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Bariatric Surgery

  • Brian Harte
Chapter

Abstract

Bariatric surgery refers to surgical procedures which alter the functioning of the gastrointestinal tract with the purpose of facilitating weight loss. Obesity is defined as body mass index (BMI) of 30 or greater; a BMI of 40 or greater is considered “severely” or “morbidly” obese. Morbidly obese individuals are potential candidates for surgery to achieve substantial weight loss. Those with BMI between 35 and 40 may also be candidates for surgery if their condition is complicated by severe comorbidities such as obstructive sleep apnea (OSA), obesityhypoventilation, or difficult-to-control diabetes. Bariatric surgery has a low complication rate (operative mortality is less than 1.5%), but patients should demonstrate understanding of lifestyle and dietary changes necessary after surgery. The screening process should be rigorous and include behavioral, psychosocial, and medical evaluations.

Keywords

Obstructive Sleep Apnea Bariatric Surgery Pulmonary Hypertension Diastolic Heart Failure Nephrogenic Diabetes Insipidus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Poirier P, Alpert MA, Fleisher LA, et al. Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science advisory from the American Heart Association. Circulation. 2009;120:86-95.PubMedCrossRefGoogle Scholar
  2. 2.
    Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108:812-821.PubMedCrossRefGoogle Scholar

Suggested Reading

  1. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systemic review and meta-analysis. JAMA. 2004;292:1724-1737.PubMedCrossRefGoogle Scholar
  2. Collazo-Clavell ML, Clark MM, McAlpine DE, et al. Assessment and preparation of patients for bariatric surgery. Mayo Clin Proc. 2006;81(10 suppl):S11-S17.PubMedGoogle Scholar
  3. Colquitt J, Clegg A, Sidhu M, et al. Surgery for morbid obesity. Cochrane Database Syst Rev.2004; 4: CD003641.Google Scholar
  4. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288:1723.PubMedCrossRefGoogle Scholar
  5. Kaw R, Aboussouan L, Auckley D, et al. Challenges in pulmonary risk assessment and perioperative management in bariatric surgery patients. Obes Surg. 2008;18:134-138.PubMedCrossRefGoogle Scholar
  6. Keating CL, Dixon JB, Moodie ML, et al. Cost-effectiveness of surgically induced weight loss for the management of type 2 diabetes: modeled lifetime analysis. Diab Care. 2009;32:567-574.CrossRefGoogle Scholar
  7. McGlinch BP, Que FG, Nelson JL, Wrobleski DM, Grant JE, Collazo-Clavell ML. Perioperative care of patients undergoing bariatric surgery. Mayo Clin Proc. 2006;81(10 suppl):S25-S33.PubMedGoogle Scholar
  8. Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4(5 suppl):S109-S184.PubMedCrossRefGoogle Scholar
  9. Perugini RA, Mason R, Czerniach DR, et al. Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass: a series of 188 patients. Arch Surg. 2003;138:541-545.PubMedCrossRefGoogle Scholar
  10. Sergio H, Scott D, Robert S, et al. Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. J Gastrointest Surg. 2002;6:354-358.CrossRefGoogle Scholar
  11. The Longitudinal Assessment of Bariatric Surgery Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445-454.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  1. 1.Department of Hospital MedicineCleveland ClinicClevelandUSA

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