Background: The appropriate surgical management of morbidly obese patients with symptomatic hernias is not well defined. The authors evaluated the role of simultaneous panniculectomy in complex abdominal wall reconstruction.
Methods: A retrospective study (2007-2010) was conducted of morbidly obese (body mass index > 40 kg/m(2)) patients undergoing open complex abdominal wall reconstruction.
Results: Thirty patients were identified. Twenty underwent simultaneous panniculectomy. The median pannus weight was 5.2 kg. Greater all-cause postoperative complications and wound-related morbidity occurred in the panniculectomy group (P < .05). Performing a panniculectomy increased the risk for a wound complication by 5-fold (P = .04). Following 7-month to 9-month follow-up, both groups had a recurrence rate of 10%.
Conclusion: Simultaneous panniculectomy in the setting of complex abdominal wall reconstruction is feasible but associated with significant postoperative morbidity. Its potential for benefit in reducing long-term hernia recurrence remains unclear.
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http://dx.doi.org/10.1016/j.amjsurg.2010.08.023 | DOI Listing |
Front Pharmacol
December 2024
2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, Romania.
Obesity is a recognized risk factor for venous thromboembolism (VTE), associated with distinct challenges in managing anticoagulation therapy. There is still limited evidence regarding the impact of extreme body weight on the pharmacokinetics, pharmacodynamics, efficacy, and safety of various anticoagulant medications. To our knowledge, this is the first comprehensive review to address both prophylactic and therapeutic anticoagulant dosages specifically for managing VTE in patients with a body mass index (BMI) ≥40 kg/m or weight ≥120 kg.
View Article and Find Full Text PDFJBJS Case Connect
October 2024
Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois.
Case: A 35-year-old man with morbid obesity sustained an ultra-low velocity (ULV) rotational knee dislocation secondary to a fall from standing. The patient was successfully treated using a subcutaneous knee-spanning internal fixator, the "INFIX" technique, which has previously been described for pelvic ring injuries.
Conclusion: This novel technique maintained the stable reduction of an ULV knee dislocation in a patient with morbid obesity until adequate healing was achieved.
Obes Surg
December 2024
Sorbonne Université, Pitié- Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
Background: In cirrhotic patients, portal hypertension increases mortality after surgery. We evaluated the impact of pre-operative transjugular intrahepatic portosystemic shunt (TIPS) on the outcomes of bariatric surgery in cirrhosis.
Methods: Multicentric retrospective cohort.
Med J Armed Forces India
December 2024
CSO Medical, Andaman & Nicobar Command HQ, India.
Background: Lower calyceal anatomy makes the stone clearance a difficult task across all treatment formats. Improvement in optics and miniaturization of instruments have offered an effective and safer alternative to percutaneous nephrolithotomy (PCNL). The study was conducted to compare the efficacy and complications associated with mini-PCNL vs standard-PCNL.
View Article and Find Full Text PDFJ Bone Joint Surg Am
December 2024
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
Background: Weight optimization methods in morbidly obese patients with a body mass index (BMI) of ≥40 kg/m2 undergoing total knee arthroplasty (TKA) have shown mixed results. The purpose of this study was to evaluate the effect of perioperative use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with a BMI of ≥40 kg/m2 undergoing primary TKA.
Methods: Using an administrative claims database, patients with morbid obesity undergoing primary TKA were stratified into GLP-1 RA use for 3 months before and after the surgical procedure (treatment group) and GLP-1 RA non-use (control group), and were matched on the basis of patient age, gender, diagnosis of type-2 diabetes mellitus, and Charlson Comorbidity Index (CCI).
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