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1.
Obes Surg ; 34(2): 635-642, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38183593

RESUMO

In the context of escalating obesity rates, bariatric surgery holds a crucial role in managing severely obese patients. With a demonstrated effectiveness in weight loss and with the advent of ambulatory surgery, bariatric surgery allows for a streamlined care pathway, ideally suited for postoperative surveillance using digital health applications. The aim of this systematic review and meta-analysis is to evaluate the effect of eHealth-delivered health services or support for adults undergoing bariatric surgery. Five studies, encompassing 2210 patients, were analysed. The intervention group showed a 10% increase in total weight reduction and a 22% reduction in excess weight loss. ED visitation rates also trended towards reduction. Despite the absence of clear statistical superiority for DHA, the findings suggest potential benefits of DHA in postoperative monitoring.


Assuntos
Cirurgia Bariátrica , Avaliação de Resultados em Cuidados de Saúde , Adulto , Humanos , Obesidade Mórbida/cirurgia , Redução de Peso
2.
J Gastrointest Surg ; 28(5): 640-650, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38704201

RESUMO

BACKGROUND: Single-anastomosis metabolic/bariatric surgery procedures may lessen the incidence of anastomotic complications. This study aimed to evaluate the feasibility and safety of performing side-to-side duodenoileal (DI) bipartition using magnetic compression anastomosis (MCA). In addition, preliminary efficacy, quality of life (QoL), and distribution of food through the DI bipartition were evaluated. METHODS: Patients with a body mass index (BMI) of ≥35.0 to 50.0 kg/m2 underwent side-to-side DI bipartition with the magnet anastomosis system (MS) with sleeve gastrectomy (SG). By endoscopic positioning, a distal magnet (250 cm proximal to the ileocecal valve) and a proximal magnet (first part of the duodenum) were aligned with laparoscopic assistance to inaugurate MCA. An isotopic study assessed transit through the bipartition. RESULTS: Between March 14, 2022 to June 1, 2022, 10 patients (BMI of 44.2 ± 1.3 kg/m2) underwent side-to-side MS DI. In 9 of 10 patients, an SG was performed concurrently. The median operative time was 161.0 minutes (IQR, 108.0-236.0), and the median hospital stay was 3 days (IQR, 2-40). Paired magnets were expelled at a median of 43 days (IQR, 21-87). There was no device-related serious advanced event within 1 year. All anastomoses were patent with satisfactory diameters after magnet expulsion and at 1 year. Respective BMI, BMI reduction, and total weight loss were 28.9 ± 1.8 kg/m2, 15.2 ± 1.8 kg/m2, and 34.2% ± 4.1%, respectively. Of note, 70.0% of patients reported that they were very satisfied. The isotopic study found a median of 19.0% of the meal transited through the ileal loop. CONCLUSION: Side-to-side MCA DI bipartition with SG in adults with class II to III obesity was feasible, safe, and efficient with good QoL at 1-year follow-up. Moreover, 19% of ingested food passed directly into the ileum.


Assuntos
Anastomose Cirúrgica , Duodeno , Estudos de Viabilidade , Gastrectomia , Imãs , Humanos , Gastrectomia/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Duodeno/cirurgia , Anastomose Cirúrgica/métodos , Seguimentos , Obesidade Mórbida/cirurgia , Íleo/cirurgia , Qualidade de Vida , Laparoscopia/métodos , Índice de Massa Corporal , Duração da Cirurgia , Cirurgia Bariátrica/métodos , Resultado do Tratamento , Trânsito Gastrointestinal
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