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  1. Article ; Online: Safety of Bariatric Surgery in Patients With Congestive Heart Failure: Results of an 11-Year Retrospective Study.

    Brathwaite, Barbara M / Howell, Raelina S / Petrone, Patrizio / Brathwaite, Collin E M

    The American surgeon

    2021  Volume 88, Issue 6, Page(s) 1195–1200

    Abstract: Introduction: Congestive heart failure (CHF) is a known risk factor for increased postoperative morbidity. However, the safety in patients with CHF has not been well established. The objective of this study was to assess the safety of surgery in ... ...

    Abstract Introduction: Congestive heart failure (CHF) is a known risk factor for increased postoperative morbidity. However, the safety in patients with CHF has not been well established. The objective of this study was to assess the safety of surgery in patients with a history of CHF undergoing bariatric surgical procedures.
    Methods: Retrospective review of a prospectively maintained Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center of Excellence database. Patients with known CHF undergoing bariatric procedures over an 11-year period were reviewed.
    Results: Over the 11-year period, 4470 total bariatric surgeries were performed, of which 41 (.92%) patients had known CHF. Twenty-one patients were men (51.2%) with a mean age of 55.8 years and mean body mass index (BMI) of 51.9. Comorbidities included hypertension (87.8%), obstructive sleep apnea (80.5%), osteoarthritis (63.4%), gastroesophageal reflux disease (56%), and diabetes (53.7%). Surgical procedures included 16 sleeve gastrectomies (SGs) (39%), 11 Roux-en-Y gastric bypasses (RYGBs) (26.8%), 10 laparoscopic adjustable gastric bands (LAGBs) (24.4%), 1 removal of a gastric band and conversion to SG (2.4%), 1 removal of a gastric band to RYGB (2.4%), 1 gastric band over RYGB pouch (2.4%), and 1 gastric band replacement (2.4%). All cases were performed minimally invasively (73.2% laparoscopic and 26.8% robotic). Mean LOS was 2.53 days. Thirty-day complications included 2 readmissions (4.9% [1 small bowel obstruction and 1 pulmonary edema]), 1 reoperation (2.4% [small bowel obstruction]), and 1 mortality (2.4%) on postoperative day 30 unrelated to the surgery.
    Conclusions: Bariatric surgery can be performed safely in patients with CHF.
    MeSH term(s) Bariatric Surgery/adverse effects ; Bariatric Surgery/methods ; Female ; Gastrectomy/methods ; Gastric Bypass/adverse effects ; Heart Failure/complications ; Heart Failure/surgery ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Obesity, Morbid/complications ; Obesity, Morbid/surgery ; Postoperative Complications/etiology ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2021-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/0003134821991975
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Outcomes of Bariatric Surgery: Patients with Body Mass Index 60 or Greater.

    Howell, Raelina S / Liu, Helen H / Boinpally, Harika / Akerman, Meredith / Carruthers, Elizabeth / Brathwaite, Barbara M / Petrone, Patrizio / Brathwaite, Collin E M

    JSLS : Journal of the Society of Laparoendoscopic Surgeons

    2021  Volume 25, Issue 2

    Abstract: Introduction: Perioperative outcomes of bariatric surgery in patients with super super obesity (SSO) (BMI ≥ 60 kg/m: Methods: A retrospective review was conducted of patients with SSO who underwent surgery from Jun 2005 through Jun 2018 at a ... ...

    Abstract Introduction: Perioperative outcomes of bariatric surgery in patients with super super obesity (SSO) (BMI ≥ 60 kg/m
    Methods: A retrospective review was conducted of patients with SSO who underwent surgery from Jun 2005 through Jun 2018 at a Metabolic and Bariatric Surgery Center of Excellence. Quantitative demographic data was summarized using descriptive statistics; categorical variables were compared using Fisher's exact test.
    Results: Two hundred fourteen procedures were performed, of which 208 were eligible for inclusion. Majority were female (65.4%). The mean age and BMI was 43 (17-68 years) and 65.9 kg/m
    Conclusion: Bariatric surgery is feasible in patients with SSO. Revision procedures may increase risk of operative complications.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bariatric Surgery/methods ; Bariatric Surgery/statistics & numerical data ; Body Mass Index ; Comorbidity ; Feasibility Studies ; Female ; Gastrectomy/methods ; Gastrectomy/statistics & numerical data ; Gastric Bypass/methods ; Gastric Bypass/statistics & numerical data ; Humans ; Laparoscopy/methods ; Laparoscopy/statistics & numerical data ; Male ; Middle Aged ; Obesity, Morbid/physiopathology ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Reoperation/methods ; Reoperation/statistics & numerical data ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2021-05-10
    Publishing country United States
    Document type Evaluation Study ; Journal Article
    ZDB-ID 2011211-7
    ISSN 1938-3797 ; 1086-8089
    ISSN (online) 1938-3797
    ISSN 1086-8089
    DOI 10.4293/JSLS.2020.00089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Gastric Banding with Previous Roux-en-Y Gastric Bypass (Band over Pouch): Not Worth the Weight.

    Sohail, Amir H / Howell, Raelina S / Brathwaite, Barbara M / Silverstein, Jeffrey / Amodu, Leo / Cherasard, Patricia / Petrone, Patrizio / Goparaju, Anirudha / Levine, Jun / Kella, Venkata / Brathwaite, Collin E M

    JSLS : Journal of the Society of Laparoendoscopic Surgeons

    2022  Volume 26, Issue 2

    Abstract: Background and objectives: Revisional bariatric surgery continues to increase. Laparoscopic adjustable gastric banding (LAGB) after previous Roux-en-Y gastric bypass (RYGB), known colloquially as "band-overpouch" has become an option despite a dearth of ...

    Abstract Background and objectives: Revisional bariatric surgery continues to increase. Laparoscopic adjustable gastric banding (LAGB) after previous Roux-en-Y gastric bypass (RYGB), known colloquially as "band-overpouch" has become an option despite a dearth of critically analyzed long-term data.
    Methods: Our prospectively maintained database was retrospectively reviewed for patients who underwent band-overpouch at our Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Center of Excellence in a 18-year period ending October 31, 2021. We evaluated: demographics, comorbidities, operative procedures, and outcomes (30-day and > 30-day).
    Results: During the study period, of 4,614 bariatric procedures performed, 42 were band-overpouch with 39 (93%) being women. Overall, mean age was 49.8 years (range 26-75), a mean weight 251 pounds (range 141-447), and mean body mass index 42.4 (range 26-62). Comorbidities included: hypertension (n = 31; 74%), diabetes (n = 27; 64%), obstructive sleep apnea (n = 26; 62%), gastroesophageal reflux disease (n = 26; 62%), and osteoarthritis (n = 25; 60%). All procedures were performed laparoscopically with no conversions to open. Mean length of stay was 1.2 days (range 1-3). Mean follow-up time was 4.2 years (range 0.5-11). Mean excess weight loss was 14.9%, 24.3%, and 28.2% at 6 months, 1 year and ≥ 3 years, respectively. There was one 30-day trocar-site hematoma requiring transfusion. Long-term events included: 1-year (1 endoscopy for retained food; 1 internal hernia), 3-year (1 LAGB erosion; 1 LAGB explant), 4-year (1 anastomotic ulcer), 6-year (1 LAGB explant and Roux-en-Y revision), and 8-year (1 LAGB erosion). One 5-year mortality occurred (2.4%), in association with hospitalization for chronic illness and malnutrition. Band erosions were successfully treated surgically without replacement.
    Conclusion: Band-overpouch is associated with moderate excess weight loss and has good short-term safety outcomes.
    MeSH term(s) Adult ; Aged ; Body Mass Index ; Female ; Gastric Bypass/methods ; Gastroplasty/adverse effects ; Gastroplasty/methods ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Reoperation/methods ; Retrospective Studies ; Treatment Outcome ; Weight Loss
    Language English
    Publishing date 2022-06-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2011211-7
    ISSN 1938-3797 ; 1086-8089
    ISSN (online) 1938-3797
    ISSN 1086-8089
    DOI 10.4293/JSLS.2022.00010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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