Analysis of Obesity-Related Outcomes and Bariatric Failure Rates With the Duodenal Switch vs Gastric Bypass for Morbid Obesity
ABSTRACT OBJECTIVE To compare the outcomes of a large cohort undergoing biliopancreatic diversion/duodenal switch (DS) vs gastric bypass (GB). DESIGN Retrospective review of the Bariatric Outcomes Longitudinal Database from 2007 to 2010. All inpatient and outpatient follow-up data were analyzed. SETTING Multicenter database. PATIENTS Patients undergoing primary DS were compared with a concurrent cohort undergoing GB. MAIN OUTCOME MEASURES The main outcome measures were (1) weight loss; (2) control of comorbidities including diabetes mellitus, hypertension, and sleep apnea; and (3) failure to achieve at least 50% excess body weight loss. RESULTS One thousand five hundred forty-five patients underwent DS and 77 406 underwent GB, with a mean preoperative body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 52 and 48, respectively (P < .01). The DS was associated with longer operative times, greater blood loss, and longer lengths of hospital stay (all P < .05). Early reoperation rates were higher in the DS group (3.3% vs 1.5%). Percentage of change in BMI was significantly greater in the DS group at all follow-up intervals (P < .05). Subgroup analysis of the superobese population (BMI >50) revealed significantly greater percentage of excess body weight loss in the DS group at 2 years (79% vs 67%; P < .01). Comorbidity control of diabetes, hypertension, and sleep apnea were all superior with the DS (all P < .05). The risk of weight loss failure was significantly reduced with DS vs GB for all patients, with a greater reduction in the BMI more than 50 subgroup. CONCLUSIONS The DS is a less commonly used bariatric operation, with higher early risks compared with GB. However, the DS achieved better weight and comorbidity control, with even more pronounced benefits among the superobese.
Article: Bariatric Surgery.International anesthesiology clinics 01/2013; 51(3):179-197. DOI:10.1097/AIA.0b013e31829813f8
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ABSTRACT: Background Bariatric surgery may prove an effective weight loss option for those struggling with severe obesity, but it is difficult to determine levels of interest in such procedures at the population level through traditional approaches. Analysis of Google Trend information may give providers and healthcare systems useful information regarding Internet users’ interest in bariatric procedures. Objective Our objective was to gather Google Trend information on worldwide Internet searches for “bariatric surgery”, “gastric bypass”, “gastric sleeve”, “gastric plication”, and “lap band” from 2004-2012 and to explore temporal relationships with relevant media events, economic variations, and policy modifications. Trend analyses were performed using Minitab V.16.0. Setting Data was collected using Google Trends. Results Trend analyses revealed that total search volume for the term “bariatric surgery” has declined roughly 25% since January 2004, although interest increased approximately 5% from 2011 to 2012. Interest in lap band procedures declined 30% over the past five years, while “gastric sleeve” has increased 15%. Spikes in search numbers show an association with events such as changing policy and insurance guidelines and media coverage for bariatric procedures. Conclusions This report illustrates that variations in Internet search volume for terms related to bariatric surgery are multifactorial in origin. Although it is impossible to ascertain if reported Internet search volume is based on interest in potentially undergoing bariatric surgery or simply general interest, this analysis reveals that search volume appears to mirror real world events. Therefore, Google Trends could be a way to supplement understanding about interest in bariatric procedures.Surgery for Obesity and Related Diseases 01/2013; 10(3). DOI:10.1016/j.soard.2013.10.007 · 4.94 Impact Factor
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ABSTRACT: Surgical treatment of obesity has become increasingly popular in recent years. The endoscopic intragastric balloon (IB) placement is often selected as a less invasive procedure compared to operative procedures. Balloon placement may give rise to concerns about gas expansion caused by altitude changes both in the upper part of gastrointestinal tract and in IB itself. The subject presented in this case report underwent placement of a liquid-filled IB and was subjected to hypobaric expositions. Both 7 500 m and 10 000 m hypobaric chamber expositions were successful in terms of management of gas expansion, which led to a conclusion that liquid-filled IB is safe for air passengers and active flying personnel both in normal and emergency situations.06/2013; DOI:10.13174/pjamp.19.02.2013.5