Comment on: High acquisition rate and internal validity in the Scandinavian Obesity Surgery Registry (SOReg)
The general practice of any modern medical specialty is rooted in evidence-based principles shaped by research. The discipline of metabolic and bariatric surgery is no exception. An abundant number of studies in our field utilize data from large and accessible registries to guide clinical management, quality improvement, asset allocation, and healthcare policy. Research evaluating the validity and methodological challenges of these data repositories, however, remain scarce.
Dan AG
Surgery For Obesity And Related Diseases
2021
2021-02-20
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Journal Article
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Access to Bariatric Surgery--Knocking Down Barriers ONE DAY AT A TIME!
BARIATRIC surgery; OPERATIVE surgery; GASTRIC bypass; MEDICAL care costs; SLEEVE gastrectomy; SLEEP apnea syndromes
Dan A
Bariatric Times
2021
2021-07
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<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
Who were the giants we lost in 2020?
BARIATRIC surgery; GASTRIC bypass; COVID-19 treatment; INTRA-abdominal hypertension; SLEEVE gastrectomy
Among them were Dr. Harvey Sugerman, Dr. Nicola Scopinaro, and the father of bariatric surgery, Dr. Edward Mason. It is fascinating to know that his interest in bariatric surgery started after he read Edward Mason's fi rst article on gastric bypass surgery for the treatment of obesity in 1967. Patients scheduled for bariatric surgery (surgical group) and patients on the surgery waiting list (control group) were prospectively assessed and were similar at baseline. In 2005, while I was a surgery fellow at the Cleveland Clinic, we hosted a large obesity surgery symposium. [Extracted from the article]
Dan A
Bariatric Times
2021
2021-04
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Full acceptance of bariatric surgery? ... Let's face reality and demand better evidence!
BARIATRIC surgery; MEDICAL personnel; GASTRIC bypass; CAROTID endarterectomy; EVIDENCE
Dan A
Bariatric Times
2021
2021-01
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A Structured Approach for Safely Reintroducing Bariatric Surgery in a COVID-19 Environment.
Humans; Male; Adult; Female; Risk Factors; Cohort Studies; Middle Aged; Clinical Protocols; Patient Selection; Bariatric Surgery; Pneumonia; Safety; Complications; COVID-19; Bariatric surgery; Betacoronavirus; Coronavirus; Coronavirus Infections/epidemiology/prevention & control; Infection Control/organization & administration; Obesity Morbid/complications/surgery; Pandemics/prevention & control; Pneumonia Viral/epidemiology/prevention & control
Due to the profound effect of novel coronavirus disease 2019 (COVID-19) on healthcare systems, surgical programs across the country have paused surgical operations and have been utilizing virtual visits to help maintain public safety. For those who treat obesity, the importance of bariatric surgery has never been more clear. Emerging studies continue to identify obesity and several other obesity-related comorbid conditions as major risk factors for a more severe COVID-19 disease course. However, this also suggests that patients seeking bariatric surgery are inherently at risk of suffering severe complications if they were to contract COVID-19 in the perioperative period. The aim of this protocol is to utilize careful analysis of existing risk stratification for bariatric patients, novel COVID-19-related data, and consensus opinion from multiple academic bariatric centers within our organization to help guide the reanimation of our programs when appropriate and to use this template to prospectively study this risk-stratified population in real time. The core principles of this protocol can be applied to any surgical specialty.
Daigle CR; Augustin T; Wilson R; Schulz K; Fathalizadeh A; Laktash A; Bauman M; Bencsath KP; Cha W; Rodriguez J; Aminian A
Obesity Surgery
2020
2020-10
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journalArticle
<a href="http://doi.org/10.1007/s11695-020-04733-8" target="_blank" rel="noreferrer noopener">10.1007/s11695-020-04733-8</a>
Pharmacotherapy for Obesity-Trends Using a Population Level National Database.
Obesity; Weight loss; Morbid obesity; Anti-obesity drugs; Bariatric surgery
BACKGROUND: Despite the growing trend of obesity, the utilization of anti-obesity therapeutic interventions is not robust in the USA. We aimed to analyze the trends of anti-obesity pharmacotherapy using a population level database. METHODS: We used an electronic health record-derived database (Explorys, IBM Watson Health) to identify adults with obesity (body mass index ≥ 30 kg/m(2)), 2010-2019. Annual rates of anti-obesity pharmacotherapy were analyzed. To assess post-bariatric utilization of these medications, the trend of adults with morbid obesity (BMI ≥ 40 kg/m (2)) who were newly started on anti-obesity medications after sleeve gastrectomy was also analyzed. RESULTS: Among 11,195,020 adults with obesity, 274,160 (2.4%) were prescribed anti-obesity medications during the study period with an increase from 1.1% in 2010 to 2.9% in 2019 (p < 0.0001). A total of 900 (3.5%) of those with morbid obesity were started on weight loss medications within 5 years of sleeve gastrectomy. Women [odds ratio (OR) 3.57, 95% confidence interval (CI) 3.51-3.58], individuals under 50 years (OR 1.59, CI 1.57-1.60), non-Hispanics (OR 1.12, 1.10-1.14, p < 0.0001), African Americans (OR 1.18, CI 1.16-1.19), Medicaid (OR 1.70, CI 1.67-1.73), and commercial insurance holders (OR 2.46, 2.43-2.49) were more likely to receive anti-obesity pharmacotherapy, p < 0.001 for all comparisons. CONCLUSION: There has been a modest increase in the prevalence of anti-obesity medications in the last 10 years, but they remain significantly underutilized. Further studies addressing the barriers to anti-obesity pharmacotherapy might help in increasing the utilization of these medications among adults with obesity.
Elangovan A; Shah R; Smith ZL
Obesity Surgery
2020
2020-09-28
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journalArticle
<a href="http://doi.org/10.1007/s11695-020-04987-2" target="_blank" rel="noreferrer noopener">10.1007/s11695-020-04987-2</a>
Safety of bariatric surgery in patients with inflammatory bowel disease: A systematic review and meta-analysis.
ulcerative colitis; bariatric surgery; inflammatory bowel disease; Crohn's disease
The efficacy of bariatric surgery in achieving weight loss and preventing long-term comorbidities such as cardiovascular diseases, diabetes mellitus and osteoarthritis is well established. Data regarding safety of bariatric surgery in patients with inflammatory bowel disease (IBD) is scarce. We attempted a systematic review and meta-analysis to evaluate the complications following bariatric surgery in patients with IBD. The primary outcomes evaluated were wound infection, Clavien-Dindo grade > II complications and IBD exacerbation (within 1 year). Secondary outcomes evaluated included overall mortality, stricture, small bowel obstruction, acute kidney injury (AKI) and thromboembolism. Pooled outcomes (event rate) with 95% confidence interval (CI) were calculated using random effects model. A total of 14 studies (all observational) with 2608 patients were included. The rates of primary outcomes were: wound infection (4.1%, 95% CI: 0.9-7.2), Clavien-Dindo grade > II complications (2.0%, 95%: CI 0.6-3.5) and IBD exacerbation (4.3%, 95% CI: 0.7-7.9). The pooled rate for other outcomes was: mortality 0.1%, stricture 6.5%, small bowel obstruction 6.7%, AKI 2.2% and thromboembolism 0.1%. Bariatric surgery is relatively safe in patients with IBD and should be pursued to reduce comorbidities associated with obesity. Future comparative studies are needed to further assess the safety of bariatric surgery in population with and without IBD.
Aziz M; Haghbin H; Sharma S; Fatima R; Ishtiaq R; Chandan S; Mohan BP; Lee-Smith W; Hassan M; Nawras A
Clinical Obesity
2020
2020-09-02
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journalArticle
<a href="http://doi.org/10.1111/cob.12405" target="_blank" rel="noreferrer noopener">10.1111/cob.12405</a>
THE OHIO & KENTUCKY ASMBS STATE CHAPTER: Building on Past History and Recent Success.
OHIO; BARIATRIC surgery; KENTUCKY; NON-insulin-dependent diabetes
Dan Adrian G; Daigle Christopher
Bariatric Times
2019
2019-01
Journal Article
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