Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure?

BackgroundCauses of failure after laparoscopic sleeve gastrectomy (LSG) are not known but may include a high residual gastric volume (RGV). The aim of this study was to use gastric computed tomography volumetry (GCTV) to investigate the RGV and relate the latter parameter to the outcome of LSG.MethodsA single-center, prospective study included patients with>24 months of follow-up after LSG. The RGV was measured with a unique GCTV technique. We determined the LSG outcomes according to a variety of criteria and examined potential relationships with the RGV. When the RGV was>250 cc, we offered a repeat LSG (RLSG).ResultsSeventy-six patients were included. The mean RGV was 255 cc but differed significantly when comparing “failure” and “success” subgroups, regardless of whether the latter were defined by a percentage of excess weight loss>50 (309 cc versus 225 cc, respectively; P = .0003), a BAROS score>3 (312 cc versus 234 cc; P = .005), the Reinhold criteria (290 cc versus 235 cc; P = .019), or the Biron criteria (308 cc versus 237 cc; P = .008). The RGV threshold (corresponding to the volume above which the probability of failure after LSG is high) was 225 cc. Fifteen RLSGs were performed during the inclusion period.ConclusionA high RGV 34 months after LSG is a risk factor for failure. Knowledge of the RGV can be of value in the management of failure after LSG.     

Bullying as a Source of Posttraumatic Growth in Individuals with Visual Impairments

Bullying has been recognized as a major public health concern and may be conceptualized as a potentially traumatic experience. A growing body of literature has documented posttraumatic growth (PTG), or positive psychological changes following traumatic experiences, yet no studies have examined bullying as a potential precursor to PTG. This work examined spontaneous expressions of PTG in response to bullying experiences in a sample of 51 adults with visual impairments (Study 1) as well as quantitative relationships between self-reported bullying severity and PTG in 33 children with visual impairments (Study 2). Adults and children with visual impairments were selected as the test populations because limited available research suggests that individuals with disabilities are disproportionally affected by bullying. Indeed, the current results revealed prevalent bullying experiences reported by adults (84 %) and children (48 %) in these samples. Further, approximately 35 % of the adults who had been bullied spontaneously reported experiencing PTG (Study 1), and self-reported severity of bullying experiences exhibited a large, positive relationship with PTG in children (Study 2). Implications and future directions are discussed.