Bariatric Times - January 2009 - (Page 31)

Bariatric Times • January 2009 Journal Watch 31 J o u r n a l Wa t c h by Laura Alexander Recent articles in bariatric multidisciplinary health Obesity surgery: evidence for diabetes prevention/management. Cummings S, Apovian CM, Khaodhiar L. J Am Diet Assoc 2008 Apr;108(4 Suppl 1):S40–4. Review. Synopsis: Authors summarize the evidence of the effect of surgical weight loss interventions on the treatment of type 2 diabetes. PMID: 18358255 Laparoscopic duodenal-jejunal exclusion in the treatment of type 2 diabetes mellitus in patients with BMI<30kg/m2 (LBMI). Ramos AC, Galvão Neto MP, de Souza YM, et al. Obes Surg 2008 Nov 6. [Epub ahead of print] Synopsis: In this study, researchers evaluated BMI, fasting glycemia, glycosylated hemoglobin, and C-peptide before and 3 and 6 months after laparoscopic duodenal-jejunal exclusion in 29 diabetic patients. They found decrease in BMI up to the third month, stabilization of weight and increase in C-peptide between the third and sixth months, and reduction in fasting glycemia and hemoglobin up to the sixth month, with only two of the patients remaining on oral medication after the sixth month. PMID: 18987919 Peripheral nerve blocks for anaesthesia and postoperative analgesia. Grossi P, Urmey WF. Curr Opin Anaesthesiol 2003 Oct;16(5):493–501. Synopsis: In this article, authors review the use of peripheral nerve blocks for perioperative treatment of unilateral surgery, including insertion sites, new techniques and devices, patient-controlled analgesia, and complications. PMID: 17021502 Making it work: setting up a regional anesthesia program that provides value. Mariano ER. Anesthesiol Clin 2008 Dec;26(4):681–92, vi. Synopsis: Author discusses how to set up a regional anesthesia program to provide peripheral nerve blocks. PMID: 19041623 Synopsis: In this retrospective cohort study, researchers evaluated 126 postbariatric panniculectomies performed over three years (96% female, mean 42 +/- 12 years old) and present resulting data on complications. They found, among other things, that 40% of the patients experienced a complication, and that only pre-panniculectomy BMI was an independent predictor for developing a postoperative complication. PMID: 17434356 Correlation of complications of body contouring surgery with increasing body mass index. Au K, Hazard SW 3rd, Dyer AM, et al. Aesthet Surg J 2008 Jul–Aug;28(4):425–9. Synopsis: Authors retrospectively reviewed the charts of 129 patients who underwent a single body contouring procedure to evaluate complication rates across all weight groups and identify predictors of poor outcomes/complications to help guide patient selection. They found, among other things, that the percentage of complications increased as weight category increased, and obese, morbidly obese and severely morbidly obese patients were more likely to experience complications than patients in the ideal weight group. PMID: 19083557 Implications of weight loss method in body contouring outcomes. Gusenoff JA, Coon D, Rubin JP. Plast Reconstr Surg 2009 Jan;123(1):373–6. Synopsis: To determine whether complications after body contouring vary by weight loss method, researchers prospectively analyzed 34 pairs of patients who lost weight either by diet and exercise or by bariatric surgery and were then matched one-to-one based on sex, age and BMI. No evidence was found for an association between weight loss method and risk in the body contouring patient, although infection rates were higher in the diet and exercise patients while bariatric patients had lower nutrition markers. PMID: 19116575 BARIATRIC SURGERY AND TYPE 2 DIABETES Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause. Taylor R. Diabetologia 2008 Oct;51(10):1781–9. Epub 2008 Aug 26. Review. Synopsis: In this article, the author describes in depth how bariatric surgery can reverse the metabolic abnormalities of type 2 diabetes. PMID: 18726585 Bariatric surgery, safety and type 2 diabetes. Spanakis E, Gragnoli C. Obes Surg 2008 Oct 2. [Epub ahead of print] Synopsis: In this review, authors introduce types of bariatric surgery along with their safety profiles, effects on type 2 diabetes, and potential mechanisms by which they may bring about the remission of type 2 diabetes. They also discuss whether bariatric surgery might be used as a treatment for type 2 diabetes in pregnant women, children, adolescents, and older individuals. PMID: 18830788 Remission of diabetes after laparoscopic gastric bypass. Smith BR, Hinojosa MW, Reavis KM, Nguyen NT. Am Surg 2008 Oct;74(10):948–52. Synopsis: Researchers evaluated the clinical outcome of 59 morbidly obese patients with diabetes who underwent laparoscopic Roux-en-Y gastric bypass. Among other things, they found that 25 patients showed improvement in their diabetes and 34 patients had remission of diabetes, and that the patients with remission had a shorter length of condition (43 months) compared to those with only improvement (103 months). They conclude that weight loss associated with laparoscopic gastric bypass improves diabetes control and results in discontinuation or reduction of antidiabetic medications, and that improvement in glucose control occurs as early as one month postoperatively. PMID: 18942620 BODY CONTOURING Body contouring surgery following bariatric surgery and dietetically induced massive weight reduction: A risk analysis. de Kerviler S, Hüsler R, Banic A, Constantinescu MA. Obes Surg 2008 Aug 27. [Epub ahead of print] Synopsis: To evaluate the effect of method of weight loss and pre-, intraand postoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction, researchers retrospectively analyzed 104 patients (87 female, mean 47.9 years old) who lost weight via bariatric surgery (n=62) or dietetically (n=42). They found, among other things, that 94.2% of the dietetic group achieved excess body mass index loss compared to 80.8% of the surgery group, but method of weight loss did not affect risk for complications from body contouring. PMID: 18751762 Post-bariatric panniculectomy: prepanniculectomy BMI impacts the complication profile. Arthurs ZM, Cuadrado D, Sohn V, et al. Am J Surg 2007 May;193(5):567–70; discussion 570. REGIONAL ANESTHESIA AND THE OBESE PATIENT Regional anesthesia and obesity. Brodsky JB, Lemmens HJ. Obes Surg 2007 Sep;17(9):1146–9. Review. Synopsis: Authors discuss the benefits and application of regional anesthetic techniques in the treatment of obese patients. PMID: 18074486 Patient comfort during regional anesthesia. Hu P, Harmon D, Frizelle H. J Clin Anesth 2007 Feb;19(1):67–74. Review. Synopsis: Authors discuss the advantages of using regional anesthetic techniques, drug combinations and adjunct measures, then provide a framework for patient comfort. PMID: 17321932

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Bariatric Times - January 2009 Surgical Perspective Psychological Perspective Metabolic Perspective Editorial Message Table of Contents Editorial Board Anesthesiology Perspective Body Contouring Perspective Journal Watch Advertiser Index News & Trends

Bariatric Times - January 2009

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