Long-term outcomes of laparoscopic sleeve gastrectomy in Denmark from 2010 to 2016: a nationwide cohort study.

BACKGROUND: Bariatric surgery is the most effective treatment of morbid obesity and obesity-related conditions. Laparoscopic sleeve gastrectomy (LSG) has become increasingly popular in Denmark and worldwide. OBJECTIVE: To evaluate long-term outcomes including postoperative complications after LSG. SETTING: University Hospitals, Denmark. METHODS: This was a nationwide multicenter cohort study including all patients who underwent LSG during 2010 to 2016 in Denmark. Data were collected from the Danish Obesity Surgery Registry and medical records. Representatives from all public bariatric centers in Denmark registered information on demography, indication, preoperative tests, operative information, weight loss, status of co-morbidities, and early and late complications. RESULTS: In total, 541 patients were included in the study. Median follow-up was 6 years, and 536 patients (99%) were available at the end of follow-up. The patients achieved a persistent weight loss. Quality of life significantly improved after both 12 and 24 months. Overall, 3% of the patients had a major complication ≤30 days after the procedure and 3% underwent reoperation. One in 5 patients (22%) had an early minor complication. In the long term, 3% of the patients had a major complication and 24% of the patients had ≥1 minor complication. The most common surgery-related healthcare contacts addressed gastroesophageal reflux, weight recurrence, and stenosis symptoms. CONCLUSIONS: Patients after LSG achieved sufficient weight loss and improved quality of life. The procedure was safe with low risk of early and late major complications. However, there was a high frequency of early and late minor complications in 22% and 24% of the patients, respectively.

Effect and safety of endoscopic sleeve gastroplasty for treating obesity - a systematic review.

INTRODUCTION: Endoscopic sleeve gastroplasty (ESG) represents a novel endoscopic bariatric procedure. It is performed with an endoscope equipped with a suturing device; sutures are placed so that they create a tube-shaped stomach, thereby facilitating weight loss. The aim of this study was to conduct a systematic review evaluating the effectiveness and safety of ESG for treatment of obesity. METHODS: This review was conducted in accordance with the PRISMA guidelines; a protocol was registered with PROSPERO before the start of the study. MEDLINE, Embase and Clinicaltrials.gov were searched through 20 February 2020. RESULTS: A total of 1,088 articles were assessed. In all, 23 studies met the inclusion criteria. The average total weight loss at 12 months was 16.3%. ESG was associated with a significantly greater weight loss than both intragastric balloon insertion (21.3 ± 6.6 versus 13.9 ± 9.0% total weight loss (TWL) at 12 months, p less than 0.05) and "high-intensity diet and lifestyle therapy" (20.6 ± 8.3 versus 14.3 ± 10.2% TWL at 12 months, p less than 0.05). In contrast, ESG was associated with a significantly lower weight loss than laparoscopic sleeve gastrectomy (17.1 ± 6.5 versus 23.6 ± 7.6% TWL at six months, p less than 0.05). ESG had a significantly lower rate of adverse events than both laparoscopic sleeve gastrectomy (5.2 versus 16.9%, p less than 0.05) and intragastric balloon placement (5.2 versus 17%, p less than 0.05). CONCLUSIONS: ESG is a safe method for treatment of obesity and facilitates a significant weight loss.

[Life-threatening malnutrition after a laparoscopic gastric bypass operation reverting the gastrointestinal tract into normal anatomy].

We present a case report of a woman who had repeating episodes of severe life-threatening malnutrition four years after a laparoscopic gastric bypass operation for severe overweight. Despite several normal examinations her condition remained unstable. She was offered a laparoscopic operation reverting the stomach and small intestine into normal anatomy and it was performed without complications so the condition resolved. The malnutrition was probably caused by a mixture of an eating disorder and the effects of the operation influencing gut hormones. It is important to handle this category of patients in a competent multidisciplinary team.

[Recruiting medical students for the surgical education]. / Rekruttering til hoveduddannelsen i kirurgi i Danmark.

For a longer period the interest for surgical education in Denmark has been low measured in the number of junior doctors choosing a surgical career. The Danish Surgical Society has reviewed the published data describing the factors involved when selecting a surgical career.

[Treatment of pilonidal sinus]. / Behandling af pilonidal sygdom.

Surgical treatment of pilonidal sinus often leads to significant pain, extended period of wound healing and convalescence, and carries a substantial risk of recurrence. Based on extant surgical evidence, the present review suggests a differential step-up surgical strategy to optimise surgical outcome in the treatment of pilonidal sinus.