Reining in Sternal Wound Infections: The Achilles' Heel of Bilateral Internal Thoracic Artery Grafting.

Although the survival advantage of bilateral internal thoracic artery grafting (BITA) is well known in patients undergoing coronary artery bypass grafting (CABG), this technique has not been widely adopted. This is mainly because of the increased risk of deep sternal wound infections (DSWI) associated with its use. However, in recent years the overall risk of DSWI has decreased.

Setting realistic expectations for weight loss after laparoscopic sleeve gastrectomy.

Introduction: Despite the clinical benefits of bariatric surgery, some patients have experienced disappointment with their weight loss. Setting realistic expectations is the key to success.

Aim: To develop a specific prediction calculator to estimate the expected body mass index (BMI) at 1 year after laparoscopic sleeve gastrectomy (LSG).

Is it the technique or wound protection that is key to reducing wound infections in Roux-en-Y gastric bypass procedures?

Introduction: An unusually high surgical site infection (SSI) rate after Roux-en-Y gastric bypass (RYGB) was noted on routine outcomes review. Surgeon A, who had a rate of 8.9%, utilized the transoral technique (passage down esophagus into gastric pouch) for anvil insertion for the circular-stapled gastrojejunostomy.

Stability After Initial Decline in Coronary Revascularization Rates in the United States.

Background: It remains uncertain how advances in revascularization techniques, availability of new evidence, and updated guidelines have influenced the annual rates of coronary revascularization in the United States.

Methods: We used the Nationwide Inpatient Sample data from 2005 to 2014 with appropriate weighting to determine national procedural volumes. To present accurately overall percutaneous coronary intervention (PCI) rates, PCI with same-day discharge numbers per year were estimated from the available literature and added to annual PCI procedures performed.

Safety of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in elderly patients - analysis of the MBSAQIP.

Background: An increase in the prevalence of obesity and longer life expectancy has resulted in an increased number of candidates over the age of 60 who are pursuing a bariatric procedure.

Objective: The aim of this study was to assess the safety of laparoscopic Roux-Y gastric bypass (LRYGB) compared to laparoscopic sleeve gastrectomy (LSG) in patients aged 60 years or older.

Setting: University Hospital, United States METHODS: Preoperative characteristics and 30-day outcomes from the MBSAQIP 2015 were selected for all patients aged 60 years or older who underwent a LSG or LRYGB.

Application of HARM Score to Measure Surgical Quality and Outcomes in Bariatric Patients.

Background: The HospitAl stay, Readmission, and Mortality rates (HARM) score is a quality indicator that is easily determined from routine administrative data. However, the HARM score has not yet been applied to patients undergoing bariatric surgery.

Objective: The aims of the present study were to adjust the HARM score to the bariatric population and to validate the ability of the modified HARM score to serve as an inexpensive tool to measure the quality of bariatric surgery.

Does Sleeve Shape Make a Difference in Outcomes?

Introduction: Sleeve gastrectomy (SG) is one of the most common procedures performed for weight loss. Many seek the "perfect sleeve" with the notion that the type of calibrating device affects sleeve shape, and this in turn will affect outcomes and complications. Two major concerns after SG are amount of weight loss and acid reflux.

Safety of Revision Sleeve Gastrectomy Compared to Roux-Y Gastric Bypass After Failed Gastric Banding: Analysis of the MBSAQIP.

Objective: The aim of this study was to assess the safety of revisional surgery to laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-Y gastric bypass (LRYGB) after failed laparoscopic adjustable gastric banding (LAGB).

Background: The number of reoperations after failed gastric banding rapidly increased in the United States during the last several years. A common approach is band removal with conversion to another weight loss procedure such as gastric bypass or sleeve gastrectomy in a single procedure.