Surgery results in greater improvement in weight loss outcomes and weight associated comorbidities compared with non-surgical interventions , regardless of the type of procedures used .
When compared with each other , certain procedures result ed in greater weight loss and improvements in comorbidities than others .
Outcomes were similar between RYGB and sleeve gastrectomy , and both of these procedures had better outcomes than adjustable gastric b and ing .
For people with very high BMI , biliopancreatic diversion with duodenal switch result ed in greater weight loss than RYGB .
Isolated sleeve gastrectomy led to better weight-loss outcomes than adjustable gastric b and ing after three years follow-up .
BACKGROUND Bariatric ( weight loss ) surgery for obesity is considered when other treatments have failed .
The effects of the available bariatric procedures compared with medical management and with each other are uncertain .
This is an up date of a Cochrane review first published in 2003 and most recently up date d in 2009 .
OBJECTIVES To assess the effects of bariatric surgery for overweight and obesity , including the control of comorbidities .
A Multicenter, Randomized Efficacy Study of the EndoBarrier Gastrointestinal Liner for Presurgical Weight Loss Prior to Bariatric Surgery
Background : The endoscopically placed duodenal-jejunal bypass sleeve or EndoBarrier Gastrointestinal Liner has been design ed to achieve weight loss in morbidly obese patients . We report on the first European experience with this device . Methods : A multicenter , r and omized clinical trial was performed . Forty-one patients were included and 30 underwent sleeve implantation . Eleven patients served as a diet control group . All patients followed the same low-calorie diet during the study period . The purpose of the study was to determine the safety and efficacy of the device . Results : Twenty-six devices were successfully implanted . In 4 patients , implantation could not be achieved . Four devices were explanted prior to the initial protocol end point because of migration ( 1 ) , dislocation of the anchor ( 1 ) , sleeve obstruction ( 1 ) , and continuous epigastric pain ( 1 ) . The remaining patients all completed the study . Mean procedure time was 35 minutes ( range : 12–102 minutes ) for a successful implantation and 17 minutes ( range : 5–99 minutes ) for explantation . There were no procedure related adverse events . During the study period the 26 duodenal-jejunal bypass sleeve patients ( 100 % ) had at least one adverse event , mainly abdominal pain and nausea during the first week after implantation . Initial mean body mass index ( BMI , kg/m2 ) was 48.9 and 47.4 kg/m2 for the device and control patients , respectively . Mean excess weight loss after 3 months was 19.0 % for device patients versus 6.9 % for control patients ( P < 0.002 ) . Absolute change in BMI at 3 months was 5.5 and 1.9 kg/m2 , respectively . Type 2 diabetes mellitus was present at baseline in 8 patients of the device group and improved in 7 patients during the study period ( lower glucose levels , HbA1c , and medication requirements ) . Conclusion : The EndoBarrier Gastrointestinal Liner is a feasible and safe noninvasive device with excellent short-term weight loss results . The device also has a significant positive effect on type 2 diabetes mellitus . Long-term r and omized and sham studies for weight loss and treatment of diabetes are necessary to determine the role of the device in the treatment of morbid obesity . This study was registered at www . clinical trials.gov ( registration number : NCT00830440 )
Surgery results in greater improvement in weight loss outcomes and weight associated comorbidities compared with non-surgical interventions , regardless of the type of procedures used .
When compared with each other , certain procedures result ed in greater weight loss and improvements in comorbidities than others .
Outcomes were similar between RYGB and sleeve gastrectomy , and both of these procedures had better outcomes than adjustable gastric b and ing .
For people with very high BMI , biliopancreatic diversion with duodenal switch result ed in greater weight loss than RYGB .
Isolated sleeve gastrectomy led to better weight-loss outcomes than adjustable gastric b and ing after three years follow-up .
BACKGROUND Bariatric ( weight loss ) surgery for obesity is considered when other treatments have failed .
The effects of the available bariatric procedures compared with medical management and with each other are uncertain .
This is an up date of a Cochrane review first published in 2003 and most recently up date d in 2009 .
OBJECTIVES To assess the effects of bariatric surgery for overweight and obesity , including the control of comorbidities .