Bariatric Surgery and the Long-Term Risk of Venous Thromboembolism: A Population-Based Cohort Study.

Purpose: Bariatric surgery is associated with a greater venous thromboembolism (VTE) risk in the weeks following surgery, but the long-term risk of VTE is incompletely characterized. We evaluated bariatric surgery in relation to long-term VTE risk.

Materials And Methods: This population-based retrospective matched cohort study within three United States-based integrated health care systems included adults with body mass index (BMI) ≥ 35 kg/m who underwent bariatric surgery between January 2005 and September 2015 (n = 30,171), matched to nonsurgical patients on site, age, sex, BMI, diabetes, insulin use, race/ethnicity, comorbidity score, and health care utilization (n = 218,961).

Long term outcomes of metabolic/bariatric surgery in adults.

The prevalence of obesity continues to rise around the world, driving up the need for effective and durable treatments. The field of metabolic/bariatric surgery has grown rapidly in the past 25 years, with observational studies and randomized controlled trials investigating a broad range of long term outcomes. Metabolic/bariatric surgery results in durable and significant weight loss and improvements in comorbid conditions, including type 2 diabetes.

Bariatric Enhanced Recovery Protocol: a Community Quality Perspective.

Introduction: Bariatric enhanced recovery protocols can decrease length of stay (LOS) and hospital costs without compromising patient safety. Increased data is needed to compare patient outcomes before and after application of enhanced recovery pathways. We present a bariatric enhanced recovery protocol (BERP) at a community hospital.

Assessment of empiric body mass index-based thromboprophylactic dosing of enoxaparin after bariatric surgery: evidence for dosage adjustment using anti-factor Xa in high-risk patients.

Background: Despite thromboprophylaxis, postoperative deep vein thrombosis and pulmonary embolism occur after bariatric surgery, perhaps because of failure to achieve optimal prophylactic levels in the obese population.

Objectives: The aim of this study was to evaluate the adequacy of prophylactic dosing of enoxaparin in patients with severe obesity by performing an antifactor Xa (AFXa) assay.

Setting: An academic medical center METHODS: In this observational study, all bariatric surgery cases at an academic center between December 2016 and April 2017 who empirically received prophylactic enoxaparin (adjusted by body mass index [BMI] threshold of 50 kg/m) were studied.

A Structured Approach for Safely Reintroducing Bariatric Surgery in a COVID-19 Environment.

Due to the profound effect of novel coronavirus disease 2019 (COVID-19) on healthcare systems, surgical programs across the country have paused surgical operations and have been utilizing virtual visits to help maintain public safety. For those who treat obesity, the importance of bariatric surgery has never been more clear. Emerging studies continue to identify obesity and several other obesity-related comorbid conditions as major risk factors for a more severe COVID-19 disease course.

Bariatric surgery is associated with a lower rate of death after myocardial infarction and stroke: A nationwide study.

Aim: To assess the potential protective effect of bariatric surgery on mortality after myocardial infarction (MI) or cerebrovascular accident (CVA).

Materials And Methods: Using the National Inpatient Sample (2007-2014), 2218 patients with a principal discharge diagnosis of acute MI and 2168 patients with ischaemic CVA who also had history of prior bariatric surgery were identified. Utilizing propensity scores, these patients were matched 1:5 with patients who had similar principal diagnoses but no history of bariatric surgery (controls).

Midterm outcomes of sleeve gastrectomy in the elderly.

Background: The increase in life expectancy presents health systems with a growing challenge in the form of elderly obesity. Bariatric surgery has been shown to be a safe and effective treatment for obesity with reduction of excess weight and improvement in obesity-related co-morbidities. However, only recently have surgeons begun performing these operations on elderly patients on a larger scale, making data regarding mid- and long-term outcomes scarce.

Single-port Laparoscopic Appendectomy: Beyond the Learning Curve: A Retrospective Comparison With Multi-port Laparoscopic Appendectomy.

Objectives: Previous comparisons between single-port laparoscopic appendectomy (SPLA) and multi-port laparoscopic appendectomy have been conflicting and limited. We compare our single-surgeon, SPLA experience with multi-port cases performed during the same time.

Methods: A retrospective chart review of 128 single-surgeon single-port and 941 multi-port laparoscopic appendectomy cases from April 2009 to December 2014 was conducted.

Which postoperative complications matter most after bariatric surgery? Prioritizing quality improvement efforts to improve national outcomes.

Background: National quality programs have been implemented to decrease the burden of adverse events on key outcomes in bariatric surgery. However, it is not well understood which complications have the most impact on patient health.

Objective: To quantify the impact of specific bariatric surgery complications on key clinical outcomes.

Factors associated with length of stay in intensive care after bariatric surgery.

Background: Although uncommon, admission to the intensive care unit (ICU) after bariatric surgery may be necessary. This study evaluates characteristics of bariatric surgery patients that are admitted to the ICU, and identifies possible risk factors for increased ICU length of stay (LOS).

Setting: Academic hospital, United States.

The effect of pregnancy before and/or after bariatric surgery on weight loss.

Background: Women of childbearing age represent 31%-36% of patients undergoing bariatric surgery. However, the influence of pregnancy before or after bariatric surgery on surgery outcomes is unclear.

Objectives: The aim of the present study was to compare the effect of pregnancy before and after bariatric surgery on overall weight loss.

Laparoscopic Three-Port Sleeve Gastrectomy: A Single Institution Case Series.

Background: Further minimization of abdominal wall trauma during laparoscopic bariatric surgery is a topic of great interest. Reducing the number of trocars may provide superior cosmetic results with less pain and shorter length of stay (LOS). However, it remains unclear if this approach compromises safety or effectiveness of weight loss.

Total Weight Loss as the Outcome Measure of Choice After Roux-en-Y Gastric Bypass.

Background: Currently, there is no agreement on the best method to describe weight loss (WL) after bariatric surgery. The aim of this study is to evaluate short-term outcomes using percent of total body weight loss (%TWL).

Methods: A single-institution retrospective study of 2420 patients undergoing Roux-en-Y gastric bypass (RYGB) was performed.

Weight loss is higher among patients who undergo body contouring procedures after bariatric surgery.

Background: As the number of patients who have undergone bariatric surgery increases, it is expected that more patients will present for body contouring procedures after weight loss. It has been reported that abdominoplasty can improve mobility, reduce skin fold complications, and improve psychosocial functioning. No previous studies have evaluated weight loss in patients who pursue plastic surgery after bariatric surgery.

Revisional bariatric surgery can improve refractory metabolic disease.

Background: It remains unclear if patients undergoing revisional surgery for inadequate weight loss/recidivism can achieve improvement of refractory metabolic syndrome (MetS).

Objective: We aimed to evaluate metabolic outcomes after reoperative bariatric surgery for unsatisfactory weight loss in patients with refractory MetS.

Setting: Academic Hospital.

Percutaneous Endoscopic Gastrostomy for Decompression of Nonmalignant Gastrointestinal Disease.

Introduction: The utility of percutaneous endoscopic gastrostomy (PEG) decompression for inoperable malignant bowel obstruction is well documented. However, there are limited data on decompressive PEG for prolonged ileus, gut dysmotility, and/or complicated nonmalignant bowel obstruction. The aim of this study was to assess the safety and short-term outcomes of decompressive PEG for nonmalignant indications.

MANAGEMENT OF ENDOCRINE DISEASE: Metabolic effects of bariatric surgery.

Obesity is associated with an increased risk of type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, osteoarthritis, numerous cancers and increased mortality. It is estimated that at least 2.8 million adults die each year due to obesity-related cardiovascular disease.

The incidence of hiatal hernia and technical feasibility of repair during bariatric surgery.

Purpose: To evaluate the incidence and outcomes of hiatal hernias (HH) that are repaired concomitantly during bariatric surgery.

Methods: We identified patients who had concomitant HH repair during bariatric surgery from 2010 to 2014. Data collected included baseline demographics, perioperative parameters, type of HH repair, and postoperative outcomes.

Bariatric surgery in the cognitively impaired.

Background: Obesity is prevalent in patients with cognitive impairment, but the risks and benefits in this complex group are unknown.

Objectives: The aim of this study was to assess outcomes in a small cohort of patients with lifelong cognitive impairment who underwent bariatric surgery and to introduce important concepts when considering surgery in this complex group.

Setting: Academic institution, United States.

Bariatric surgery outcomes in patients with systemic lupus erythematosus.

Background: Obesity is common among systemic lupus erythematosus (SLE) patients. An increased perioperative risk after major surgery in SLE has been reported. The aim of this study was to describe postoperative outcomes among SLE patients undergoing bariatric surgery.

Critical appraisal of salvage banding for weight loss failure after gastric bypass.

Background: Placement of an adjustable gastric band (AGB) over the gastric pouch after RYGB failure has had varied results. The aim of this study was to evaluate safety and outcomes of AGB after RYGB failure.

Methods: Twenty-eight patients who underwent laparoscopic placement of an AGB around the gastric pouch as a revisional procedure for inadequate weight loss or recidivism after RYGB between 2008-2011 were identified.