The Skinny on he Role of Endoscopy in Bariatric SurgeryPatricia Raymond
Obesity epidemic; so where does endoscopy fit in with current bariatric surgery in preoperative assessment and management of complications, and what's under development for primary endoscopic bariatric techniques-- get the skinny here!
The Skinny on he Role of Endoscopy in Bariatric SurgeryPatricia Raymond
Obesity epidemic; so where does endoscopy fit in with current bariatric surgery in preoperative assessment and management of complications, and what's under development for primary endoscopic bariatric techniques-- get the skinny here!
Surgical Management of Obesity درمان جراحی چاقی
انواع اعمال جراحی :
محدود کننده جذب :
گاسترینگ باندینگ قابل تنظیم لاپاراسکوپیک
گاسترکتومی آسینی
مختل کننده جذب مواد غذایی :
انحراف صفراوی پانکراسی
سوئیچ دئودنال
ترکیبی :
بای پس معده
گاستریک باندینگ قابل تنظیم لاپاراسکوپیکLAGB
قرار دادن یک نوار سیلیکونی بادشونده دور قسمت پروگزیمال معده که نوار به یک سیستم مخزنی که اجازه تنظیم سفتی نوار را فراهم می آورد متصل می شود. این سیستم مخزنی به وسیله یک پورت زیرجلدی قابل دسترس می شود.
دونوع نوار برای این روش استفاده می شود :
lap-bandگاستریک باندینگ قابل تنظیم
گاستریک باندینگ قابل تنظیم سوئدی
این عمل جراحی بیشتر به صورت سرپایی انجام می شود وچون دستگاه گوارش مورد تهاجم قرار نمی گیرد خطر نسبی این عمل کمتر از اعمال دیگر است.
بیمارانی که برای کاهش وزن ناشکیبا هستند ، بی تحرک هستند ، قادر به ورزش نیستند و انتظار دارند که بتوانند به عادات غذایی قبلی خود بدون تغییر ادامه دهند کاندید خوبی برای این عمل نیستند.
تنظیمات باند و جلسات گروه حمایتی پس از عمل برای نتایج خوب بسیار مهم هستند.تنظیمات باند مانند بخشی از جراحی مهم است.
توافق کلی این است که کاهش کمتر از دو پوند در هفته اندیکاسیون افزایش محدودیت باند با اضافه کردن مایع است.
نتایج:
به طور میانگین 5تا7 سال بعد از عمل بیماران به ترتیب 60% و 58% از وزن اضافی را کم کردند.
هایپرتانسیون در 55% بیماران طی یک سال برطرف شده
آپنه انسدادی به 2%کاهش داشته
آسم و افسردگی بهبود داشته
در بیش از 50% موارد بهبودی داشته GERD
عوارض:
- پرولاپس: قسمت تحتانی معده به سمت بالا هل داده شده و در لومن باند گیر می کند.نیازبه جراحی دوباره دارد.
- سرخورردن
- صدمه بافتی به خاطر فرسودگی باند
- عوارض پورت و لوله هاَ
شکست در کاهش وزن بیشتر از اعمال دیگر رخ می دهد.
Five Year Outcome Sleeve Gastrectomy Mini-Gastric Bypass From a Community Hos...Dr. Robert Rutledge
Five Year Outcome Sleeve Gastrectomy Mini-Gastric Bypass From a Community Hospital in Punjab, India
Dr K S Kular
Kular Medical Education & Research Society
Kular Group of Institutes
drkskular@gmail.com
www.kularhospital.com
Sleeve
MGB
Kular Hospital
Sleeve v MGB (Hint: MGB Better)
Weight Loss Raw Data, Weight Loss Excluding SG Revisions v Age Wt matched MGBs, Resolution of Co-Morbidities, Patient Satisfaction, Dyspepsia/Bile Reflux
Conclusions
Understant what is obesity and Bariatric Surgery, what are the risk factors and how to overcome on the it. For more information visit at http://gisurgery.info
Dr Pravin John and Dr John Thanakumar, Anurag Hospital, Coimbatore present the differences between metabolic and obesity surgery - dept of advanced laparoscopy and obesity
The Mini-Gastric Bypass: Best Treatment Type 2 Diabetes Mellitus
Dr K S Kular
Kular Medical Education & Research Society ,
Kular Group of Institutes ,
drkskular@gmail.com
www.kularhospital.com
Why Consider the MGB?
With the Band/Sleeve/RNY available
Why even consider the Mini-Gastric Bypass?
6 yr study 29,820 BCBS plan members.
"Laparoscopic RNY and Lap Band both Fail to reduce overall health care costs in the long term."
Impact of Bariatric Surgery on Health Care Costs of Obese Persons, A 6-Year Follow-up of Surgical and Comparison Cohorts Using Health Plan Data Jonathan P. Weiner, et al. JAMA Surg. 2013;148(6)
Sleeve gastrectomy surgery is the best option for weight loss.Dr.Ramesh is an icon in the field of medical science. He has a lot of experience in the field of surgery.
Gastric Sleeve Surgery Complications - Gastric sleeve surgery is is a surgery where your stomach will be cut off so that you have a smaller stomach. Its purpose to reduce your eating portion so that you will feel full more quickly.
Surgical Management of Obesity درمان جراحی چاقی
انواع اعمال جراحی :
محدود کننده جذب :
گاسترینگ باندینگ قابل تنظیم لاپاراسکوپیک
گاسترکتومی آسینی
مختل کننده جذب مواد غذایی :
انحراف صفراوی پانکراسی
سوئیچ دئودنال
ترکیبی :
بای پس معده
گاستریک باندینگ قابل تنظیم لاپاراسکوپیکLAGB
قرار دادن یک نوار سیلیکونی بادشونده دور قسمت پروگزیمال معده که نوار به یک سیستم مخزنی که اجازه تنظیم سفتی نوار را فراهم می آورد متصل می شود. این سیستم مخزنی به وسیله یک پورت زیرجلدی قابل دسترس می شود.
دونوع نوار برای این روش استفاده می شود :
lap-bandگاستریک باندینگ قابل تنظیم
گاستریک باندینگ قابل تنظیم سوئدی
این عمل جراحی بیشتر به صورت سرپایی انجام می شود وچون دستگاه گوارش مورد تهاجم قرار نمی گیرد خطر نسبی این عمل کمتر از اعمال دیگر است.
بیمارانی که برای کاهش وزن ناشکیبا هستند ، بی تحرک هستند ، قادر به ورزش نیستند و انتظار دارند که بتوانند به عادات غذایی قبلی خود بدون تغییر ادامه دهند کاندید خوبی برای این عمل نیستند.
تنظیمات باند و جلسات گروه حمایتی پس از عمل برای نتایج خوب بسیار مهم هستند.تنظیمات باند مانند بخشی از جراحی مهم است.
توافق کلی این است که کاهش کمتر از دو پوند در هفته اندیکاسیون افزایش محدودیت باند با اضافه کردن مایع است.
نتایج:
به طور میانگین 5تا7 سال بعد از عمل بیماران به ترتیب 60% و 58% از وزن اضافی را کم کردند.
هایپرتانسیون در 55% بیماران طی یک سال برطرف شده
آپنه انسدادی به 2%کاهش داشته
آسم و افسردگی بهبود داشته
در بیش از 50% موارد بهبودی داشته GERD
عوارض:
- پرولاپس: قسمت تحتانی معده به سمت بالا هل داده شده و در لومن باند گیر می کند.نیازبه جراحی دوباره دارد.
- سرخورردن
- صدمه بافتی به خاطر فرسودگی باند
- عوارض پورت و لوله هاَ
شکست در کاهش وزن بیشتر از اعمال دیگر رخ می دهد.
Five Year Outcome Sleeve Gastrectomy Mini-Gastric Bypass From a Community Hos...Dr. Robert Rutledge
Five Year Outcome Sleeve Gastrectomy Mini-Gastric Bypass From a Community Hospital in Punjab, India
Dr K S Kular
Kular Medical Education & Research Society
Kular Group of Institutes
drkskular@gmail.com
www.kularhospital.com
Sleeve
MGB
Kular Hospital
Sleeve v MGB (Hint: MGB Better)
Weight Loss Raw Data, Weight Loss Excluding SG Revisions v Age Wt matched MGBs, Resolution of Co-Morbidities, Patient Satisfaction, Dyspepsia/Bile Reflux
Conclusions
Understant what is obesity and Bariatric Surgery, what are the risk factors and how to overcome on the it. For more information visit at http://gisurgery.info
Dr Pravin John and Dr John Thanakumar, Anurag Hospital, Coimbatore present the differences between metabolic and obesity surgery - dept of advanced laparoscopy and obesity
The Mini-Gastric Bypass: Best Treatment Type 2 Diabetes Mellitus
Dr K S Kular
Kular Medical Education & Research Society ,
Kular Group of Institutes ,
drkskular@gmail.com
www.kularhospital.com
Why Consider the MGB?
With the Band/Sleeve/RNY available
Why even consider the Mini-Gastric Bypass?
6 yr study 29,820 BCBS plan members.
"Laparoscopic RNY and Lap Band both Fail to reduce overall health care costs in the long term."
Impact of Bariatric Surgery on Health Care Costs of Obese Persons, A 6-Year Follow-up of Surgical and Comparison Cohorts Using Health Plan Data Jonathan P. Weiner, et al. JAMA Surg. 2013;148(6)
Sleeve gastrectomy surgery is the best option for weight loss.Dr.Ramesh is an icon in the field of medical science. He has a lot of experience in the field of surgery.
Gastric Sleeve Surgery Complications - Gastric sleeve surgery is is a surgery where your stomach will be cut off so that you have a smaller stomach. Its purpose to reduce your eating portion so that you will feel full more quickly.
Se entiende por menopausia a la última menstruación, climaterio es la etapa en que la mujer pasa a la vida no reproductiva, el mismo incluye a la etapa previa a la menopausia (pre-menopausia) y la etapa posterior (posmenopausica).
Edad media de 50 años y su relación con la expectativa de vida.
A nivel hormonal se correlaciona con un aumento de la FSH mayor de 40 mUI/ml (por menor síntesis de estrógenos).
Sleeve vs Mini-Gastric Bypass
IN EVERY STUDY, by every measure, the Mini-Gastric Bypass is equal to or better than every other form of bariatric surgery
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
1. Sleeve Gastrectomy in Patients with BMI < 35. It Makes Sense! Samer G. Mattar, MD, FRCS, FACS Associate Professor of Surgery Indiana University
2. Outline Evolution of Sleeve Gastrectomy Safety profile of SG Outcomes of SG SG in BMI <35
3. Sleeve Gastrectomy Tubular stomach Two thirds of stomach removed Stomach capacity ≈ 100 mL Based upon Magenstrasse and Mill Procedure Initially used in 2 stage procedure for super morbidly obese Weight loss proved promising with some pts electing not to proceed with second portion of procedure Braghetto et al. Obes Surg. November/December 2007 Regan et al. Obes Surg. December 2003
4. EvolutionMagenstrasse & Mill2003 Developed by Johnston in UK 100 patients No deaths Major complication rate = 4% EWL% at 1 yr. = 61% Johnston D et al. Obes Surg 2003 (13)1: 10
6. 2 Staged LBPD-DS in High Risk Patients – Mount Sinai2003 First reported by Gagner in 2003 Reserved for patients BMI >60 Attempt to reduce morbidity and mortality Interval time was 1 yr EWL% = 33% (about 100 pound weight loss) Regan JP et al. Obes Surg 2003 (13)6:861
8. 118 Patients Median BMI 55, Median age 47 41% male 31 patients intra-operative decision: 5 anatomy (adhesions, short mesentery) 16 prolonged OR time/intraop complications 11 unexpected operative findings 47% EWL at 24 months
12. Results of LRYGB = -One death Morbidity 8% EWL% = an extra 20% Cottam et al Surg Endosc 2006 (20)6:859
13. 126 Patients, 47% male Mean age 49.5 years Mean BMI 65.3 kg/m2 42% ASA III, 52% ASA IV No perioperative mortality 46% EWL at one year * P < 0.05
14. Sleeve Gastrectomy as a Definitive Operation Staged patients were not returning for 2nd stage. Bougie size gradually decreased from 60F to 34F Resection initiated 5-6 cm from pylorus
15. Expected Weight Loss Outcomes %EWL is about 50% at 1 year. In an Austrian study of 126 patients, 64% lost > 50% excess weight within a mean of 20 months. In a French study of 137 patients, median 2 y %EWL was 55%. (Felberbauer et al, Obes Surg 2008) (Chazelet, Topart, Verhaege. In press)
16. Current EvidenceMetanalysis – 5 year Follow Up 35 Studies between 1/03 and 1/09 2,410 patients Pre-op BMI 35 – 69 kg/m2 (50) Post-op BMI 26 – 53 kg/m2 (36) Follow-up 3 months to 5 years EWL%: 33 – 83% (55%) Complication rate 0 – 24% 3 postoperative mortalities (0.12%) Brethauer et al. SOARD 2009 (4): 469-475
18. F.D.A. Approves Band Device for Less Obese By ANDREW POLLACK Published: February 16, 2011 People no longer need to be quite as obese as before to qualify for weight loss surgery. The Food and Drug Administration on Wednesday approved the wider use of Allergan’s Lap-Band stomach-restricting device to some people who are just barely obese. Allergan estimated that more than 26 million Americans would be newly eligible for the surgery, more than doubling the 15 million to 18 million eligible under the old standard.
19.
20. More loss of hunger in Sleeve Gastrectomy group80% 70% Sleeve Gastrectomy 60% EWL (BMI(25)) Adjustable Gastric Band 50% 40% 30% 20% 10% 0% 0 10 20 30 40 50 60 Time (Mo) Himpens et al. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 2006;16:1450–6.
22. Gastric Emptying: Accelerated 67 patients 3 groups: lean control, mo with DM2 no LSG, mo with Dm2 with LSG All patients had GE half time and SBTT Shah et al: SOARD 2010;4(6):152-7
24. Ileal interposition with SG in BMI < 35 454 patients in Goiania, Brazil Mean BMI = 29 +/- 3 All were diabetic > 3 years Mean duration of DM2 was 10 years Mean HgA1C = 8.8% DePaula AL, et al. World J Surg 2011;35(1):102-8
25. Ileal interposition with SG in BMI < 35 Mortality = 0.4% Major complications = 6.4% Re-admission rate = 4.4% DePaula AL, et al. World J Surg 2011;35(1):102-8
27. Conclusion The incidence of obesity continues to rise. Prior studies have shown that early treatment of obesity results in better resolution of comorbidities. FDA has approved gastric band in BMI < 35. SG is more effective than the band. Therefore, it makes sense to offer it to patients with BMI <35!
Editor's Notes
In most cases, the decision to performe sleeve gastrectomy was made preoperatively due to the patient’s BMI, comorbididites, or age. In 31 cases, the decision was made intraoperatively for the reasons shown here