STUDY ROUNDUP

Published in February 2014 Issue             


Metabolic Syndrome is Less Likely to Resolve in Hispanics and Non-Hispanic Blacks After Bariatric Surgery


According to a new study of more than 4,000 bariatric surgery patients in the Annals of Surgery (February), metabolic syndrome was less likely to resolve if patients had a sleeve gastrectomy, had higher BMIs at surgery, were older, were male or were either Hispanic or non-Hispanic black. Researchers concluded bariatric surgery may be most effective for younger, less obese patients who are early in the course of their cardiometabolic disease and recommend future research investigate factors that lead to lower rates of disease resolution after bariatric surgery for racial/ethnic minority groups.


Comparison of the Long-term Results of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy for Morbid Obesity: A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials


A meta-analysis of 32 studies of 6,526 patients found RYGB was more effective in resolving co-morbid conditions (type 2 diabetes, hypertension, hypercholesterolemia, gastroesophageal reflux disease and arthritis) than sleeve gastrectomy. However, sleeve gastrectomy resulted in lower complication rates, reoperations and less time in the operating room. The study was in the February edition of Surgical Laparoscopy Endoscopy & Percutaneous Techniques.


Risk Prediction of Complications of Metabolic Syndrome Before and 6-Years After Gastric Bypass


A study of 131 patients published in the online edition of SOARD (January 31) found in addition to “remarkable” control of diabetes, dyslipidemia, and hypertension after RYGB, patients with type 2 diabetes saw a “significant reduction” in predicted risk of major complications including nephropathy, retinopathy (four-year risk), and cardiovascular disease and mortality (range of 18-47%) at a median post-surgical follow-up time of six years. A diabetes remission rate of 61% was associated with a mean percent excess weight loss of 60.7 ± 25.1%. RYGB was associated with a relative risk reduction of 27% for 10-year overall risk of coronary heart disease (CHD), stroke, and peripheral vascular disease (CHD 20%, stroke 42% and myocardial infraction 40%). Four-year risk of diabetic retinopathy was also significantly decreased.


Comorbidity Resolution in Morbidly Obese Children and Adolescents Undergoing Sleeve Gastrectomy


According to a new study of children and adolescents, sleeve gastrectomy resulted in the remission or improvement of 90.3% of comorbidities (dyslipidemia, hypertension, diabetes, and obstructive sleep apnea) within two years of surgery and 64.9% within the first three months. Researchers reviewed 226 patients (mean age 14.4 ± 4.0, 50.4% females) from King Saud University-affiliated hospitals with an average BMI of 48.2 ± 10.1 kg/m2. Few complications, no mortality and normal growth were reported. The study was published online in SOARD.


Laparoscopic Sleeve Gastrectomy in Patients With Preexisting Gastroesophageal Reflux Disease


According to a study published in JAMA Surgery (February 5), LSG failed to “reliably” improve or relieve gastroesophageal reflux disease (GERD) in patients with preoperative GERD (44.5% LSG vs. 50.4% GB). Researchers examined the outcomes of 4,832 LSG and 33,867 GB patients who had surgery between January 1, 2007 and December 31, 2010. The majority of LSG patients (84.1%) continued to suffer from GERD, compared to 62.8% of bypass patients who saw complete resolution of their symptoms within six months of surgery. Of patients who did not have GERD prior to surgery, 8.6% of LSG patients developed the disease following the procedure. Among the LSG cohort, the presence of preoperative GERD was associated with increased postoperative complications (15.1% LSG vs. 10.6% GB), gastrointestinal adverse events (6.9% vs. 3.6%), and increased need for revisional surgery (0.6% vs. 0.3%).


The Effect of Dietary Counseling on Nutrient Intakes in Gastric Banding
Surgery Patients


A 23-patient study published in the Journal of Investigative Medicine (December 2013) found more than 50% of GB patients had inadequate dietary intake of 13 nutrients despite receiving dietary intervention during the 12-week period following surgery. Patients showed an overconsumption of sodium and a significant reduction in energy from saturated and trans-fatty acid, absolute protein, cholesterol, and potassium intake, and an increase in vitamin K intake. The amount of patients who did not meet the required nutrients for an additional 27 nutrients did not change and was relatively high. Study authors concluded nutritional counseling in GB patients beyond 12 weeks after surgery may help improve their dietary nutrient intakes.