저자, Kaplan JA ; Department of Surgery, University of California San Francisco, San Francisco, California. Electronic address: [email protected]. Schecter SC ; Department of Surgery, University of California San Francisco, San Francisco, California. Rogers SJ ; Department of Surgery, University of California San Francisco, San Francisco, California. Lin MYC ; Department of Surgery, University of California San Francisco, San Francisco, California. Posselt AM ; Department of Surgery, University of California San Francisco, San Francisco, California. Carter JT ; Department of Surgery, University of California San Francisco, San Francisco, California. ; Content Provider, MEDLINE Ultimate ; 초록, Background: Patients who take chronic corticosteroids are increasingly referred for bariatric surgery. Little is known about their clinical outcomes. Objective: Determine whether chronic steroid use is associated with increased morbidity and mortality after stapled bariatric procedures. Setting: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Methods: All patients who underwent laparoscopic sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass and were reported to the ACS-NSQIP from 2011 to 2013 were reviewed. Patients were grouped based on type of surgery and history of chronic steroid use. Primary outcome measures were mortality and serious morbidity in the first 30 days. Regression analyses were used to determine predictors of outcome. Results: Of 23,798 patients who underwent laparoscopic sleeve gastrectomy and 38,184 who underwent Roux-en-Y gastric bypass, 385 (1.6%) and 430 (1.1%), respectively, were on chronic steroids. Patients on chronic steroids had a 3.4 times increased likelihood of dying within 30 days (95% confidence interval 1.4-8.1, P = .007), and 2-fold increased odds of serious complications (95% confidence interval 1.2-2.3, P = .008), regardless of surgery type. In multivariate regression, steroid usage remained an independent predictor of mortality and serious complications. Conclusion: In a large, nationally representative patient database, steroid use independently predicted mortality and serious postoperative complications after stapled bariatric procedures. Surgeons should be cautious about offering stapled bariatric procedures to patients on chronic steroids. (Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.) ; Publication Type, Journal Article
Highlights ; · Machine learning models predicted complications better than logistic regression. ; · Surgery type was the most important feature to predict complications. ; · The logistic regression model exhibited the best fairness metrics for race.
Objectives: ; Summarize the indications for bariatric surgery. ; Outline the contraindications to bariatric surgery. ; Review the complications of bariatric surgery. ; Describe the importance of collaboration and coordination amongst the interprofessional team to facilitate safe bariatric surgery to minimize complications and improve patient outcomes.
The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic an...
Major updates to 1991 National Institutes of Health guidelines for bariatric surgery
The aim of the study was to analyze the indications, results... repeated surgery. Results: Overall, amongs 103 obese patients with a BMI over 35 kg / m2, qualified for bariatric treatment...
Bariatric surgery, or metabolic and weight loss surgery, has become a widely accepted and effective therapeutic modality for individuals with severe obesity and its associated comorbidities. Obesit...
(IFSO) Indications for Metabolic and Bariatric Surgery Dan Eisenberg 1 & Scott A. Shikora 2 & Edo Aarts 3 & Ali Aminian 4 & Luigi Angrisani 5 & Ricardo V. Cohen 6 & Maurizio de Luca 7...
Recent months have brought about important changes in the indications for bariatric surgery. According to the latest International Federation for the Surgery of Obesity and Metabolic...
The guideline contains recommendations based on the scientific evidence and on a consensus of experts from multiple disciplines about the indications for bariatric surgery, the choice of procedure,...