Bariatric Times

MAY 2018

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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21 Bariatric Times • May 2018 Journal Watch Journal Watch Anthropometric and clinical profiles of post-bariatric patients submitted to procedures in plastic surgery. Rosa SC, Macedo JLS, Casulari LA, et al. Rev Col Bras Cir. 2018;45(2):e1613. Epub 2018 Apr 16. Synopsis: Researchers investigated clinical profiles of patients who had Roux-en-Y gastroplasty and opted for plastic surgery following the bariatric surgical procedure. The study included 139 patients with a mean body mass index of 27.44kg/ m 2 , mean weight loss of 47.02kg, and received plastic surgery, on average, 42 months after bariatric surgery. The two most common comorbidities were arterial hypertension (11.5%) and arthropathy (5.4%). Researchers noted that while this profile was similar to past studies, their patient population had fewer postoperative complications. PMID: 29668809 Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: the mediating role of loss of control eating. Conceição EM, de Lourdes M, Pinto- Bastos A, et al. Int J Eat Disord. 2018 Apr 17. [Epub ahead of print] Synopsis: This study investigated various problematic eating behaviors (PEB) and how they are connected to loss of control (LOC) and psychopathology. The study included 163 patients before bariatric surgery and 131 patients after bariatric surgery. The results found a variety of PEBs, all of which occurred in similar frequencies—objective PEB (8.8%), subjective PEB (9.8%), compulsive grazing (11.9%), and noncompulsive grazing (12.2). The researchers determined that "PEBs differ in the psychopathology severity, independently of the experience of LOC eating during the eating episodes." PMID: 29663468 Devices and endoscopic bariatric therapies for obesity. Saunders KH, Igel LI, Saumoy M, et al. Curr Obes Rep. 2018 Apr 17. [Epub ahead of print] Synopsis: Researchers reviewed United States Food and Drug Administration (FDA)-approved and investigational devices, in addition to endoscopic bariatric treatments for obesity, over the past few years. They determined that these procedures and devices are helping to close the gap in effectively treating obesity and could even be more effective than medications for obesity. They also added that combination therapies can often be most effective because every patient requires a different weight loss strategy. PMID: 29667157 An autopsy case of misdiagnosed Wenicke's syndrome after intragastric balloon therapy. Vellante P, Carnevale A, D'Ovidio C. Case Rep Gastrointest Med. 2018 Feb 13;2018:1510850. Synopsis: Wernicke's syndrome, which develops in a patient as a result of thiamine deficiency and can sometimes occur after bariatric surgery, can impact patients who have intragastric balloon procedures as well. The researchers provide a case report of a 51-year-old patient who received an intragastric balloon and died after Wernicke's syndrome was diagnosed too late, ultimately due to complications with pneumonia. PMID: 29666718 Older age confers a higher risk of 30-day morbidity and mortality following laparoscopic bariatric surgery: an analysis of the Metabolic and Bariatric Surgery Quality Improvement Program. Haskins IN, Ju T, Whitlock AE, et al. Obes Surg. 2018 Apr 17. [Epub ahead of print] Synopsis: Patients who had either laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were separated into five equal age quintiles based on the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Of the 266,544 patients included in the analysis, the researchers determined that old age increased the risk of all morbidity outcomes except for venous thromboembolism events, 30-day mortality, and the composite morbidity and mortality outcome. The risk was even higher for patients who had RYGB compared to those who had SG. PMID: 29663253 Retrospective comparison of single-port sleeve gastrectomy versus three-port laparoscopic sleeve gastrectomy: a propensity score adjustment analysis. Mauriello C, Chouillard E, d'alessandro A, et al. Obes Surg. 2018 Apr 16. [Epub ahead of print] Synopsis: The authors compared two methods of sleeve gastrectomy based on the quantity of ports used. They determined that excess weight loss was similar between the single-port and three-port sleeve gastrectomy methods. PMID: 29663249 Bone health following bariatric surgery: implications for management strategies to attenuate bone loss. Ben-Porat T, Elazary R, Sherf- Dagan S, et al. Adv Nutr. 2018 Mar 1;9(2):114–127. Synopsis: Patients who have bariatric surgery are at a higher risk for metabolic bone disease for a variety of reasons, such as rapid weight loss, restricted diet, and lower intestinal nutrient absorption. The researchers review bone health management in patients who have had bariatric surgery, both before and after the procedure occurs. PMID: 29659692 Efficacy and safety of stents in the treatment of fistula after bariatric surgery: a systematic review and meta- analysis. Okazaki O, Bernardo WM, Brunaldi VO, et al. Obes Surg. 2018 Apr 13. [Epub ahead of print] Synopsis: The researchers investigated the effectiveness of stents in fistulas after bariatric surgery, measuring "overall success rate of fistula closure, mean number of stents per patient, mean stent dwelling time, and procedure- associated complications." They determined that stents for fistulas is effective in certain patients who have either sleeve gastrectomy or Roux- en-Y gastric bypass. PMID: 29654447 Laparoscopic adjustable gastric banding in adolescents with severe obesity: psychological aspects, decision makers of surgery, and 2-year outcomes. A case series. Riqiun E, Schmitt F, Bouhours-Nouet N, et al. Arch Pediatr. 2018 Apr 11. Pii: S09 29-693X(18)30061-7 [Epub ahead of print] Synopsis: Of the 35 adolescent patients included in the study, 54 percent had a psychiatric history and 85 percent had psychiatric comorbidities. The researchers conducted interviews with each patient in the study, concluding that surgery is feasible in younger patients and results in significant excess weight loss. Excess weight loss was 46 percent after the first year and 51 percent after two years. PMID: 29656036 BT A quick look at the noteworthy articles in bariatric and metabolic research Bariatric Times. 2018;15(5):21.

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