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  • 1
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Obesity Surgery Vol. 31, No. 7 ( 2021-07), p. 3218-3226
    In: Obesity Surgery, Springer Science and Business Media LLC, Vol. 31, No. 7 ( 2021-07), p. 3218-3226
    Abstract: Nonalcoholic fatty liver disease (NAFLD) is a common condition in patients with obesity. Bariatric surgery has often been proposed as a viable treatment option, but the ideal surgical procedure remains unclear. Inconsistently, reports on postoperative deterioration of liver function put further doubt on which technique to apply. Aim of this study was to assess the impact of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on the postoperative recovery of liver function. Methods A total of 175 patients with obesity that underwent bariatric surgery in our institution were included in this prospective cohort study. BMI, laboratory values, and liver function capacity (using LiMAx) were assessed preoperatively and at 6 and 12 months postoperatively. Generalized linear model (GLM) was performed to determine variables influencing liver function capacity after the operation. Results Prior to operations, 64% of patients presented with a diminished liver function capacity, as measured by LiMAx test. Liver function capacity significantly recovered after 12 months in the SG group (300 μg/kg/h preop vs. 367 μg/kg/h postop) but not in the RYGB group (306 μg/kg/h preop vs. 349 μg/kg/h). Preoperative factors impeding liver function recovery included type 2 diabetes mellitus (T2DM), weight, male sex, AST/thrombocyte ratio (APRI), and gamma-glutamyltransferase (GGT). Conclusion Bariatric surgery, especially sleeve gastrectomy, leads to an improvement of liver function. However, in some patients with T2DM, higher preoperative weight and male sex postoperative deterioration of liver function capacity may occur. Graphical abstract
    Type of Medium: Online Resource
    ISSN: 0960-8923 , 1708-0428
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2087903-9
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  • 2
    In: JHEP Reports, Elsevier BV, Vol. 2, No. 2 ( 2020-04), p. 100080-
    Type of Medium: Online Resource
    ISSN: 2589-5559
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2972660-8
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  • 3
    In: Surgical Endoscopy, Springer Science and Business Media LLC, Vol. 36, No. 6 ( 2022-06), p. 4401-4407
    Abstract: Bariatric surgery in super-super-obese (SSO) patients remains a continuous challenge due to intraabdominal fat masses, higher liver volume and existing comorbidities. A convenient procedure in SSO patients is one anastomosis gastric bypass (OAGB). The aim of this study was to compare the outcome of SSO patients undergoing OAGB in comparison to laparoscopic sleeve gastrectomy (LSG). Methods We retrospectively reviewed data from SSO patients who underwent OAGB and LSG in our institution between 2008 and 2020. Primary endpoints included percentage total body weight loss and percentage BMI loss at 12, 24, and 36 months after the operation. Secondary endpoints were perioperative complications, procedure length, length of hospital stay and outcome of comorbidities. Results 243 patients were included in this study. 93 patients underwent LSG and 150 underwent OAGB. At any of the time points evaluated, weight loss in patients after OAGB was greater than in LSG patients, while procedure length was significantly shorter for OAGB than LSG (81.4 vs. 92.1 min, p -value  〈  0.001). Additionally, mean length of hospital stay was shorter in the OAGB group (3.4 vs. 4.5 days, p -value  〈  0.001). There were more severe complications (Clavien-Dindo ≥ 3a) in the LSG group (11.8% vs 2.7%, p -value = 0.005). Conclusion In this retrospective analysis, OAGB was superior to LSG in terms of weight loss in SSO patients. Procedure length and hospital stay were shorter after OAGB in comparison to LSG and there were fewer severe complications. OAGB can therefore be regarded a safe and effective treatment modality for SSO patients.
    Type of Medium: Online Resource
    ISSN: 0930-2794 , 1432-2218
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463171-4
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  • 4
    In: BMC Surgery, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: During the worldwide COVID-19 pandemic, the quality of surgical education experiences sudden major restrictions. Students’ presence in the operating theater and on wards is reduced to a bare minimum and face-to-face teaching is diminished. Aim of this study was therefore to evaluate alternative but feasible educational concepts, such as an online-only-platform for undergraduates. Objective A new online platform for undergraduate surgical education was implemented. A virtual curriculum for online-only education was designed. Methods A video-based online platform was designed. Following this, a cohort of medical students participating in a (voluntary) surgical course was randomized into a test and control group. Prior to conducting a written exam, students in the test group prepared using the video platform. Students in the control group prepared with standard surgical text books. Results of the exam were used to compare educational means. Results Students in the test group preparing through the video-based online platform reached significantly higher scores in the written exams (p = 0.0001) than students of the control group. A trend towards reduced preparation time that did not reach statistical significance was detectable in the test group (p = 0.090). Scores of “perceived workload” and “desire to become a surgeon” offered no differences between the groups. (p = 0.474 and 1.000). Conclusions An online-only, virtual curriculum proved feasible for surgical education in undergraduates. While blended learning concepts were applied in both groups, only the test group had access to case-based videos of surgical procedures and scored significantly better in the written exams. Thus, video-based virtual education offers a realistic alternative to face-to-face teaching or conventional text books in times of restricted access to the operating theatre.
    Type of Medium: Online Resource
    ISSN: 1471-2482
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050442-1
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