Experts issue recommendations for the treatment of post-bariatric surgery patients

PharmaLive.com (4 November 2010) - the Endocrine Society has published a new line of clinical practice, endocrine and nutrition for adults after surgery Bariatric, Managing Director, including those with diabetes mellitus. The directive contains a series of clinical recommendations developed by a group of expert evidence-based. The guideline is published in the issue of the journal of clinical endocrinology and metabolism (JCEM), a publication of the endocrine disruptive company November 2010.

The United States obesity rate increased by 24% between 1999 and 2004. Bariatric Surgery has gained wide acceptance in the treatment of obesity serious, especially when complicated by type 2 diabetes.Common operations include laparoscopic banding procedures and gastric surgery, which limit the amount of food in the stomach and intestine .the patients undergoing Bariatric Surgery may continue to live in the resurgence of weight and may also be associated Comorbidities, including type 2 diabetes, the disease Polycystic disease ovarian, metabolic disease of bone, foie gras, hypertension and obstructive sleep apnea.

«Weight loss surgery is not a guarantee of success, and patients need post-operative care, said David Heber, MD, Dr., University of California and Chairman of the task force developed guidelines.»To help prevent weight regain, co-morbidity is managed appropriately and facilitate the transition to life after surgery Bariatric, the guidance recommends that patients receive the support of a multidisciplinary team comprising a doctor experienced front-line, an endocrinologist or a gastroenterologist.»

Other recommendations of the guideline include:

Active nutrition education of the patient and clinical support to prevent and detect the nutritional deficiencies for patients undergoing bariatric surgery.management of potential nutritional deficiencies for patients undergoing procedures as well as strategies malabsorption compensate for food intolerance in patients who have had a malabsorption procedure to reduce the risk of clinically significant nutritional deficiencies;patient enrollment in a comprehensive program for power management and lifestyle;andFuture research to address the effectiveness of endocrine post-operative intensive and nutritional care in reducing morbidity and mortality of chronic diseases associated with obesity.

Hormone, affiliate society patient education Foundation disruptors, has published a guide for patients described compagnon.Il steps patients and their health care team should take to avoid nutritional deficiencies and complications as a result, such as protein malnutrition loss or bone, particularly after malabsorption.Le guide operations explains that, in most patients, health problems related to obesity disappear or improve substantially after chirurgicale.Il encourages patients also have expectations realistic about what surgery can do for them and changes in lifestyle that they lose weight and keep it off the coast.

Guide for patients are located online at: www.hormone.org/bariatric-patient-guide.

Editor's note: this article is not intended to provide medical advice, diagnosis or treatment.

Source of the story:

The story above is reproduced (with drafting adaptations by staff at PharmaLive.com) material supplied by the endocrine disruptive company, via EurekAlert!, a service of AAAS.

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More fat around internal organs may mean more complications after liver surgery

PharmaLive.com (16 November 2010) - amount of intra-abdominal fat seems to be associated with the risk of complications after major surgery of the liver, according to an article published in the November issue of the archives of surgery, one of the JAMA/Archives Journals. However, appearing in overweight or who have a high body mass index (BMI) were not associated with increased post-operative risk.

Approximately 65% of the u.s. population is currently overweight, half of those eligible as obese, according to background information in the article. Increase the frequency of obesity "surgeons review requires more critical of the effect of overweight and obesity on their patients," write the authors. " Literature currently presents mixed conclusions about the effect of overweight and obesity on various surgical populations with different measures of obesity used in these studies.»

Katherine Morris, M.D. and his colleagues at Memorial Sloan - Kettering Cancer Center in New York, studied 349 patients undergoing a surgical removal of part of the liver from June 1996 and November 2001. Computed tomography (CT) analysis before surgery were used to estimate the amount of fat as perinephritic, a measure of fat around the kidneys, which has been used as a substitute for the intra-abdominal fat.In addition, BMI patients was calculated using data size and poids.Les authors have also used computed tomography to measure external abdominal fat. Complications were followed by the cancer centre database.

After the major operations of liver, 230 patients (65.9%) have complications and nine (2.6%) patients died.The average duration of hospital stay was 10.8 days.

As measured by the amount of grease around the kidney patients with intra-abdominal fat than were more likely to have complications, including serious complications, longer length of hospital stay, and were more likely to die within 30 days that patients with less material grasses.Les patients with a higher mass index (BMI) body had procedures which took over time; However, BMI and external abdominal fat measures not were not associated with complications rate, the onset of serious complications, the duration of the stay or the risk of death within 30 days.

IMC appears to be a poor measure obesity puts abdominal surgery patients at risk type, the authors note.""As defined as perinephritic grease unique and simple substitution, intra-abdominal fat could serve as a risk stratifying patients for mortality, the rate of complication, severity of complications and increasing length of stay," they write.

"This should help surgeons be better able to identify patients at high risk and, conversely, not reject a transaction based on the presumed someone external obesity risk."Now that most of our patients taken into account for a major upper abdominal resection will preoperative CT scan, provided as perinephritic looking fat rich information is easily determined and should not be ignored.

Editor's note: this article is not intended to provide medical advice, diagnosis or treatment.

Source of the story:

The story above is reproduced (with drafting adaptations by staff at PharmaLive.com) materials provided by JAMA and archives of newspapers.

Reference of the review:

Katherine Morris.Scott Tuorto.Mithat pirates.Laurent Schwartz.Ronald DeMatteo.Michael of Angelica .William r. Jarnagin; Fong Yuman.Simple Intra-abdominal for predicting outcome of abdominal fat steps .Archives surgery, 2010; 145 (11): 1069-1073 DOI: 10.1001/archsurg.2010.222

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