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Medicina
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Obesity and Bariatric Surgery: Challenges, Trends and Perspectives in Perioperative...
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Obesity and Bariatric Surgery: Challenges, Trends and Perspectives in Perioperative Practice

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (1 January 2022) | Viewed by 8875

Special Issue Editors

Dr. Sjaak Pouwels

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Guest Editor
1. Department of General, Abdominal Surgery and Coloproctology, Helios St. Elisabeth Klinik, Oberhausen, Germany
2. Helios Obesity Center West, Helios St. Elisabeth Hospital Oberhausen, Oberhausen, Germany
3. Faculty of Health, University of Witten/Herdecke, Witten, Germany
Interests: intensive care medicine; bariatric surgery; oncological surgery; logistics; perioperative optimalisation
Special Issues, Collections and Topics in MDPI journals
Dr. Chetan Parmar

E-Mail Website
Co-Guest Editor
Honorary Associate Professor – UCL, Consultant Bariatric Surgeon - The Whittington Hospital NHS Trust, London, UK
Interests: bariatric and metabolic surgery; one-anastomosis gastric bypass; cardiovascular effects of bariatric and metabolic surgery; SARS-CoV-2/COVID-19
Dr. Yitka Graham

E-Mail Website
Co-Guest Editor
Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
Interests: patient experience; professional roles of bariatric multidisciplinary teams; the role of social media and technology in patient support; long-term follow up; stigma of obesity
Dr. Dharmanand Ramnarain

E-Mail Website
Co-Guest Editor
Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
Interests: bariatric surgery; SARS-CoV-2/COVID-19; cardiopulmonary remodelling; diabetes physiology; gastro-intestinal hormones; post-intensive care syndrome; PICS; ICU memory recall; vitamin supplementation;, intensive care medicine

Special Issue Information

Dear Colleagues,

Obesity has a known significant impact on healthcare; currently, approximately 30% of the world’s population is classified as either overweight or obese (kg/m2). Bariatric surgery has been shown to be a longstanding treatment option that induces significant and sustained (long-term) weight-loss and comorbidity reduction. Over the last fifty years, surgical techniques have improved tremendously; procedures ranging from gastric banding to sleeve gastrectomy and one-anastomosis gastric bypass have become mainstream interventions. An increasing body of evidence has clearly demonstrated the significant effects of bariatric surgery on metabolic disorders and heart and lung diseases, reducing the overall burden of these diseases. These advances have permitted surgeons to develop tailored approaches and extend the breadth of patients who stand to benefit from bariatric and metabolic surgery.

The COVID-19 pandemic has highlighted awareness of obesity as a risk factor for developing the illness, drawing on retrospective studies from other pandemics in China, Italy, the United States of America and Spain. This creates a need to emphasise on the treatment of obesity and puts bariatric and metabolic surgery in a new light. We invite you to submit research on the challenges, trends and perspectives in perioperative practice in bariatric surgery and treatment of obesity.

Dr. Sjaak Pouwels
Dr. Chetan Parmar
Dr. Yitka Graham
Dr. Dharmanand Ramnarain
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Bariatric surgery and metabolic surgery
  • Gastro-intestinal hormones
  • Allied health professional roles
  • Post-intensive care syndrome
  • Complications
  • Vitamin supplementation
  • SARS-CoV-2/COVID-19
  • Intensive care medicine
  • Cardiopulmonary remodelling
  • Diabetes physiology

Published Papers (4 papers)

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Research

11 pages, 643 KiB  
Article
Mid-Term Outcomes of Laparoscopic Gastric Greater Curvature Plication versus Roux-en-Y Gastric Bypass: Weight Loss, Gastrointestinal Symptoms, and Health-Related Quality of Life
by Rita Gudaityte, Agne Kavaliauskaite and Almantas Maleckas
Medicina 2022, 58(1), 64; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58010064 - 31 Dec 2021
Cited by 2 | Viewed by 1536
Abstract
Background and Objectives: Laparoscopic gastric greater curvature plication (LGGCP) is considered to be less invasive, technically simpler, and less costly. Few studies have compared LGGCP to gastric bypass. The aim of this prospective study was to evaluate the mid-term outcomes of LGGCP [...] Read more.
Background and Objectives: Laparoscopic gastric greater curvature plication (LGGCP) is considered to be less invasive, technically simpler, and less costly. Few studies have compared LGGCP to gastric bypass. The aim of this prospective study was to evaluate the mid-term outcomes of LGGCP such as weight loss, gastrointestinal symptoms, and health-related quality of life (HRQoL) in comparison to laparoscopic Roux-en-Y gastric bypass (LRYGB). Materials and Methods: Between 2017 April and 2018 December, 112 patients were included in the study. Fifty patients had LGGCP, and sixty-two patients underwent LRYGB. Demographics, comorbidities, complications, percentage of excess body mass index loss (%EBMIL), gastrointestinal symptoms (GSRS questionnaire), and HRQoL (EQ-5D-3L questionnaire) were analysed. Gastrointestinal symptoms and HRQoL data are presented as the mean and median with the interquartile range (25th–75th percentile). Follow-up at 1 year and 3 year was performed. Results: The follow-up rate was 96.4% and 92.9%, 1 year and 3 year after surgery, respectively. Mean (SD) %EBMIL 1 year after surgery was 59.05 (25.34) in the LGGCP group and 82.40 (19.03) in the LRYGB group (p < 0.001) and 3 year after was 41.44 (26.74) and 75.59 (19.14), respectively (p < 0.001). The scores of all gastrointestinal symptoms measured by the GSRS questionnaire significantly decreased 3 year after both procedures, except reflux after LGGCP. Patients 3 year after LGGCP had a significantly lower abdominal pain score as compared to patients after LRYGB (1.01; 1.0 (1.0–1.0) and 1.20; 1.0 (1.0–1.33), respectively (p < 0.001); however, LGGCP resulted in significantly more GERD symptoms (1.79; 1.25 (1.0–2.5) and 1.18; 1.0 (1.0–1.0), respectively (p < 0.001)). Three years after surgery, the quality of life was significantly lower in the LGGCP group (0.762; 0.779 (0.690–0.794) and 0.898; 1.000 (0.783–1.000), respectively (p < 0.001)). Conclusions: Three years after surgery, LGGCP patients lost significantly less weight, had less abdominal pain and more reflux symptoms, and a lower quality of life as compared to LRYGB patients. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Challenges, Trends and Perspectives in Perioperative Practice)
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16 pages, 711 KiB  
Article
Bariatric Surgery: Late Outcomes in Patients Who Reduced Comorbidities at Early Follow-Up
by Rebeca Rocha de Almeida, Felipe J. Aidar, Márcia Ferreira Cândido de Souza, Victor Batista Oliveira, Joselina Luzia Menezes Oliveira, Leonardo Baumworcel, Larissa Monteiro Costa Pereira, Larissa Marina Santana Mendonça de Oliveira, Jamille Oliveira Costa, Raysa Manuelle Santos Rocha, José Augusto Soares Barreto-Filho, Eduardo Borba Neves, Alfonso López Díaz-de-Durana, José Rodrigo Santos Silva, Marcos Antonio Almeida-Santos and Antônio Carlos Sobral Sousa
Medicina 2021, 57(9), 995; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57090995 - 21 Sep 2021
Cited by 2 | Viewed by 2299
Abstract
Backgroundand Objectives: In severe obesity, a relevant weight loss can promote the reduction of comorbidities, such as systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM2). Bariatric surgery (BS) has been an essential resource in the therapy of this disease with [...] Read more.
Backgroundand Objectives: In severe obesity, a relevant weight loss can promote the reduction of comorbidities, such as systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM2). Bariatric surgery (BS) has been an essential resource in the therapy of this disease with a short-term reduction of cardiometabolic risk (CR). This study aimed to evaluate the reduction of factors associated with the CR in patients undergoing BS at a 5-year follow-up. Materials and Methods: This is a longitudinal, retrospective study carried out with patients undergoing BS by the Brazilian Public Healthcare System (PHS). Anthropometric and clinical parameters related to the CR (DM2, dyslipidemia, and SAH), quantified by the Assessment of Obesity-Related Comorbidities (AORC) score, were evaluated at the following moments: admission and preoperative and postoperative returns (3 months, 6 months, 1 to 5 years). Results: The sample had a mean age of 44.69 ± 9.49 years and were predominantly in the age group 20–29 years (34.80%) and women (72.46%). At admission to the service, 42.3% had DM2, 50.7% dyslipidemia, and 78.9% SAH. Regarding BS, the gastric bypass technique was used in 92.86% of the sample, and the waiting time for the procedure was 28.3 ± 24.4 months. In the pre- and postoperative period of 3 months, there was a significant reduction in the frequency of DM2 (p < 0.003), dyslipidemia (p < 0.000), and SAH (p < 0.000). However, at postoperative follow-up from 6 months to 5 years, there was no significant reduction in the comorbidities studied. After five years, 35.7% had total remission of DM2 and 2.9% partial remission of DM2, 44.2% had control and remission of dyslipidemia, and 19.6% of SAH (AORC score ≤ 2 for the comorbidities). Conclusion: BS promoted a reduction of the CR in the first three months after BS in severely obese PHS users. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Challenges, Trends and Perspectives in Perioperative Practice)
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9 pages, 679 KiB  
Article
Obesity May Not Be Associated with 28-Day Mortality, Duration of Invasive Mechanical Ventilation and Length of Intensive Care Unit and Hospital Stay in Critically Ill Patients with Severe Acute Respiratory Syndrome Coronavirus-2: A Retrospective Cohort Study
by Sjaak Pouwels, Dharmanand Ramnarain, Emily Aupers, Laura Rutjes-Weurding and Jos van Oers
Medicina 2021, 57(7), 674; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57070674 - 29 Jun 2021
Cited by 11 | Viewed by 1858
Abstract
Background and Objectives: The aim of this study was to investigate the association between obesity and 28-day mortality, duration of invasive mechanical ventilation and length of stay at the Intensive Care Unit (ICU) and hospital in patients admitted to the ICU for SARS-CoV-2 [...] Read more.
Background and Objectives: The aim of this study was to investigate the association between obesity and 28-day mortality, duration of invasive mechanical ventilation and length of stay at the Intensive Care Unit (ICU) and hospital in patients admitted to the ICU for SARS-CoV-2 pneumonia. Materials and Methods: This was a retrospective observational cohort study in patients admitted to the ICU for SARS-CoV-2 pneumonia, in a single Dutch center. The association between obesity (body mass index > 30 kg/m2) and 28-day mortality, duration of invasive mechanical ventilation and length of ICU and hospital stay was investigated. Results: In 121 critically ill patients, pneumonia due to SARS-CoV-2 was confirmed by RT-PCR. Forty-eight patients had obesity (33.5%). The 28-day all-cause mortality was 28.1%. Patients with obesity had no significant difference in 28-day survival in Kaplan–Meier curves (log rank p 0.545) compared with patients without obesity. Obesity made no significant contribution in a multivariate Cox regression model for prediction of 28-day mortality (p = 0.124), but age and the Sequential Organ Failure Assessment (SOFA) score were significant independent factors (p < 0.001 and 0.002, respectively). No statistically significant correlation was observed between obesity and duration of invasive mechanical ventilation and length of ICU and hospital stay. Conclusion: One-third of the patients admitted to the ICU for SARS-CoV-2 pneumonia had obesity. The present study showed no relationship between obesity and 28-day mortality, duration of invasive mechanical ventilation, ICU and hospital length of stay. Further studies are needed to substantiate these findings. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Challenges, Trends and Perspectives in Perioperative Practice)
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10 pages, 1125 KiB  
Article
Five-Year Outcomes in Bariatric Surgery Patients
by Olga Nedeljkovic-Arsenovic, Marko Banovic, Dejan Radenkovic, Nemanja Rancic, Snezana Polovina, Dragan Micic and Ivana Nedeljkovic
Medicina 2020, 56(12), 669; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56120669 - 03 Dec 2020
Cited by 6 | Viewed by 2359
Abstract
Background and objectives: Obesity presents as a multifactorial, pandemic disease that arises as a consequence of unequal energy intake and energy consumption. Obesity adversely affects the quality of life, leading not only to disability, but also to various other disorders. Bariatric surgery is [...] Read more.
Background and objectives: Obesity presents as a multifactorial, pandemic disease that arises as a consequence of unequal energy intake and energy consumption. Obesity adversely affects the quality of life, leading not only to disability, but also to various other disorders. Bariatric surgery is the most effective method for achieving significant and sustained weight loss in individuals with extreme obesity. The aim of this study was to examine how well surgically induced weight loss is maintained after five years of follow-up and its effects on cardiovascular risk factors and outcome. Materials and Methods: This is a retrospective cross-sectional study of 66 patients with morbid obesity, with body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 and obesity-related health conditions, aged 20 to 61 years, mostly women (77.3%) who underwent laparoscopic Roux-en-Y gastric bypass surgery. Results: Average follow-up was 6.42 years (95% CI 6.30–6.54 years) after surgery, with survival rate of 97% in operated individuals. There was a statistically significant reduction of weight and body mass index 6 months and 5 years after surgery in comparison to the initial values (p < 0.001). Of 62 patients who presented weight loss at the end of the follow-up period, 38 were able to maintain the amount of weight loss that was attained 6 months after surgery, while 24 patients regained weight compared to their postoperative weight at 6 months. Two patients reported no weight loss after treatment. Significant weight reduction was associated with better control of diabetes and increased self-reported physical activity at 6 months and 5 years after surgery, as well as with a reduction of the use of anti-diabetic and anti-hypertensive medications. Conclusions: Our research demonstrates a positive long-term impact of bariatric surgery on patients’ health conditions, significant and sustained weight loss, and decrease in BMI, which were associated with a reduction of co-morbidities and risk factors for cardiovascular diseases. Full article
(This article belongs to the Special Issue Obesity and Bariatric Surgery: Challenges, Trends and Perspectives in Perioperative Practice)
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