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1.
Background The aim of this study is to examine the relationship between oxidative plasma protein and thiol stress and weight loss after
laparoscopic adjustable gastric banding (LAGB).
Methods Plasma protein carbonyl (PCO) concentration as a marker of protein oxidation, plasma thiol (PSH) and erythrocyte glutathione
concentration (GSH, major intracellular thiol), as an antioxidant and metabolic markers, such as Homeostatic Model Assessment
– Insulin resistance (HOMA-IR), BMI and plasma lipids were determined in morbidly obese patients (n 22, mean age 34.7 ± 11
years, BMI 48.4 ± 6.4 kg/m2) at baseline and 1 and 6 months after operation. Baseline levels in patients were also compared with the levels in agematched
controls (n 20, BMI 21.3 ± 1.8 kg/m2). Plasma PCO and thiols and erythrocyte GSH concentrations were determined spectrophotometrically.
Results Plasma PCO were significantly higher and plasma and erythrocyte thiol concentrations were significantly lower in morbidly
obese patients than in controls (for each comparison, P < 0.01). BMI, plasma triglycerides and HOMA-IR were positively correlated with plasma PCO and negatively correlated with
plasma P-SH and erythrocyte GSH (for each comparison, P < 0.01). Plasma HDL-cholesterol levels were positively correlated with plasma erythrocyte GSH (r = 0.405, P < 0.01) and negative correlated with plasma PCO (r = −0.273, P < 0.01). One and 6 months after the LAGB operation, total weight loss was 13.2 ± 6.3 and 35.5 ± 7.5 kg, respectively. Plasma
PCO concentrations were decreased and P-SH and erythrocyte GSH concentrations were elevated following weight loss (for each,
P < 0.01). Only plasma P-SH levels were restored to the control levels 6 months after LAGB.
Conclusions Obesity and insulin resistance appear to be associated with plasma protein oxidation and thiol concentrations. Protein and
thiol oxidative stress was improved by weight loss after LAGB in the short-term. 相似文献
2.
Laparoscopic adjustable gastric banding (LAGB) has become a standard restrictive procedure in the USA for the treatment of
severe obesity (body mass index, BMI > 35 kg/m2). Mildly obese individuals (BMI < 35 kg/m2) are also at increased risk from obesity-related conditions. Recently, an FDA panel supported its use in this subgroup. We
compared the perioperative outcomes of LAGB in mildly and severely obese. Thirty consecutive patients (mildly obese n = 10; severely obese n = 20) that underwent preoperative medical weight loss followed by LAGB procedures were prospectively evaluated. Outcome variables
included: operative room (OR) time, intraoperative estimated blood loss (EBL), length of hospital (LOS), and intensive care
unit (ICU) stay, reoperations, readmissions, 30-day morbidity and mortality. Demographic data was comparable between groups.
BMI was significantly higher in the severely obese compared to mildly obese (44.0 ± 5 vs. 33.6 ± 1 kg/m2). OR time, EBL, LOS, and ICU admissions were similar between BMI groups. There were no reoperations or 30-day mortality in
either group. Minor morbidity was only observed in the severely obese group. BMI correlated with OR time and EBL. In mildly
obese, LAGB is as safe as in the severely obese with no perioperative morbidity. The perioperative outcomes and hospital resource
utilization are comparable between BMI groups. Lower BMI is associated with lower operative times and blood loss. 相似文献
3.
Background In the present study, criteria were investigated to predict major benefit after laparoscopic adjustable gastric banding (LAGB).
Materials and Methods 85 morbidly obese patients were operated with LAGB between 1999 and 2005. Seventy-one of these patients were analyzed according
to several possible predictive characteristics for success as the primary endpoint. Success was defined as excess body weight
loss (EBWL) >50% and no band removal. Median follow-up was 27 months (range 8–90 months).
Results In total, median EBWL was 43% (−41 to 171.5%) with a decrease in BMI of 8.0 kg/m2 (−9 to 35 kg/m2). Success rate was 37% (n = 26). These patients were compared to all other patients (n = 45). Significant success predictors were baseline absolute BW, EBW, BMI (p < 0.01), BMI with a threshold value of 50 kg/m2 (p = 0.02), and female sex (p = 0.02) as well as postoperative vomiting (p = 0.02), eating behavior and physical activity after LAGB (p < 0.01). Baseline EBW and change in eating behavior after surgery were identified as independent predictors in multivariate
analysis.
Conclusion Patients with a lower excess body weight who improve especially their eating behavior after surgery have the highest chance
of success after LAGB. 相似文献
4.
Ekaterina Tiktinsky Leonid Lantsberg Sophie Lantsberg Solly Mizrahi Svetlana Agranotvich Michael Friger Boris Kirshtein 《Obesity surgery》2009,19(9):1270-1273
Background Laparoscopic adjustable gastric banding (LAGB) has been popularized as an effective, safe, minimally invasive surgical technique
for the treatment of morbid obesity. We performed a pilot study to evaluate gastric emptying of semisolid meals and antral
motility following LAGB.
Methods Gastric emptying half-time was compared in normal volunteers and morbidly obese patients before and 6–12 months after LAGB
using sulfur colloid-labeled semisolid meals.
Results There was no difference in mean age between groups. Women were prevalent in the group of obese patients. BMI was higher in
patients before surgery (p < 0.001). Patients following LAGB demonstrated prolonged gastric pouch emptying (T1/2 = 36.6 ± 9.8 min) compared to subjects
without surgery (23.8 ± 4.7 min) and healthy volunteers (22.8 ± 6.8 min; p < 0.001). Similar gastric contractility was found all groups (3.3 ± 0.4; p = 0.968). No cases of band slippage or pouch dilatation were observed during mean follow-up of 11.4 months.
Conclusions A standard normal gastric pouch emptying rate of semisolids in asymptomatic patients after LAGB was established. Postoperative
prolongation of gastric emptying is a matter of mechanical delay without gastric pouch denervation. This study provides a
first step of future functional evaluation of complications following this type of bariatric surgery. 相似文献
5.
Zambon S Romanato G Sartore G Marin R Busetto L Zanoni S Favretti F Sergi G Fioretto P Manzato E 《Obesity surgery》2009,19(2):190-195
Background Small dense low-density lipoprotein (LDL) are atherogenic particles frequently observed in obese patients. Fatty acids modulate
LDL. Objective of this study was to determine the relations between plasma phospholipid fatty acid composition and the presence
of small dense LDL particles in morbidly obese patients treated with laparoscopic gastric banding (LAGB).
Methods Small dense LDL, plasma lipids, lipoproteins, apoproteins, and phospholipid fatty acid composition (a marker of dietary fatty
acid intake) were quantified before and 12 months after surgery in four men and 11 women who were morbidly obese and (BMI > 40 kg/m2) eligible for surgery, consecutively treated with LAGB at the Department of Medical and Surgical Sciences of the University
of Padova.
Results BMI was 48.3 ± 4.8 kg/m2 before and 36.1 ± 5.5 kg/m2 after LAGB. Plasma triglycerides and apoprotein E levels significantly decreased, while HDL cholesterol significantly increased
after LAGB. A reduction of small dense LDL with an increase of LDL relative flotation (0.34 ± 0.04 before vs 0.38 ± 0.03 after
LAGB, p < 0.001) was also observed. These modifications were neither related to weight reduction nor to changes in phospholipid fatty
acid composition, but they were associated to triglyceride reduction, which explained 76.7% of the LDL relative flotation
variation.
Conclusion Weight loss obtained by LAGB in morbidly obese subjects was accompanied by triglyceride reduction, high-density lipoprotein
increase, and an improvement of the atherogenic LDL profile. Triglyceride reduction, but not the extent of weight loss or
dietary fatty acid modifications, is the determinant of modifications of LDL physical properties in these patients. 相似文献
6.
Background There is concern that surgically-induced weight loss in obese subjects is associated with a disproportionate decrease in lean body mass (LBM) and in skeletal muscle mass (SMM), a major constituent of LBM. To address this issue, 1) we measured total and regional body composition following gastric
banding in a group of obese subjects, and 2) we compared these data to those of a non-surgical control group of similar age
and body size.
Methods Body composition was assessed by dualenergy X-ray absorptiometry (DEXA) before and after laparoscopic adjustable silicone
gastric banding (LAGB) in 32 women (after 1 year: age 43.7 ± 8.4 years, BMI 36.4 ± 5.9 kg/m2, mean ± SD), and in 117 control women (age 44.5 ± 7.5 years; BMI 36.7 ± 5.5 kg/m2) referred for non-surgical weight management, prior to weight loss. SMM was estimated using a published equation based on
LBM of the extremities (appendicular LBM).
Results 1 year after LAGB, body weight loss (−23.7 ± 11.6 kg, P < 10−6) was mainly due to decreased fat mass (−21.2 ± 11.2 kg, P < 10−6), and total LBM was modestly, although significantly, decreased (−2.1 ± 4.2 kg, P = 0.01). Appendicular LBM (−0.7 ± 2.7 kg)
and total SMM (−0.9 ± 3.0 kg) were not significantly modified. None of the body composition variables was significantly decreased
in weight-reduced subjects compared to the control group, especially appendicular LBM and total SMM.
Conclusions Results provide no evidence for a decrease in appendicular LBM and total SMM with weight loss following LAGB. Follow-up of
these obese patients revealed a very favorable pattern of change in total and regional body composition, with preservation
of muscle mass. 相似文献
7.
Expression of ghrelin in fundus is increased after gastric banding in morbidly obese patients 总被引:1,自引:0,他引:1
Uzzan B Catheline JM Lagorce C Airinei G Bon C Cohen R Perret GY Aparicio T Benamouzig R 《Obesity surgery》2007,17(9):1159-1164
Background Ghrelin, a 28 amino-acid acylated orexigenic peptide secreted by the stomach, acts on the hypothalamic arcuate nucleus which
stimulates feeding behavior. Serum ghrelin level increases during fasting and decreases after a meal. Serum ghrelin is low
in obese patients. Whether ghrelin is implicated in weight loss in obese patients after laparoscopic adjustable gastric banding
(LAGB) is still debated. In this study, we assessed serum ghrelin level and gastric fundus expression before and 1 year after
LAGB.
Methods Gastric fundus expression of ghrelin was assessed by immunohistochemistry using a rabbit anti-human ghrelin antibody simultaneously
with serum total ghrelin levels (RIA) in 13 obese patients (2 men and 11 women) after an overnight fast, before LAGB and 1 year
after. Immunostaining was “blindly” analyzed by a single pathologist, measuring the density of stained fundic cells near muscularis
mucosa.
Results Mean age of the 13 patients was 41 years, and mean baseline BMI was 46 kg/m2. Pre- and post- LAGB gastric expression of ghrelin was analyzable in 11 patients. It was always identified, mostly with moderate
or intense staining. Mean density of stained cells significantly increased 1 year after LAGB: 31/mm2 (21–38) before vs 38/mm2 (27–57) after surgery (P < 0.01). This increase did not correlate with changes in BMI, nor did pre- or postoperative gastric expression of ghrelin
correlate with the corresponding serum values.
Conclusion We showed for the first time that ghrelin expression assessed by immunohistochemistry was present in the fundus of all 11
obese patients and that it was significantly increased 1 year after LAGB, which would exclude a pathogenetic role of ghrelin
in weight loss after LAGB. 相似文献
8.
de Goederen-van der Meij S Pierik RG Oudkerk Pool M Gouma DJ Mathus-Vliegen LM 《Obesity surgery》2007,17(1):88-94
Background We studied whether weight loss by intragastric balloon would predict the outcome of subsequent gastric banding with regard
to weight loss and BMI reduction.
Methods A prospective cohort of patients with a body mass index (BMI) >40 kg/m2 received an intragastric balloon for 6 months followed by laparoscopic adjustable gastric banding (LAGB). Successful ballooninduced
weight loss was defined as ≥10% weight loss after 6 months. Successful surgical weight loss was defined as an additional 15%
weight loss in the following 12 months. Patients were divided in group A, losing ≥10% of their initial weight with 6 months’
balloon treatment, and group B, losing <10% of their initial weight.
Results In 40 patients (32 female, 8 male; age 36.6 yr, range 26–54), the mean BMI decreased from 46.5 to 40.5 kg/m2 (P < 0.001) after 6 months of balloon treatment and to 35.2 kg/m2 (P < 0.001) 12 months after LAGB. Group A (25 patients) and group B (15 patients) had a significant difference in BMI decrease,
12.4 vs 9.0 kg/m2 (P < 0.05), after the total study duration of 18 months. However, there was no difference in BMI reduction (4.7 kg/m2 vs 5.8 kg/m2) in the 12 months after LAGB. 6 patients in group A lost ≥10% of their starting weight during 6 months balloon treatment
as well as ≥15% 12 months following LAGB. 6 patients in group B lost <10% of their starting weight after 6 months of BIB,
but also lost ≥15% 12 months following LAGB.
Conclusion Intragastric balloon did not predict the success of subsequent LAGB. 相似文献
9.
Juan Ybarra Eugenia Resmini Francesc Planas Francesc Navarro-López Susan Webb Jose Maria Pou Alicia Santos Carlos Ballesta-López 《Obesity surgery》2009,19(9):1324-1332
Background It is well known that obesity is a risk factor for severe cardiovascular complications, such as coronary heart disease, heart
failure, stroke, venous thromboembolic disease, and atrial fibrillation. Left ventricle (LV) and left atrium (LA) enlargement
is a characteristic feature of these patients with the consequent cardiovascular risk. Factors other than hemodynamic may
influence LA remodeling. The aim of the study is to evaluate the relationship between adiponectin and LA size in uncomplicated
obese patients.
Methods Seventy-four asymptomatic obese patients and an age- and sex-matched control group (N = 70) were recruited. A detailed clinical, echocardiographic, and analytical study was performed. Insulin resistance was
assessed using the homeostasis model assessment for insulin resistance (HOMA-IR) method. Insulin sensitivity was assessed
measuring serum total adiponectin concentrations.
Results Adiponectin levels were lower in the obese group (P < 0.001) and particularly so in those obese participants with enlarged LA (32%; P < 0.0005). LA sizes were higher in the obese group (P < 0.0005). Adiponectin displayed significant correlations with body mass index, glucose, insulin, high-density lipoprotein
cholesterol, and triglyceride concentrations as well as HOMA-IR (P < 0.001 for all). Adiponectin displayed significant correlations with LV mass and LA size, diastolic and systolic cardiac
volumes and diameters, and cardiac output (P < 0.001 for all). Adiponectin correlations with LA size (r = −0.429; P < 0.001) persisted after adjustment for HOMA-IR, age, sex, and LV mass.
Conclusions A novel inverse relationship between adiponectin and LA size independent of age, sex, insulin resistance, and LV mass appears
in our series. Adiponectin could be a link between adipose tissue and the heart, having an influence on cardiac remodeling. 相似文献
10.
Ybarra J Bobbioni-Harsch E Chassot G Huber O Morel P Assimacopoulos-Jeannet F Golay A 《Obesity surgery》2009,19(3):327-331
Background Studies done on serial changes in plasma ghrelin levels after gastric bypass (GBP) have yielded contrasting results since
decreased, unchanged, or increased levels have been reported in the literature. This study investigates whether or not GBP
has an inhibitory effect on fasting ghrelin levels independently of weight loss.
Methods Fasting ghrelin levels were measured in 115 stable body weight females, classified as normal body weight (NW; body mass index
(BMI) < 25 kg/m2), overweight (OW; BMI 25–30 kg/m2), and obese subjects, divided in three subgroups with increasing BMI (BMI 30–40 kg/m2; BMI 40–50 kg/m2; BMI >50 kg/m2).
Results Each obese subgroup showed significantly lower ghrelin levels as compared to both NW (p < 0.0001) and OW subjects (p < 0.05 or 0.005); however, no significant differences were observed within the three obese subgroups. Forty-nine obese patients
underwent a GBP. Plasma ghrelin, measured at 3, 6, and 12 months after GBP, significantly increased from the sixth month on
(p < 0.0001). When patients were classified, at each postoperative time point, according to their actual BMI, ghrelin was significantly
(p = 0.0002) related to postoperative BMI and not significantly different from ghrelin measured in stable body weight conditions.
Conclusions Fasting ghrelin displays an inversely significant correlation with BMI in both stable body weight conditions and after GBP.
No evidence was found that GBP had an effect on fasting ghrelin levels, independent of weight loss. 相似文献
11.
Purpose We combined laparoscopic adjustable gastric banding (LAGB) and laparoscopic partial gastrectomy into a single procedure (GBSR).
Methods The 6- and 12-month percent excess weight loss (EWL) was compared to results expected from the literature for LAGB and laparoscopic
Roux-en-Y gastric bypass (LRYGB) using t test. The time to band adjustment was compared with the 6-week period experienced in our setting for LAGB using a sign test.
Results Eighteen patients were considered. One patient had gastric leak and had the band removed in postoperative day 1. Seventeen
patients were followed-up. The patients, 4 men and 13 women, had a mean age of 38.8 years, an initial mean BMI of 52.4 kg/m2, and a mean of 8.3 comorbidities. All required outpatient band adjustment, eight at 4 months, eight at 5 months, and one
at 6 months; the median 5 months was greater than the 6 weeks expected for LAGB (P < 0.001). The mean 6-month EWL, 28.6%, was similar to that expected for LAGB (P = 0.24) and less than that expected for LYRGB (P < 0.001). The mean 12-month EWL, 57.4%, was greater than that expected for LAGB (P < 0.001) and less than that expected for LYRGB (P < 0.001).
Conclusion Although GBSR’s EWL at 6 and 12 months is less than that of LRYGB, GBSR should be further studied and applied in specific
situations only.
Presented at SAGES in Las Vegas. 相似文献
12.
Renata Ramalho Cristina Guimarães Cidália Gil Celestino Neves João Tiago Guimarães Luís Delgado 《Obesity surgery》2009,19(7):915-920
Background Inflammatory status underlying obesity seems to be implicated in several aspects of metabolic syndrome.
Objective This study aimed to investigate the association between weight loss achieved by laparoscopic gastric banding (LAGB) surgery,
chronic inflammatory markers, and nutritional state.
Methods Thirty-two morbid obese females were enrolled in the study and evaluated at baseline, 1 and 18 months after LAGB surgery.
Serum immunoglobulin G (IgG), IgA, IgM, C-reactive protein (CRP), haptoglobin, alpha-1 antitrypsin, total proteins, albumin,
prealbumin, transferrin, ferritin, and transferrin soluble receptor were evaluated. In addition, total cholesterol, low-density
lipoprotein cholesterol, high-density lipoprotein cholesterol, and fasting glucose were also evaluated.
Results In average, patients presented 18.7% and 63.2% excess body weight loss 1 and 18 months after LAGB, respectively (p < 0.01). CRP and total cholesterol mean levels were elevated (1.03 ± 1.11 mg dL−1 and 2.02 ± 0.41 g L−1) at the presurgery study. CRP mean levels were significantly reduced when compared to reference range (p < 0.01) 18 months after the LAGB surgery. Prealbumin as well as serum total protein mean levels decreased 1 month after surgery
(p < 0.01) and values returned to normal at 18 months after surgery. Albumin mean levels showed an increase during the postsurgery
evaluations. Serum IgA and IgM concentrations were significantly increased at 1 month after surgery compared to baseline (p < 0.01, both cases).
Conclusions Our results indicate that amelioration of inflammatory markers after LAGB does not seem to negatively impact nutritional status
following weight reduction surgery. However, careful attention should be driven to serum IgA. Adequacy of nutritional intake
and complete serial laboratory measurements should be always included in the required life-long follow-up of patients surgically
treated for morbid obesity. 相似文献
13.
Holly?E.?Richter Jennifer?M.?Creasman Deborah?L.?Myers Thomas?L.?Wheeler Kathryn?L.?Burgio Leslee?L.?Subak for the Program to Reduce Incontinence by Diet Exercise Research Group 《International urogynecology journal》2008,19(12):1653-1658
The purpose of this study was to describe urodynamic characteristics of overweight or obese women with urinary incontinence
and explore the relationship between urodynamic parameters, body mass index (BMI), and abdominal circumference (AC). One hundred
ten women underwent a standardized cough stress test and urodynamic study. Eighty-six percent of women had urodynamic stress
incontinence and 15% detrusor overactivity. Intra-abdominal pressure (Pabd) at maximum cystometric capacity (MCC) increased
0.4 cm H2O per kg/m2 unit of BMI (95% confidence interval [CI] = 0.0,0.7, p = 0.04) and 0.4 cm H2O per 2 cm increase in AC (CI = 0.2, 0.7, p < 0.01). Intravesical pressure (Pves) at MCC increased 0.4 cm H2O per 2 cm increase in AC (CI = 0.0, 0.8, p = 0.05) but was not associated with BMI (p = 0.18). BMI and AC had a stronger association with Pabd than with Pves, suggesting a possible mechanism for the association
between obesity and urinary incontinence. 相似文献
14.
Reinehr T Roth CL Schernthaner GH Kopp HP Kriwanek S Schernthaner G 《Obesity surgery》2007,17(12):1571-1577
Background Peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) are cosecreted in the same enteroendocrine L-cells of the gut and reported
to inhibit food intake additively. However, findings in human studies regarding these peptides are controversial. The aim
of this study was to analyze the relationships between fasting PYY, GLP-1, and weight status in morbidly obese patients before
and after surgically induced weight loss.
Methods Fasting GLP-1, PYY, glucose, and insulin concentrations; blood pressure; and body-mass index (BMI) were determined in 30 morbidly
obese adults (mean BMI 45.8, mean age 40 years) before bariatric surgery [Roux-en-Y gastric bypass (RYGB): n = 19; gastric banding (GB): n = 11] and after weight loss (mean 50% excess weight loss) in the course of mean 2 years.
Results GLP-1 concentrations decreased (mean −20 pg/ml; mean −38%; p = 0.001) and PYY concentrations increased (mean +19 pg/ml; mean +19%, p = 0.036) after bariatric surgery. The weight loss and changes of GLP-1 were significantly (p < 0.05) more pronounced after RYGB as compared to GB, whereas the changes of PYY did not differ significantly between the
patients who had undergone RYGB or GB.
Conclusions In morbidly obese adults reducing their weight by bariatric surgery, fasting PYY levels increased and GLP-1 concentrations
decreased independently of each other. Therefore, the relationship between PYY and GLP-1 seems more complicated than might
be anticipated from animal and in vitro studies.
T. Reinehr and C. L. Roth contributed equally to this work. 相似文献
15.
Background Among the restrictive procedures the role of restrictive vs. resecting the stomach is still ambiguous. This study evaluate
which is the role of the stomach with respect to blood glucose levels (BG) and percent excess weight loss (EWL) over the 18 months
after restrictive procedures in morbid obese diabetic patients.
Methods We retrospectively compared a group of patients who underwent partial gastrectomy (just part of the gastric body) with gastric
banding (GBSR; n = 27), sleeve gastrectomy (part of gastric body and complete fundus resection; LSG; n = 53) to laparoscopic gastric banding (LAGB; n = 100). Differences among groups at 3, 6, 12, and 18 months were evaluated by analysis of variance. The three cohorts were
diabetic patients similar in BMI, age, and gender.
Results At 12 and 18 months, LSG had higher EWL (P < 0.05) and lower BG (P < 0.05) than did either LAGB or GBSR. There were no operative deaths. Complications: LAGB—two staple-line oozing, two wound
infections; LSG—one hemorrhage, two staple-line oozing, two leaks; GBSR—one hemorrhage, two wound infections. All complications
were readily treated.
Conclusions LSG provides better weight loss and glucose control at 1 year and 1.5 years after surgery than does either LAGB or GBSR, suggesting
that gastric fundus resection plays an important, not yet well-defined, role. 相似文献
16.
Ulderico Freo Michele Carron Federico Innocente Mirto Foletto Donato Nitti Carlo Ori 《Obesity surgery》2011,21(7):850-857
Monitoring depth of anesthesia may improve anesthetic dosing and postanesthetic recovery in obese patients. Sixty morbidly
obese patients undergoing laparoscopic adjustable gastric bandage (LAGB) were randomly assigned to receive anesthesia with
sevoflurane titrated by either standard clinical parameters (SCP) (target = baseline hemodynamic parameters ± 20%) or by A-line
ARX index (AAI) (target = 20 ± 5). Heart rate, arterial blood pressure, inspiratory and expiratory gas concentrations, and
AAI were recorded in all patients at 5-min intervals, but AAI was made available only to the anesthesiologist assigned to
AAI-monitored patients. Emergence times in surgery room and recovery times in postanesthesia care unit (PACU) were recorded
at 1- and 30-min intervals. Mean intraoperative values of AAI were higher in AAI-monitored than in SCP-monitored patients
(22.5 vs 15.0, p = 0.001). Compared to SCP monitoring, AAI monitoring reduced consumption of sevoflurane by 20% (p = 0.014), times to eye opening by 2.4 min (p = 0.001) and to extubation by 2.5 min (p = 0.009) and to achieve SpO2 92% in room air by 17 min (p = 0.001). Aldrete scores were higher in AAI- than in SCP-monitored patients at arrival in PACU (p = 0.035), but Aldrete scores ≥9 were attained in similar times. AAI monitoring can improve titration of and recovery from
sevoflurane for LAGB. 相似文献
17.
Johansson Hans-Erik Haenni Arvo Öhrvall Margareta Sundbom Magnus Zethelius Björn 《Obesity surgery》2009,19(5):601-607
Background Roux-en-Y gastric bypass (RYGBP) powerfully reduces type 2 diabetes (T2DM) incidence. Proinsulin predicts development of T2DM.
Adjustable gastric banding is associated with lowered proinsulin but after RYGBP information is scant.
Methods Twenty-one non-diabetic morbidly obese patients who underwent RYGBP surgery were evaluated before (baseline), at 12 months
(first follow-up), and at 42 months, range 36–50 (second follow-up), after surgery and compared to a control group, matched
at baseline regarding fasting glucose, insulin, proinsulin, alanine aminotransferase (ALT), high-density lipoprotein (HDL)
cholesterol, and body mass index (BMI).
Results In the RYGBP group, fasting serum proinsulin concentrations were markedly lowered from 13.5 to 3.5 pmol/l at first follow-up
and to 4.9 pmol/l at second follow-up (p < 0.001, respectively). Fasting insulin concentrations were reduced from 83.4 to 24.6 pmol/l at first follow-up (p < 0.001) and to 36.4 pmol/l at second follow-up (p < 0.01). ALT was lowered from 0.62 to 0.34 μkatal/l at first follow-up and continued to lower to 0.24 μkatal/l at second
follow-up (p < 0.001, respectively). The further decrease between first and second follow-up was also significant (p = 0.002). HDL cholesterol increased from 1.16 to 1.45 mmol/l at the first follow-up and continued to increase at second follow-up
to 1.58 mmol/l (p < 0.001, respectively). The further increase between first and second follow-up was also significant (p = 0.006). The differences between groups at first follow-up were significant for BMI, proinsulin, insulin, ALT, and HDL cholesterol
(p = 0.04–0.001).
Conclusion RYGBP surgery in morbidly obese patients is not only characterized by markedly and sustained lowered BMI but also lowered
concentrations of proinsulin, insulin, and ALT and increased HDL cholesterol.
An erratum to this article can be found at 相似文献
18.
Eyal Sheiner Evgenia Balaban Jacob Dreiher Isaac Levi Amalia Levy 《Obesity surgery》2009,19(9):1286-1292
Background The objective of this study was to investigate pregnancy outcome of patients following different types of bariatric surgery.
Methods A population-based study includes all pregnancies of patients with bariatric surgeries delivered during 1988–2008. Pregnancy
outcome was compared between the different types of surgeries.
Results This retrospective study included 449 deliveries: 394 deliveries following pure restrictive operations—laparoscopic gastric
banding (LAGB; n = 202), silastic ring vertical gastroplasty (SRVG; n = 136), and vertical-banded gastroplasty (VBG; n = 56)—and 55 deliveries following restrictive and malabsorptive Roux-en-Y gastric bypass (RGB). While no significant differences
were noted between the groups regarding body mass index (BMI) before the bariatric operations or prepregnancy BMI, patients
following LAGB had significantly higher BMI before delivery (36.8 ± 5.9 kg compared to the SRVG 33.4 ± 6.0, VBG 34.2 ± 5.4,
and RGB 34.9 ± 6.8 groups; p < 0.001). Following LAGB, patients had higher weight gain during pregnancy (13.1 ± 9.6 kg) compared to the SRVG (8.8 ± 7.4),
VBG (8.5 ± 8.0), and RGB (11.6 ± 9.6; p < 0.001) groups. The interval between operation and pregnancy was shorter in the LAGB group (22.8 months) compared to the
SRVG (41.0) and the VBG (42.1) groups and was significantly higher in the RGB group (57.4; p < 0.001). Birth weight was significantly higher among newborns of patients following RBG (3,332.8 ± 475.5 g) compared to
the restrictive procedures (3,104.3 ± 578.7 in the LAGB, 3,086.7 ± 533.1 in the SRVG, and 3,199.2 ± 427.2 in the VBG groups).
No significant differences in low birth weight (<2,500 g) or macrosomia (>4,000 g), or low Apgar scores or perinatal mortality
were noted between the groups.
Conclusion There is no difference in the affect on pregnancy outcome among the different forms of bariatric surgeries; all procedures
have basically comparable perinatal outcome.
Précis Pregnancy outcome is not negatively affected by any specific bariatric operation; all procedures have basically comparable
perinatal outcome. 相似文献
19.
Assimakopoulos K Karaivazoglou K Panayiotopoulos S Hyphantis T Iconomou G Kalfarentzos F 《Obesity surgery》2011,21(3):362-366
Bariatric surgery is an effective treatment for obesity; few studies, however, have investigated its impact on patients’ sexuality.
We aimed to determine bariatric surgery’s effect on female patients’ body mass index (BMI), anxiety and depressive symptoms,
and sexual function and delineate predictors of treatment outcomes. Fifty-nine obese female bariatric candidates were administered
the Hospital Anxiety and Depression Scale and the Female Sexual Function Index 1 week before surgery (T1) and 1 year after
(T2). Statistical analysis revealed significant reductions in BMI (p < 0.001), depression (p < 0.001), and sexual pain levels (p = 0.014) and significant improvements in sexual desire (p = 0.005), arousal (p = 0.001), lubrication (p = 0.003), satisfaction (p = 0.012), and total sexual function (p = 0.003) postoperatively. Postoperative total sexual function was independently predicted by baseline sexual function and
low baseline BMI. Bariatric surgery is an effective way to reduce weight, manage depression, and improve sexual function in
female obese patients. 相似文献
20.
Santiago-Recuerda A Gómez-Terreros FJ Caballero P Martin-Duce A Soleto MJ Vesperinas G Pérez-Fernández E Villamor J Alvarez-Sala R 《Obesity surgery》2007,17(5):689-697
Background The authors studied changes in the upper airway in morbidly obese women and the relationship to sleep apnea-hypopnea syndrome
(OSAS).
Methods Patients underwent a cardiorespiratory polygraphic study, respiratory function test (spirometry, plethysmography, maximum
inspiratory pressures and arterial blood gas analysis), and computed tomographic studies of the upper airway.
Results 40 morbidly obese women being evaluated for bariatric surgery (mean age 39.6 ± 9.6 years old, BMI 48.7 ± 5.6 kg/m2) were studied. 37 women had OSAS, and 14 had severe OSAS. Results on respiratory function tests were normal. BMI and weight
had a positive correlation with apnea-hypopnea index (AHI), apnea index (AI), desaturation index (DI), lowest oxygen saturation
and CT90. Uvula diameter had a negative correlation with FEV1, FVC, VC IN and a positive correlation with TLC. Retropharynx soft tissue at the retropalatal level had a negative correlation
with FEV1, FVC and VC IN. The oropharynx area at maximal inspiration (total lung capacity) obtained a negative correlation with the
AHI (r = −0.423, P = 0.044), AI (r = −0.484, P = 0.042) and DI (r = −0.484, P = 0.019).
Conclusions Prevalence of OSAS in morbidly obese women is very high. Our results show the significant correlation between BMI and AHI
in morbidly obese women. Uvula diameter and retropharynx soft tissue are the upper airway parameters with higher relationship
with pulmonary function. A reduction in the cross-sectional area of the airway at the level of the oropharynx could be related
to the severity of OSAS in morbidly obese women. 相似文献