Bariatric Times - February 2009 - (Page 34) 34 Journal Watch Bariatric Times • February 2009 J o u r n a l Wa t c h Recent articles in bariatric multidisciplinary health by Laura Alexander ISSUES RELATED TO THE SMALL BOWEL IN BARIATRIC SURGERY Internal hernias and nonclosure of mesenteric defects during laparoscopic Roux-en-Y gastric bypass. Madan AK, Lo Menzo E, Dhawan N, Tichansky DS. Obes Surg. 2008 Oct 17. [Epub ahead of print] Synopsis: To examine the hypothesis that not closing defects during laparoscopic Roux-en-Y gastric bypass would not result in a significant internal hernia rate, authors reviewed 54 patients who were inspected for internal hernias in a reoperation after laparoscopic Roux-enY gastric bypass (out of 387 patients total). They found no internal hernias, and conclude that routine closure of defects is unnecessary with their method of laparoscopic Roux-en-Y gastric bypass. PMID: 18931883 Gastrojejunal stomal reduction with the T-tag device in porcine models (with videos). Tang SJ, Olukoga CO, Provost DA, et al. Gastrointest Endosc. 2008;68(1):132–138. Synopsis: To evaluate feasibility, efficacy, and safety of stomal reduction with endoscopic T–tag devices, authors performed endoscopic gastrojejunal stomal reduction/revision on three newly created gastrojejunal stomas in each of two 110-pound pigs, then assessed effectiveness of stomal reduction at necropsy. They found moderate stomal reduction in the five stomas, which could be accessed by endoscopy. Authors conclude that this procedure is technically feasible and effective in twothirds of trials, but is associated with a small risk of adjacent organ/tissue injury with the current prototype device and deployment method. PMID: 18577481 Roux limb obstruction secondary to constriction at transverse mesocolon rent after laparoscopic Roux-en-Y gastric bypass. Ahmed AR, Rickards G, Messing S, et al. Surg Obes Relat Dis. 2008 Jun 6. [Epub ahead of print] Synopsis: To examine the incidence, timing, and associated weight loss of Roux limb compression, authors performed a retrospective chart review of patients who underwent laparoscopic Roux-en-Y gastric bypass then developed symptomatic small bowel obstruction requiring operative intervention. They found, among other things, that 20 patients (out of 2,215) developed symptomatic Roux limb compression on average 48 days after the bypass. Authors conclude that Roux limb obstruction occurs earlier after gastric bypass than do internal hernias, and is not associated with significant weight loss. PMID: 18539542 Use of endoscopic stents to treat anastomotic complications after bariatric surgery. Eubanks S, Edwards CA, Fearing NM, et al. J Am Coll Surg. 2008 May;206(5):935–938; discussion 938–939. Synopsis: Authors report the results of a retrospective evaluation of 19 patients treated for staple line complications after bariatric surgery using a total of 34 endoscopic, silicone-covered stents. They found that immediately after the procedure, symptoms improved for 90 percent and oral feeding commenced for 70 percent of patients. Authors conclude that treating post-bariatric anastomotic complications with endoscopic covered stents allows both rapid healing and oral nutrition. PMID: 18471727 Small bowel bypass as treatment for functional gastric obstruction. Lutrzykowski M. Obes Surg. 2008 Aug;18(8):1053–1055. Synopsis: In this case report, authors discuss two patients with a functional gastric obstruction who were successfully treated by small bowel bypass, relieving symptoms of obstruction and allowing normal food intake. PMID: 18461423 exhibited by 64 morbidly obese patients followed for three years after undergoing open biliopancreatic diversion by the Scopinaro technique. Among the results are changing percentages of deficiency over time for various micronutrients. PMID: 19088468 Nutritional and psychological considerations after bariatric surgery. Song A, Fernstrom MH. Aesthet Surg J. 2008 Mar–Apr;28(2):195–9. Synopsis: In this article, authors discuss the effects of bariatric surgery on a wide variety of nutritional issues, such as absorption of nutrients and alternations in bone metabolism, as well as psychological issues, such as mood and personality disorders and destructive eating behaviors. PMID: 19083527 Recommended nutritional supplements for bariatric surgery patients. Malone M. Ann Pharmacother. 2008 Dec;42(12):1851–1858. Epub 2008 Nov 18. Review. Synopsis: Author discusses the results of a literature search on nutritional supplements commonly required after bariatric surgery, including the role of type of surgery on the types of nutritional deficiencies that occur. PMID: 19017827 Prevention of vitamin and mineral deficiencies after bariatric surgery: evidence and algorithms. Schweitzer DH, Posthuma EF. Obes Surg 2008 Nov;18(11):1485–1488. Synopsis: Authors provide an algorithm for adequate nutrition after bariatric surgery. PMID: 18369680 PMID: 19155434 Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. Pereira MA, Jacobs DR Jr, Van Horn L, et al. JAMA 2002 Apr 24;287(16):2081–2089. Synopsis: To examine associations between dairy intake and incidence of insulin resistance syndrome, adjusting for confounding lifestyle and dietary factors, researchers used a diet history interview to follow 3,157 black and white adults ages 18 to 30 for 10 years (1985/86 to 1995/96). They found, among other things, that dairy consumption was inversely associated with the incidence of all insulin resistance syndrome components among overweight but not lean individuals. PMID: 11966382 Is higher dairy consumption associated with lower body weight and fewer metabolic disturbances? The Hoorn Study. Snijder MB, van der Heijden AA, van Dam RM, et al. Am J Clin Nutr 2007 Apr;85(4):989–95. Synopsis: To evaluate the associations of dairy consumption with body weight and other components of the metabolic syndrome, researchers assessed dairy consumption in 2,064 Dutch men and women ages 50–75 using a semiquantitative food-frequency questionnaire. They found that in this population, higher dairy consumption was not associated with lower weight or more favorable levels of components of the metabolic syndrome, except for a modest association with lower blood pressure. PMID: 17413097 Milk and the metabolic syndrome. Pfeuffer M, Schrezenmeir J. Obes Rev. 2007 Mar;8(2):109–18. Review. Synopsis: Authors discuss possible mechanisms for why diary consumption appears to be inversely associated with occurrence of metabolic disorders such as obesity and glucose intolerance, for example the contribution of dairy components, such as whey proteins and amino acids, as well as the effects of fermented products and probiotic bacteria on cholesterol. PMID: 17300277 DAIRY AND OBESITY Review of the effect of dairy products on non-lipid risk factors for cardiovascular disease. Lamarche B. J Am Coll Nutr. 2008 Dec;27(6):741S–746S. Synopsis: In this review, author discusses the effects of dairy foods and of some of their components on non-lipid cardiovascular disease risk factors, in particular blood pressure, inflammation, insulin resistance and type 2 diabetes, obesity, and the metabolic syndrome. NUTRITIONAL CONSIDERATIONS Clinical results and nutritional consequences of biliopancreatic diversion: 3 years of follow-up. de Luis DA, Pacheco D, Izaola O, et al. Ann Nutr Metab. 2008 Dec 16;53(3–4):234–239. Synopsis: Authors discuss the clinical results and nutritional complications
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.