RESUMEN
Background: Bariatric surgery is seen as one of the most successful option for the control of morbid obesity and obesity related complications. Although, there are many surgical options available the Lincey Alexida, Xiaohua Qi, Patrick B. Asdell, José M. Martínez Landrón, Samarth B. Patel, Faustino Allongo. Frederick Tiesenga. Laparoscopic Adjustable Gastric Band as a Revision Surgery for Failed Vertical Gastric Sleeve or Roux-en-Y Gastric Bypass. IAIM, 2017; 4(12): 37-42. Page 38 laparoscopic vertical sleeve gastrectomy and the Roux-en-Y gastric bypass are among the most selected treatment methods. Even though the sleeve gastrectomy and the gastric bypass has proven to be efficacious in weight reduction in morbid obesity there are still some reported failures. Aim: This study main objective is to see if an adjustable gastric band can be offered as a sensible option for patients who have had a previously failed vertical sleeve gastrectomy or the Roux-en-Y gastric bypass surgery. The procedure will be classified as a revision surgery to increase the possibilities of additional weight loss not achieved with the sleeve gastrectomy or gastric bypass surgery alone. Method: A retrospective review of the charts for all the bariatric patients from April 2012 to April 2017 was conducted. The chart review yielded 12 patients who underwent either adjustable band over a previously failed vertical sleeve procedure or the adjustable band over a previously failed Roux-enY gastric bypass procedure. The patients were divided into two groups, group A and B. Group A is comprised of the 8 out 12 patients who had a previous failed gastric sleeve procedure. Group B has the remaining 4 patients who had a failed gastric bypass procedure. Observation: Both groups who underwent adjustable gastric band laparoscopically as a revision procedure after a two year follow up appointment showed Group A had a mean estimate weight loss of 30.75 lbs. (11%) with a mean Body Mass Index of 40.7 kg/m2 and Group B had a mean estimate weight loss of 42 lbs. (15%) with a mean Body Mass Index of 36.77 kg/m2 . Group A had an Excess Body Weight Loss of 27% at 1 month and 33% at the 2 year follow up and Group B had an Excess Body Weight Loss of 42.2%. Group B had an Excess Body Weight Loss of 15.1 % at 1 month and 42.2% at the 2 year follow up. Conclusion: Group A had an average of 27% Excess Body Weight Loss and Group B had an Excess Body Weight Loss of 15.1% after 1 month on follow up. Our study was limited by the small sample size. We suggest that further investigational studies, with greater and more diverse sample sizes, be conducted to assure the benefit of using the adjustable gastric band as a revision surgery. Based on our results we conclude that the adjustable gastric band as a revision surgery is a promising and sensible alternative treatment option for patients with a previously failed laparoscopic vertical sleeve gastrectomy or a failed Roux-en-Y gastric bypass.
RESUMEN
Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. Objectives: To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. Materials and methods: We prospectively as well as retrospectively studied 46 patients treated with total hip replacement or hemiarthroplasty. Pain, range of motion, hip function, haris hip score and complications were assessed clinically while hip stability, femoral anteversion, acetabular cup inclination and acetabular erosions were assessed radiographically. Results: In our study according to Harris hip score, group A (hemiarthroplasty group) showed 58.33% excellent to good result whereas 33.34% shows fair to poor result. In group B (total hip replacement group) 90.91% showed excellent to good result and 9.08% showed fair to poor result. In this study, the overall Harris hip score was 76.33 with SD±19.091 in hemiarthroplasty group and 86.45 with SD±6.363 in Total hip replacement group with p-value 0.0224(<0.05). Nitin Kumar Singh, Himanshu Jain, Sonal Garg, Sachin Yadav. Primary total hip arthroplasty versus hemiarthroplasty for displaced neck femur fractures in older patients. IAIM, 2017; 4(10): 209-215. Page 210 Conclusion: So we concluded in our one year of study that total hip replacement had better functional outcome in fracture neck of femur in elderly treated by either hemiarthroplasty or total hip replacement and total hip replacement is less painful than hemiarthroplasty.
RESUMEN
xMajority of osteoporotic vertebral compression fracture present with back pain and some of them with spinal deformity. Percutaneous vertebroplasty not only addresses pain relief but also the correction of spinal deformity with least post-operative morbidity. 72 patients with osteoporotic compression fracture and spinal deformity with chronic invalidating pain treated with percutaneous vertebroplasty were followed for 2.8 years with an average of 1.3 years.47% showed excellent,13% showed good and 40% showed fair result on vas score. There was good improvement in stature in 43%, fair in 40% and 17% showed no improvement.