Obesity is a worldwide increasing concern, and its prevalence has risen rapidly over the past several decades. Since nonsurgical treatment for weight loss in morbidly obese patients has poor long-term outcomes, bariatric surgery has gained acceptance and popularity in the last years. The laparoscopic Roux-en-Y gastric bypass has proved to be safe and effective, with successful long-term outcomes in morbidly obese patients. Key elements for the success of the operation are careful patient selection, a comprehensive preoperative evaluation, and a properly executed operation that respects the key technical elements.
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References
1.
HillJO, WyatHR, ReedGW, PetersJC. Obesity and the environment, where do we go from here?. Science, 2003; 299:853–855.
2.
OgdenCL, CarrollMD, FryarCD, FlegalKM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief, 2015; 219:1–8.
3.
GuhDP, ZhangW, BansbackN, AmarsiZ, BirminghamCL, AnisAH. The incidence of co-morbidities related to obesity and overweight: A systematic review and metaanalysis. BMC Public Health, 2009; 9:88.
MasonEE, ItoC. Gastric bypass in obesity. Surg Clin North Am, 1967; 47:1345–1351.
6.
GriffenWOJr., YoungVL, StevensonCC.A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg, 1977; 186:500–509.
7.
WittgroveAC, ClarkGW, TremblayLJ. Laparoscopic gastric bypass, Roux-en-Y: Preliminary report of five cases. Obes Surg, 1994; 4:353–357.
8.
VilallongaR, HimpensJ, van de VrandeS. Long-term (7 years) follow-up of Roux-en-Y gastric bypass on obese adolescent patients (<18 years). Obes Facts, 2016; 9:91–100.
9.
MehaffeyJH, LaParDJ, ClementKC, et al.10-year outcomes after Roux-en-Y gastric bypass. Ann Surg, 2016; 264:121–126.
10.
KothariSN, BorgertAJ, KalliesKJ, et al.Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis, 2017; 13:972–978.
11.
NguyenNT, KimE, VuS, PhelanM. Ten-year outcomes of a prospective randomized trial of laparoscopic gastric bypass versus laparoscopic gastric banding. Ann Surg, 2018; 268:106–113.
RanasingheC, GamageP, KatulandaP, et al.Relationship between body mass index (BMI) and body fat percentage, estimated by bioelectrical impedance, in a group of Sri Lankan adults: A cross sectional study. BMC Public Health, 2013; 13:797.
14.
OrtegaFB, SuiX, LavieCJ, et al.Body mass index, the most widely used but also widely criticized index: Would a gold-standard measure of total body fat be a better predictor of cardiovascular disease mortality?. Mayo Clin Proc, 2016; 91:443–455.
15.
RyanDH, KahanS. Guideline recommendations for obesity management. Med Clin North Am, 2018; 102:49–63.
SAGES Guidelines Committee. SAGES guideline for clinical application of laparoscopic bariatric surgery. Surg Obes Relat Dis, 2009; 5:387–405.
18.
MechanickJI, YoudimA, JonesDB, et al.Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical supportof the bariatric surgery patient—2013 update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring), 2013; 21:S1–S27.
19.
GreenwayFL.Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes, 2015; 39:1188–1196.
20.
LivhitsM, MercadoC, YermilovI, et al.Is social support associated with greater weight loss after bariatric surgery?: A systematic review. Obes Rev, 2011; 12:142–148.
21.
SauerlandS, AngrisaniL, BelachewM, et al.Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc, 2005; 19:200–221.
22.
DuX, ZhangSQ, ChengZ, et al.Preoperative cardiac, pulmonary and digestive comorbidities of morbidly obese patients undergoing bariatric surgery: Morbidity, assessment and management. Hepatogastroenterology, 2014; 61:683–688.
23.
HamouiN, AnthoneG, CrookesPF. The value of pulmonary function testing prior to bariatric surgery. Obes Surg, 2006; 16:1570–1573.
24.
StampferMJ, MaclureKM, ColditzGA, et al.Risk of symptomatic gallstones in women with severe obesity. Am J Clin Nutr, 1992; 55:652–658.
25.
LiangRJ, WangHH, LeeWJ, et al.Diagnostic value of ultrasonographic examination for nonalcoholic steatohepatitis in morbidly obese patients undergoing laparoscopic bariatric surgery. Obes Surg, 2007; 17:45–56.
26.
De PalmaGD, ForestieriP. Role of endoscopy in the bariatric surgery of patients. World J Gastroenterol, 2014; 20:7777–7784.
27.
HaenenFW, GysB, MoreelsT, MichielsenM, GysT, LafullardeT. Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass: A case report. Acta Chir Belg, 2017; 117:391–393.
28.
KrimpuriRD, YokleyJM, SeeholzerEL, et al.Qualifying for bariatric surgery: Is preoperative weight loss a reliable predictor of postoperative weight loss?. Surg Obes Relat Dis, 2018; 14:60–64.
29.
AlamiRS, MortonJM, SchusterR, et al.Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis, 2007; 3:141–145; discussion 145–146.
