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  1. Article: Superior mesenteric artery syndrome secondary to thyrotoxicosis.

    Jacobs, Abigail / Brasileiro Silva Pacheco, Tulio / Sohail, Amir / Goparaju, Anirudha

    Journal of surgical case reports

    2022  Volume 2022, Issue 9, Page(s) rjac428

    Abstract: Superior mesenteric artery (SMA) syndrome is defined as a narrowed space and decreased angle between the SMA and aorta leading to partial or complete obstruction of the third portion of the duodenum. SMA syndrome patients may have comorbid conditions ... ...

    Abstract Superior mesenteric artery (SMA) syndrome is defined as a narrowed space and decreased angle between the SMA and aorta leading to partial or complete obstruction of the third portion of the duodenum. SMA syndrome patients may have comorbid conditions associated with extreme weight loss, hypermetabolism or malnutrition. We present the case of a 55-year-old male with SMA syndrome due to acute weight loss secondary to thyrotoxicosis. The patient was nutritionally optimized and euthyroid prior to undergoing a robotic-assisted duodenojejunostomy. In this patient, the thyrotoxicosis was controlled medically, and he remained euthyroid postoperatively. His duodenal obstruction was relieved by the operation and he continued to gain weight appropriately.
    Language English
    Publishing date 2022-09-20
    Publishing country England
    Document type Case Reports
    ZDB-ID 2580919-2
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjac428
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Superior mesenteric artery thrombosis in a patient with COVID-19 pneumonia and

    Maniar, Yesha / Hashmi, Hassan / Silverstein, Jeffrey / Chung, Christine / Kella, Venkata / Goparaju, Anirudha

    Journal of surgical case reports

    2022  Volume 2022, Issue 5, Page(s) rjac146

    Abstract: COVID-19, a novel respiratory viral illness, has spread globally and led to over 111 million cases worldwide. Most commonly, patients present with respiratory symptoms, and those with increased severity progress to acute hypoxic respiratory failure. ... ...

    Abstract COVID-19, a novel respiratory viral illness, has spread globally and led to over 111 million cases worldwide. Most commonly, patients present with respiratory symptoms, and those with increased severity progress to acute hypoxic respiratory failure. Additionally, a portion of patients are noted to have coagulopathy and are considered to be at an increased risk for thromboembolic events. In this article, we present a unique case of a patient with severe abdominal pain in the setting of COVID-19 pneumonia and community acquired
    Language English
    Publishing date 2022-05-17
    Publishing country England
    Document type Case Reports
    ZDB-ID 2580919-2
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjac146
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Predictors of Length of Hospital Stay After Reduction of Internal Hernia in Patients With a History of Roux-en-Y Gastric Bypass.

    Sohail, Amir H / Hurwitz, Joshua C / Silverstein, Jeffrey / Hakmi, Hazim / Sajan, Abin / Ye, Ivan B / Pacheco, Tulio Brasileiro Silva / Zielinski, Gregory R / Gangwani, Manesh Kumar / Petrone, Patrizio / Levine, Jun / Kella, Venkata / Brathwaite, Collin E M / Goparaju, Anirudha

    The American surgeon

    2024  Volume 90, Issue 6, Page(s) 1255–1259

    Abstract: Background: Postoperative internal hernias after Roux-en-Y gastric bypass (RYGB) have an incidence of 2%-9% and are a surgical emergency. Evidence on factors associated with length of stay (LOS) after emergent internal hernia reduction in RYGB patients ... ...

    Abstract Background: Postoperative internal hernias after Roux-en-Y gastric bypass (RYGB) have an incidence of 2%-9% and are a surgical emergency. Evidence on factors associated with length of stay (LOS) after emergent internal hernia reduction in RYGB patients is limited.
    Methods: This is a retrospective review of patients who underwent internal hernia reduction after RYGB at our tertiary care center over a 5 year period from 2015 to 2020. Demographics, comorbidities, and intra- and postoperative hospital course were collected. Univariate and multivariate linear regressions were used to investigate factors associated with LOS.
    Results: We identified 38 patients with internal hernia after RYGB. These patients with mean age 44.1 years were majority female (71.1%) and white race (60.5%). Of the 24 patients where the RYGB was done at our institution, the mean RYGB to IH interval was 43 months. Petersen's defect (57.8%) followed by jejuno-jejunal mesenteric defect (31.6%) were the most common locations for IH. Both Petersen's and jejuno-jejunal mesenteric hernias were found in 4 cases (10.5%). Revision of bypass and small bowel resection were required in 13.2% and 5.3% of cases, respectively. The median (interquartile range) length of stay (LOS) was 2 days. On the multivariate analysis, male sex (
    Conclusion: The most common location of IH after RYGB is Petersen's defect, followed by jejuno-jejunal mesenteric defect. LOS was significantly associated with male sex, exploratory laparotomy, and resection of small bowel.
    MeSH term(s) Humans ; Female ; Gastric Bypass ; Male ; Adult ; Retrospective Studies ; Length of Stay/statistics & numerical data ; Postoperative Complications/epidemiology ; Middle Aged ; Herniorrhaphy/methods ; Internal Hernia/surgery ; Internal Hernia/etiology ; Risk Factors ; Obesity, Morbid/surgery ; Obesity, Morbid/complications ; Reoperation/statistics & numerical data
    Language English
    Publishing date 2024-01-16
    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 10.1177/00031348241227215
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uk I Zs.106: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Impact of Enhanced Recovery After Surgery (ERAS) Combined with Bariatric Surgery Targeting Opioid Prescriptions (BSTOP) Protocol on Patient Outcomes, Length of Stay and Opioid Prescription After Bariatric Surgery.

    Silverstein, Jeffrey / Sohail, Amir H / Silva-Pacheco, Tulio B / Khayat, Adam / Amodu, Leo / Cherasard, Patricia / Levine, Jun / Goparaju, Anirudha / Kella, Venkata / Shahidul, Islam / Petrone, Patrizio / Brathwaite, Collin E M

    Obesity surgery

    2023  Volume 33, Issue 10, Page(s) 3206–3211

    Abstract: Background: Evidence shows that 14.2% of opioid-naive patients have long-term opioid dependence after bariatric surgery. Enhanced recovery after surgery (ERAS) protocols are widely used in bariatric surgery, while bariatric surgery targeting opioid ... ...

    Abstract Background: Evidence shows that 14.2% of opioid-naive patients have long-term opioid dependence after bariatric surgery. Enhanced recovery after surgery (ERAS) protocols are widely used in bariatric surgery, while bariatric surgery targeting opioid prescriptions (BSTOP) protocols were recently introduced. We will investigate the combined impact of ERAS and BSTOP protocols after bariatric surgery.
    Methods: We conducted a retrospective review for patients who underwent either a sleeve gastrectomy or Roux-en-Y gastric bypass at a tertiary care center. Pre-intervention and post-intervention data were compared. Primary outcomes were length of stay (LOS), 30-day readmission, 30-day complications, and discharge on opioids. Multivariate Poisson regression with robust standard error was used to analyze LOS.
    Results: There was no significant difference in 30-day emergency room visits (3.3% vs. 4.0%; p value = 0.631), 30-day readmission (4.4% vs. 5.4%; p value = 0.577) or 30-day complication rate (4.2% vs. 6.4%; p value = 0.199). LOS was significantly lower in the post-intervention group; mean (interquartile range) 2 (1-2) days vs. 1 (1-2) day, p value < 0.001. On multivariate analysis, the post-intervention group had 0.74 (95% confidence interval 0.65-0.85; p value < 0.001) times lower LOS as compared to pre-intervention group. Patients with DM had a significantly longer LOS (relative risk: 1.22; p = 0.018). No other covariates were associated with LOS (p value < 0.05 for all). BSTOP analysis found a significant difference between the two groups. Discharge on opioids decreased from 40.6% pre-intervention to 7.1% post-intervention.
    Conclusion: ERAS and BSTOP protocols reduced length of stay and opioid need at discharge without an increase in complication or readmission rates.
    MeSH term(s) Humans ; Analgesics, Opioid/therapeutic use ; Enhanced Recovery After Surgery ; Length of Stay ; Obesity, Morbid/surgery ; Bariatric Surgery ; Prescriptions
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2023-08-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-023-06794-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3381: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. 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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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5183: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 310: Show issues

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