Reporting Weight Loss 2007

Obesity Surgery (Impact Factor: 3.75). 06/2007; 17(5):565-8. DOI: 10.1007/s11695-007-9116-0
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    • "The ideal body weight of each patient was estimated based on the formula that corresponds to the midpoint of the medium frame of the Metropolitan tables. The degree of weight loss was assessed with %EWL and percent of excess BMI loss (%EBL), which were calculated using the following formulas [2]: "
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    ABSTRACT: Purpose Bariatric surgery has become more prevalent owing to the worldwide obesity epidemic. With the growing number of bariatric procedures performed annually, the requirement for revisional and secondary operations is increasing accordingly. This study aimed to evaluate the initial experience of revisional bariatric surgery at a single specialized center. Methods A retrospective review of the prospectively established database identified all patients who underwent revisional bariatric surgery between January 2008 and August 2013. The causes, surgical outcomes, and efficacy of the revisional surgeries were analyzed. Results Twenty-two revisional surgeries were performed laparoscopically during the study period (13 laparoscopic adjustable gastric banding, 9 laparoscopic sleeve gastrectomy). The most common indication for revision was weight regain or insufficient weight loss (12/23, 52.2%), and Roux-en-Y gastric bypass (RYGB) was the most commonly performed secondary procedure (17/23, 73.9%, including four resectional RYGB procedures). Gastric pouch leak occurred in one patient following revisional RYGB, which required reoperation on the first postoperative day. The mean body mass index decreased from 35.9 to 28.8 kg/m2 at a mean follow-up period of 10 months after revision. The percent excess weight losses at 1, 3, 6, and 12 months postoperatively were 18.8%, 41.1%, 40.1%, and 47.4%, respectively. Conclusion Revisional bariatric surgery can be successfully performed via a laparoscopic approach with acceptable risk. Deliberate selection for the proper revisional procedure can efficiently manage undesirable results from the primary surgery.
    Annals of Surgical Treatment and Research 06/2014; 86(6):295-301. DOI:10.4174/astr.2014.86.6.295
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    • "Furthermore, we extracted baseline BMI, baseline prevalence of DM, (mean) follow-up time, %EWL 1–2 years after surgery, and the prevalence of DM 1–2 years after surgery. %EWL was defined as described by Deitel et al. (14). The criteria used to classify DM were not the same in all included studies. "
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    ABSTRACT: It has been postulated that the effectiveness of bariatric surgery varies between ethnic groups. However, data regarding this topic are inconclusive, as most studies included few patients from minority groups. We conducted a meta-analysis to determine the difference in percentage of excess weight loss (%EWL) 1-2 years after bariatric surgery in people of African and Caucasian descent. We also studied differences in diabetes mellitus (DM) remission. We performed a MEDLINE and EMBASE search for studies reporting %EWL and/or DM remission after bariatric surgery and including both African Americans and Caucasians. The 613 publications obtained were reviewed. We included 14 studies (1,087 African Americans and 2,714 Caucasians); all provided data on %EWL and 3 on DM remission. We extracted surgery type, %EWL, and DM remission 1-2 years after surgery. After analyzing %EWL for any surgery type, we performed subanalyses for malabsorptive and restrictive surgery. The overall absolute mean %EWL difference between African Americans and Caucasians was -8.36% (95% CI -10.79 to -5.93) significantly in favor of Caucasians. Results were similar for malabsorptive (-8.39% [-11.38 to -5.40]) and restrictive (-8.46% [-12.95 to -3.97]) surgery. The remission of DM was somewhat more frequent in African American patients than in Caucasian patients (1.41 [0.56-3.52]). However, this was not statistically significant. In %EWL terms, bariatric surgery is more effective in Caucasians than in African Americans, regardless of procedure type. Further studies are needed to investigate the exact mechanisms behind these disparities and to determine whether ethnic differences exist in the remission of comorbidities after bariatric surgery.
    Diabetes care 09/2012; 35(9):1951-8. DOI:10.2337/dc12-0260 · 8.42 Impact Factor
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    • "However, 1 report expressed weight in terms of BMI at the moment of the initial procedure and revision, but after revision, weight loss was expressed in percentage of excess weight loss (%EWL). The amount of excess weight in %EWL is calculated as an individual value based on the Metropolitan Life Insurance Company tables [25] "
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    ABSTRACT: Background: After Roux-en-Y gastric bypass (RYGB), a substantial number of patients do not achieve successful long-term weight loss. In cases of loss of restriction, the application of an adjustable gastric band ("salvage banding") over the gastric pouch, or gastrojejunostomy, could prevent weight regain or increase weight loss. The objective of this literature review is to provide an overview of the studies that report the effect of salvage banding after failed RYGB. Methods: A systemic literature search was conducted in PubMed, Google Scholar, Medline, the Cochrane Library, and the online websites of specific bariatric surgery journals to identify all relevant studies describing salvage banding after failed RYGB. Results: Seven studies, with a total of 94 patients, were included for a systemic literature review. Inclusion criteria for salvage banding varied from unsuccessful weight loss to technical pouch failure. After salvage banding, all studies reported further weight loss, varying from 55.9%-94.2% excess body mass index loss (EBMIL) after 12-42 months of follow-up. In the included study group, 18% (17/94) of the patients developed long-term complications requiring a re-revision in 17% (16/94) of the cases. Conclusion: The results of all 9 studies that were included in this review report a further increase in weight loss after salvage banding for failed RYGB. In case of insufficient weight loss or technical pouch failure after RYGB, all reports suggest that salvage banding is a safe and feasible revisional procedure. Prospective studies are necessary to determine to the success of direct application of an adjustable gastric band in primary RYGB.
    Surgery for Obesity and Related Diseases 08/2012; 8(6). DOI:10.1016/j.soard.2012.07.019 · 4.07 Impact Factor
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