Predicted weight loss result of laparoscopic sleeve gastrectomy: Review of the first 82 consecutive patients in an Asian bariatric unit.

BACKGROUND: Obesity is a great concern in developed countries such as Taiwan. Laparoscopic sleeve gastrectomy (LSG) is becoming a popular and stand-alone bariatric procedure. The aim of this study is to analyze the factors that affect the weight loss outcome in our patients after LSG. METHODS: Eighty-two consecutive patients who underwent LSG between Oct. 2012 and Sept. 2015 were included. Patients were asked to fill out questionnaires during first visit. The endpoint of this review was the factors affecting excess weight loss (%EWL) ≧ 50% at post-operative 12-months. RESULTS: Sixty-seven patients (81.7%) completed 12 months of post-operative follow-up. The pre-operative mean weight and height were 109.7 kg and 165.7 cm (BMI of 40.4 kg/m2). There was no surgical mortality, but 2 (2.4%) patients suffered from severe complications. The mean post-operative body weights in post-operative months 1, 3, 6 and 12 were 100.4 kg, 90.5 kg, 88.0 kg, 83.6 kg, with 18.8%, 37.1%, 57.1% and 51.2% EWL. The percentage of total weight loss (%TWL) after 12 months follow-up was 23.2%. In univariate analysis, younger patients achieved better than 50% EWL (p = 0.013). Patients who reported pre-operative alcohol consumption, without psychiatric history and without osteoarthritis showed a better trend of achieving 50% EWL. In multi-variate analysis, younger patients (p = 0.042), with pre-operative alcohol consumption (p = 0.036) and without psychiatric history (p = 0.040) significantly achieved more than 50% EWL. CONCLUSION: Younger age, pre-operative alcohol consumption and absence of psychiatric disease were positive predictor factors for successful weight loss after LSG.

Image-guided video-assisted thoracoscopic surgery for small ground glass opacities: a case series.

BACKGROUND: This case series demonstrated the feasibility of the image-guided video-assisted thoracoscopic surgery (iVATS) for localization and removal of ground glass opacities (GGOs). The procedure was performed in a hybrid operating room (OR) using C-arm cone-beam computed tomography (CBCT) equipped with a laser-guided navigation system. METHODS: Between October 1st 2016 to July 31st 2017, 14 consecutive patients presenting with GGOs underwent iVATS procedure. The efficacy and safety of the procedure were assessed through a retrospective chart review. RESULTS: The median GGOs size was 7 mm [interquartile range (IQR): 4-10 mm] with a median depth-to-size (D-S) ratio of 1.16 (IQR: 0-2.3). All of the lesions were visible on intraoperative CBCT images and localizations were successful in all patients with a median localization time of 22 min (IQR: 16-44 min). No patient required a conversion to thoracotomy. There was no operative mortality and the median length of postoperative stay was 4 days (IQR: 3-6 days). The final pathological diagnoses were as follows: primary lung cancer (n=6), lung metastases (n=2), and benign lung lesions (n=6). CONCLUSIONS: Our study suggests the iVATS could be a helpful tool for single-stage detection and removal of GGOs.