| 1. |
- Maret-Ouda, John, et al.
(författare)
-
Esophageal adenocarcinoma after obesity surgery in a population-based cohort study
- 2015
-
Ingår i: Surgery for Obesity and Related Diseases. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 1550-7289. ; 13:1, s. 28-34
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Obesity is strongly associated with esophageal adenocarcinoma (EAC), yet whether weight loss reduces the risk of EAC is unclear. Objectives: To test the hypothesis that the risk of EAC decreases following weight reduction achieved by obesity surgery. Setting: Nationwide register-based cohort study. Methods: This study included a majority of individuals who underwent obesity surgery in Sweden in 1980-2012. The incidence of EAC following obesity surgery was compared to the incidence in the corresponding background population of Sweden by means of calculation of standardized incidence ratios (SIRs) with 95% confidence intervals (CIs). The risk of EAC after obesity surgery was also compared with the risk in non-operated obese individuals by means of multivariable Cox regression, providing hazard ratios (HRs) with 95% CIs, adjusted for potential confounders. Results: Among 34,437 study participants undergoing obesity surgery and 239,775 person- 15" years of follow-up, 8 cases of EAC occurred (SIR 1.6, 95% CI 0.7-3.2). No clear trend of decreased SIRs was seen in relation to increased follow-up time after surgery. The SIR of EACs (n=53) among 123,695 non-operated obese individuals (673,238 person-years) was increased to a similar extent as in the obesity surgery cohort (SIR=1.9, 95% CI 1.4-2.5). Cox regression showed no difference in risk of EAC between operated and non-operated participants (adjusted HR=0.9, 95% CI 0.4-1.9). Conclusions: The risk of EAC might not decrease following obesity surgery, but even larger studies with longer follow-up are needed to establish this association.
|
|
| 2. |
- Al-Tai, Saif, 1978-, et al.
(författare)
-
The impact of the bougie size and the extent of antral resection on weight-loss and postoperative complications following sleeve gastrectomy : results from the Scandinavian Obesity Surgery Registry
- 2024
-
Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 20:2, s. 139-145
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The optimal sleeve diameter and distance from the pylorus to the edge of the resection line in laparoscopic sleeve gastrectomy (LSG) remain controversial.OBJECTIVES: To evaluate the influence of bougie size and antral resection distance from the pylorus on postoperative complications and weight-loss results in LSG.SETTING: Nationwide registry-based study.METHODS: This study included all LSGs performed in Sweden between 2012 and 2019. Data were obtained from the Scandinavian Obesity Surgery Registry. Reference bougie size of 35-36 Fr and an antral resection distance of 5 cm from the pylorus were compared to narrower bougie size (30-32 Fr), shorter distances (1-4 cm), and extended distances (6-8 cm) from the pylorus in assessing postoperative complications and weight loss as the outcomes of LSG. RESULTS: The study included 9,360 patients with postoperative follow-up rates of 96%, 79%, and 50% at 30 days, 1 year, and 2 years, respectively. Narrow bougie and short antral resection distance from the pylorus were significantly associated with increased postoperative weight loss. Bougie size was not associated with increased early or late complications. However, short antral resection distance was associated with high risk of overall early complications [odds ratio: 1.46 (1.17-1.82, P = .001)], although no impact on late complications at 1 and 2 years was observed.CONCLUSIONS: Using a narrow bougie and initiating resection closer to the pylorus were associated with greater maximum weight loss. Although a closer resection to the pylorus was associated with an increased risk of early postoperative complications, no association was observed with the use of narrow bougie for LSG.
|
|
| 3. |
|
|
| 4. |
- Axer, Stephan, 1971-, et al.
(författare)
-
Predictive factors of complications in revisional gastric bypass surgery : results from the Scandinavian Obesity Surgery Registry
- 2019
-
Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 15:12, s. 2094-2100
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Roux-en-Y gastric bypass is the most common procedure for revisional bariatric surgery. This study is an analysis of revisional gastric bypass operations (rGBP) compared with primary gastric bypass (pGBP) performed in Sweden between 2007 and 2016.Objective: The aim was to compare the incidence of adverse events in primary and revisional gastric bypass surgery and to identify predictive factors of intraoperative, early, and late complications in revisional gastric bypass surgery.Setting: Forty-four hospitals.Methods: Registered study from the Scandinavian Obesity Surgery Registry. The study group (rGBP) comprised 1795 patients, and the control group (pGBP) comprised 46,055 patients.Results: Median follow-up time was 28 months. The rate of open procedures was significantly higher in the rGBP group (39.1% versus 2.4%; P < .001) decreasing from 70.8% in 2007 to 8.5% in 2016. Intraoperative complications (15.5% versus 3.0%, P < .001), early complications (24.6% versus 8.7%; P < .001), and late complications (17.7% versus 8.7%; P < .001) occurred more often in the rGBP group. Open access in revisional surgery was an independent risk factor for intraoperative complications (odds ratio 3.87; 95% confidence interval: 2.69-5.57, P < .001), early complications (odds ratio 2.08; 95% confidence interval: 1.53-2.83, P < .001), and late complications (odds ratio 1.91; 95% confidence interval: 1.31-2.78, P = .001). Indication for revision or type of index operation were not associated with complications.Conclusion: RGBP was associated with a higher incidence of intraoperative, early, and late complications compared with pGBP. Open access in revisional surgery was predictive of complications regardless of the index operation or indication for revision.
|
|
| 5. |
- Axer, Stephan, 1971-, et al.
(författare)
-
Weight loss and alterations in co-morbidities after revisional gastric bypass : A case-matched study from the Scandinavian Obesity Surgery Registry
- 2017
-
Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 13:5, s. 796-800
-
Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden, Roux-en-Y gastric bypass is the most common procedure when revising a previous bariatric procedure. This study is an analysis of all revisional gastric bypass operations (rGBP) compared with a matched group of primary gastric bypass (pGBP) operated between 2007 and 2012.Objective: The aim was to determine whether improvement of obesity-related co-morbidity and changes in weight after revisional gastric bypass surgery were comparable with those seen after primary surgery.Setting: 44 hospitals in SwedenMethods: Retrospective data were retrieved from the Scandinavian Obesity Surgery Registry. The study group (rGBP) comprised 1224 patients, and the control group (pGBP) comprised 3612 patients matched for age and gender.Results: The indication for revision was weight failure in 512 patients (42%), a late complication of the initial procedure in 330 patients (27%), and a combination of weight failure and complication in 303 patients (25%). A total of 66% of patients in the rGBP group and 67% in the pGBP group completed the 2-year follow-up in the Scandinavian Obesity Surgery Registry.The rGBP-group had significantly less excess BMI loss (%EBMIL, 59.4 +/- 147.0 versus 79.5 +/- 24.7, P < .001) and a lower dyslipidemia remission rate (42.9% versus 62.0%, P = .005) at the time of the 2-year follow-up. Remission rates of sleep apnea, hypertension, type 2 diabetes, and depression were similar. The effects on obesity-related co-morbidity were not related to the indication for revisional surgery or the initial bariatric procedure.Conclusion: Even if weight results might be inferior compared with primary bypass procedures, the improvement of co-morbidity is similar. (C) 2017 American Society for Metabolic and Bariatric Surgery. All right reserved
|
|
| 6. |
- Beamish, A. J., et al.
(författare)
-
Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y in adolescents
- 2023
-
Ingår i: Surgery for Obesity and Related Diseases. - : ELSEVIER SCIENCE INC. - 1550-7289 .- 1878-7533. ; 19:10, s. 1154-1161
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Roux-en-Y gastric bypass (RYGB) among adolescents with obesity results in signif-icant weight loss; however, depot-specific changes have been understudied.Objective: We hypothesized that visceral adipose tissue (VAT) reduction in adolescents undergoing RYGB would be greater than other depots and associated with improvement in cardiometabolic risk factors.Setting: Three specialized treatment centers in Sweden. Methods: Fifty-nine adolescents underwent dual x-ray absorptiometry before surgery and at 1, 2, and 5 years after RYGB. Changes in body composition in multiple depots (total fat, lean body, gynoid fat, android fat, subcutaneous adipose tissue, and VAT) and cardiometabolic risk factors were assessed using multiple linear regression analysis and generalized estimating equations adjusting for age, sex, and baseline risk factor levels. Data are presented as percent change (95% CI) with regression models showing slopes and estimated P values.Results: At 1 year post-RYGB, a significant reduction was observed across all body composition measures (P , .001) with the greatest reduction observed in VAT (-65.1% [-68.7, -61.8]). From year 1 to 5 years post-RYGB, a regain was observed in all depots except lean body mass (1.2% [.3, 2.7], P 5 .105). A sex-specific difference in overall trajectories was only observed in lean body mass with males consistently having higher mean levels. Change in VAT at 1 year correlated with change in triglycerides (slope: .21 mg/dL/kg, P = .034) and fasting plasma insulin (slope: 44 pmol/L/kg, P = .027). Conclusions: Adiposity measures all decreased after RYGB but poorly predicted change in cardio-metabolic risk. Despite significant reductions at 1 year, a steady regain was observed out to 5 years, with values still well below baseline. Further research should consider control group comparison and extended follow-up.
|
|
| 7. |
|
|
| 8. |
- Biörserud, Christina, et al.
(författare)
-
Experience of excess skin after gastric bypass or duodenal switch in patients with super obesity.
- 2014
-
Ingår i: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. - : Elsevier BV. - 1878-7533. ; 10:5, s. 891-896
-
Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about the patient's experience of excess skin after bariatric surgery in patients with body mass index, (BMI)>50 kg/m(2). The objective of this study was to evaluate experience of excess skin after laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) or laparoscopic Roux-en-Y gastric bypass (LRYGB) and explore possible gender differences. Another aim was to analyze possible correlation between the reported experiences of excess skin with changes in weight, BMI, and hip and waist circumference after surgery.
|
|
| 9. |
- Brissman, M., et al.
(författare)
-
High estimated prevalence of bariatric surgery in young adults treated for pediatric obesity
- 2021
-
Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier BV. - 1550-7289. ; 17:2, s. 398-405
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the modest effects of behavioral treatment on obesity in adolescence, bariatric surgery is rarely performed. Obesity often persists from childhood to adulthood, but it is not known how many individuals proceed with bariatric surgery in young adulthood. Objective: The aim of this study was to determine what proportion of individuals who received pediatric behavioral obesity treatment subsequently underwent bariatric surgery in early adulthood, and to identify predictors thereof. Setting: National registries, Sweden. Methods: In this prospective cohort study, the Swedish Childhood Obesity Treatment Register was linked to several national registers. Results: The childhood obesity cohort included 6502 (45% females) with a median age at follow-up of 21.7 years (interquartile range [IQR] 5.2). Of these, 8.2% underwent bariatric surgery at a median age of 20.9 years (IQR 4.2). The estimated cumulative incidence of bariatric surgery at age 30 was 21.5%. Obesity-related co-morbidities were identified in 31.7% before bariatric surgery in the childhood obesity cohort. Predictors of bariatric surgery were female sex, high body mass index standard deviation score (BMI SDS) at the start and end of treatment, poor treatment response, as well as own or parental cardiometabolic disease. Conclusions: More than a fifth are estimated to undergo bariatric surgery in early adulthood, despite having received pediatric behavioral obesity treatment. Our results indicate that for many children, behavioral treatment is insufficient in reducing obesity and preventing obesity-related co-morbidity. Therefore, it is reasonable to assume that more effective treatment of adolescents with severe obesity, including more rigorous behavioral support and pharmacologic treatment, but also more frequent use of bariatric surgery, would benefit this group of patients. © 2020 American Society for Bariatric Surgery
|
|
| 10. |
- Bruze, Gustaf, et al.
(författare)
-
Hospital admission after gastric bypass : a nationwide cohort study with up to 6 years follow-up.
- 2017
-
Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 13:6, s. 962-969
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several studies have addressed short-term admission rates after bariatric surgery. However, studies on long-term admission rates are few and population based studies are even scarcer.OBJECTIVE: The aim of this study was to assess short- and long-term admission rates for gastrointestinal surgery after gastric bypass in Sweden compared with admission rates in the general population.SETTING: Swedish healthcare system.METHODS: The surgery cohort consisted of adults with body mass index≥35 identified in the Scandinavian Obesity Surgery Registry (n = 28,331; mean age 41 years; 76% women; Roux-en-Y gastric bypass performed 2007-2012). For each individual, up to 10 comparators from the general population were matched on birth year, sex, and place of residence (n = 274,513). The primary outcome was inpatient admissions due to gastrointestinal surgery retrieved from the National Patient Register through December 31, 2014. Conditional hazard ratios (HR) were estimated using Cox regression.RESULTS: All-cause admission rates were 6.5%, 21.4%, and 65.9% during 30 days, 1 year, and 6 years after surgery, respectively. The corresponding rates for gastrointestinal surgery were 1.8%, 6.8%, and 24.4%. Compared with that of the general population, there was an increased risk of all-cause hospital admission at 1 year (HR 2.6 [2.5-2.6]) and 6 years (HR 2.7 [2.6-2.7]). The risk of hospital admission for any gastrointestinal surgical procedure was greatly increased throughout the study period (HR 8.6 [8.4-8.9]). Female sex, psychiatric disease, and low education were risk factors.CONCLUSION: We found a significant risk of admission to hospital over>6 years after gastric bypass surgery.
|
|
