loss and suggest a possible future use of fMRI in screening LAGB surgery candidates.
    Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
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    ABSTRACT: Background The effect of laparoscopic sleeve gastrectomy (LSG) in gastroesophageal reflux disease (GERD) is controversial. However, it has been reported that up to 22% of patients presented with symptomatic GERD after LSG. Objectives The aim of our study was to evaluate the necessity of preoperative manometric testing in LSG patients. Material and Methods We prospectively collected the data on LSG candidate patients who underwent preoperative manometric testing. The normal range for the lower esophageal sphincter (LES) pressure is 10.0-45.0mmHg. Each patient was interviewed for the GERD score questionnaire (scaled severity and frequency of heartburn, regurgitation, epigastric pain, epigastric fullness, dysphagia and cough) at the time of the manometric study. Results 49 patients were studied. The mean preoperative LES pressure was 13.2±7.7 mmHg (range, 1.0-34.4). Eleven patients responded that they had one or more moderate to severe GERD symptoms more than 2-4 times a week, of which 9 had competent LES pressures. Thirteen (26.5%) patients had decreased LES pressures, and only 3 (23.1%) of these reported moderate to severe symptoms of GERD. In 26 LSG patients with postoperative results, the mean preoperative LES pressure was 14.8±8.0 mmHg (range, 3.5-34.4), and the mean GERD score did not show a significant difference at 9 months after LSG. Twenty-two had normal LES pressures, and 16 (72.8%) of these patients reported reflux symptoms preoperatively. Only two (12.5%) of these symptomatic patients reported a higher GERD score postoperatively,but the difference was not significant. Of the 4 patients who had low LES pressures, only 1 patient complained of mild GERD symptoms preoperatively. However, this patient and another without preoperative symptoms developed severe GERD symptoms postoperatively. Conclusions Manometric study may be necessary in LSG patients to accurately evaluate GERD and the LES pressure.
    Surgery for Obesity and Related Diseases 01/2014;
  • Surgery for Obesity and Related Diseases 01/2014;
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    ABSTRACT: Numerous epidemiologic studies link psoriasis and obesity. Recent studies have shown remission or improvement in psoriasis after weight loss surgery. This editorial reviews the literature and aims to address important findings as well as directions for future studies.
    Surgery for Obesity and Related Diseases 01/2014;

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