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Journal Watch 09/01/2014

This week we report on papers from Clinical Endocrinology; Applied Physiology, Nutrition, and Metabolism; International Journal of Surgery Case Reports; Surgical Endoscopy and Echocardiography…

Effects of Bariatric Surgery on Pericardial Ectopic Fat Depositions and Cardiovascular function.

Published in Clinical Endocrinology, this study assessed myocardial triglyceride (TG) content, pericardial fat and cardiac function in obese, insulin-dependent type 2 diabetes patients before and 16 weeks after Roux-en-Y gastric bypass (RYGB) surgery. Ectopic fat accumulation and cardiovascular function and were assessed with MR imaging and myocardial TG content with MR spectroscopy before and 16 weeks after RYGB surgery. The results showed that surgical-induced weight loss leads to a larger decrease in paracardial than epicardial fat. Abstract

Healthy strategies for successful weight loss and weight maintenance: a systematic review.

Featured in the journal Applied Physiology, Nutrition, and Metabolism, this systematic review examined the evidence available for successful diet strategies for weight loss and weight maintenance among adults. The researchers found that for significant safe weight loss, an energy deficit was required, which was commonly achieved by reduced fat intake. Increased dietary fibre was also a component of 21% of successful interventions. Physical activity was included in 88% of successful interventions, and behaviour training such as self-monitoring was part of 92% of successful interventions. They concluded that a comprehensive approach, including reduced dietary intake, regular physical activity, and behavioural strategies, is warranted and is supported by the research evidence. Abstract

One stage laparoscopic left adrenalectomy and sleeve gastrectomy by direct supragastric approach.

Published in the International Journal of Surgery Case Reports, this paper presents a case of a sleeve gastrectomy and a left adrenalectomy by laparoscopy for a morbidly obese patient with Cushing's syndrome.

A 52 year-old male patient with a BMI53 was diagnosed as having Cushing's syndrome caused by a left adrenal tumor. Sleeve gastrectomy was performed according to the usual technique and adrenalectomy was performed at the same time by a left supragastric approach. They concluded that the approach used for the adrenalectomy proved itself to be feasible after the sleeve gastrectomy. Both procedures can be safely done in experience teams and sleeve gastrectomy facilitated the direct supragastric approach. Abstract

Learning curve and robot set-up/operative times in singly docked totally robotic Roux-en-Y Gastric bypass.

Featured in Surgical Endoscopy, the primary aim of this study was to analyse the learning curve and the times for necessary steps for singly docked totally robotic Roux–en–Y gastric bypass (RREYGB). Variables of interest for this study were patient demographics, preoperative body mass index, previous surgical history, clinically relevant perioperative events, and operative times for various steps in the procedure. Abstract

Causes of small bowel obstruction after Roux-en-Y gastric bypass: A review of 2,395 cases at a single institution.

Also published in Surgical Endoscopy, this paper shows that not every bowel obstruction after gastric bypass is related to internal hernia, other causes of bowel obstruction should be considered. Also it demonstrates that closure of all the spaces including Peterson defect will reduce the risk of bowel obstruction related to internal herniation to 1.1%. Abstract

Feasibility and prognostic value of stress echocardiography in obese, morbidly obese, and super obese patients referred for bariatric surgery.

Featured in Echocardiography, the aim of this study was to investigate the feasibility of stress echocardiography (SE) in morbidly obese patients undergoing bariatric surgery. Stress echocardiography is feasible in the morbidly obese patients. After a long-term follow-up of three years, maximum follow-up of ~nine years, these patients had a very low event rate. The researchers concluded that stress echocardiography was feasible and effective imaging modality in very morbidly obese patients preoperatively scheduled to undergo bariatric surgery. Negative predictive value of stress echocardiography is confirmed in this cohort. Abstract