Cargando…

Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study

BACKGROUND: Obesity surgery mortality risk scoring system (OS-MRS) classifies patients into high, intermediate and low risk, based on age, body mass index, sex and other comorbidities such as hypertension and history of pulmonary embolism. High-risk patients not only have a higher mortality but are...

Descripción completa

Detalles Bibliográficos
Autores principales: Younus, Hafsa, Chakravartty, Saurav, Sarma, Diwakar R., Patel, Ameet G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153580/
https://www.ncbi.nlm.nih.gov/pubmed/29948870
http://dx.doi.org/10.1007/s11695-018-3322-9
_version_ 1783357531368718336
author Younus, Hafsa
Chakravartty, Saurav
Sarma, Diwakar R.
Patel, Ameet G.
author_facet Younus, Hafsa
Chakravartty, Saurav
Sarma, Diwakar R.
Patel, Ameet G.
author_sort Younus, Hafsa
collection PubMed
description BACKGROUND: Obesity surgery mortality risk scoring system (OS-MRS) classifies patients into high, intermediate and low risk, based on age, body mass index, sex and other comorbidities such as hypertension and history of pulmonary embolism. High-risk patients not only have a higher mortality but are more likely to develop post-operative complications necessitating intervention or prolonged hospital stay following bariatric surgery. Endoscopically placed duodenal-jejunal bypass sleeve (Endobarrier) has been designed to achieve weight loss and improve glycaemic control in morbidly obese patients with clinically proven effectiveness. The aim of this study was to assess if pre-operative insertion of endobarrier in high-risk patients can decrease morbidity and length of stay after bariatric surgery. MATERIALS AND METHODS: Between 2012 and 2014, a cohort of 11 high-risk patients had an Endobarrier inserted (E&BS group) for 1 year prior to definitive bariatric surgery. These patients were compared against a similar group undergoing primary bariatric surgery (PBS group) during same duration. The two groups were matched for age, gender, body mass index, comorbidities, surgical procedure and OS-MRS using propensity score matching. Outcome measures included operative time, morbidity, length of stay, intensive therapy unit (ITU) stay, readmission rate, percentage excess weight loss (%EWL) and percentage total weight loss (%TWL). RESULTS: Patient characteristics and OS-MRS were similar in both groups (match tolerance 0.1). There was no significant difference in total length of stay, readmission rate, %EWL and %TWL. Operative time, ITU stay, post-operative complications and severity of complications were significantly less in the E&BS group (p < 0.05) with significant likelihood of planned ITU admissions in the PBS group (p < 0.05). CONCLUSION: Endobarrier could be considered as a pre bariatric surgical intervention in high-risk patients. It may result in improved post-operative outcomes in high-risk bariatric patients.
format Online
Article
Text
id pubmed-6153580
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-61535802018-10-04 Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study Younus, Hafsa Chakravartty, Saurav Sarma, Diwakar R. Patel, Ameet G. Obes Surg Original Contributions BACKGROUND: Obesity surgery mortality risk scoring system (OS-MRS) classifies patients into high, intermediate and low risk, based on age, body mass index, sex and other comorbidities such as hypertension and history of pulmonary embolism. High-risk patients not only have a higher mortality but are more likely to develop post-operative complications necessitating intervention or prolonged hospital stay following bariatric surgery. Endoscopically placed duodenal-jejunal bypass sleeve (Endobarrier) has been designed to achieve weight loss and improve glycaemic control in morbidly obese patients with clinically proven effectiveness. The aim of this study was to assess if pre-operative insertion of endobarrier in high-risk patients can decrease morbidity and length of stay after bariatric surgery. MATERIALS AND METHODS: Between 2012 and 2014, a cohort of 11 high-risk patients had an Endobarrier inserted (E&BS group) for 1 year prior to definitive bariatric surgery. These patients were compared against a similar group undergoing primary bariatric surgery (PBS group) during same duration. The two groups were matched for age, gender, body mass index, comorbidities, surgical procedure and OS-MRS using propensity score matching. Outcome measures included operative time, morbidity, length of stay, intensive therapy unit (ITU) stay, readmission rate, percentage excess weight loss (%EWL) and percentage total weight loss (%TWL). RESULTS: Patient characteristics and OS-MRS were similar in both groups (match tolerance 0.1). There was no significant difference in total length of stay, readmission rate, %EWL and %TWL. Operative time, ITU stay, post-operative complications and severity of complications were significantly less in the E&BS group (p < 0.05) with significant likelihood of planned ITU admissions in the PBS group (p < 0.05). CONCLUSION: Endobarrier could be considered as a pre bariatric surgical intervention in high-risk patients. It may result in improved post-operative outcomes in high-risk bariatric patients. Springer US 2018-06-09 2018 /pmc/articles/PMC6153580/ /pubmed/29948870 http://dx.doi.org/10.1007/s11695-018-3322-9 Text en © The Author(s) 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Contributions
Younus, Hafsa
Chakravartty, Saurav
Sarma, Diwakar R.
Patel, Ameet G.
Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study
title Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study
title_full Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study
title_fullStr Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study
title_full_unstemmed Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study
title_short Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study
title_sort endobarrier as a pre bariatric surgical intervention in high-risk patients: a feasibility study
topic Original Contributions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153580/
https://www.ncbi.nlm.nih.gov/pubmed/29948870
http://dx.doi.org/10.1007/s11695-018-3322-9
work_keys_str_mv AT younushafsa endobarrierasaprebariatricsurgicalinterventioninhighriskpatientsafeasibilitystudy
AT chakravarttysaurav endobarrierasaprebariatricsurgicalinterventioninhighriskpatientsafeasibilitystudy
AT sarmadiwakarr endobarrierasaprebariatricsurgicalinterventioninhighriskpatientsafeasibilitystudy
AT patelameetg endobarrierasaprebariatricsurgicalinterventioninhighriskpatientsafeasibilitystudy