Comparing quality of life outcomes between Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass using the RAND36 questionnaire.

BACKGROUND: Obesity surgery is an effective treatment to improve the health of patients. There is a lack of data regarding weight loss surgery outcomes and effects on Quality of Life (QoL). This study aims to compare changes in QoL following either Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic Roux-en-Y Gastric Bypass (LRYGB). METHODS: SF36 questionnaires were mailed to all LSG and LRYGB patients who underwent surgery in 2013. Demographic data was obtained from hospital records. Statistical analysis was undertaken using Stats direct. RESULTS: 158 patients were sent postal questionnaires. 60 were returned (38%). 41 were women, 16 LSG, 44 LRYGB, mean age 52 years, mean BMI pre-surgery 41.0. Both procedures yielded similar weight loss over 2 year follow up (p = 0.01), and similar improvements in obesity related co-morbidities. These procedures yielded significant improvements in all QoL scales and domains other than the emotional role limitations scale following sleeve gastrectomy. CONCLUSION: Bariatric surgery has been shown to improve a patient's QoL. More research is needed to explain the reasons why there was a difference between Sleeve and Bypass procedures in emotional changes to patients.

Tongue tie: the evidence for frenotomy.

Tongue tie or ankyloglossia is a congenital variation characterised by a short lingual frenulum which may result in restriction of tongue movement and thus impact on function. Tongue tie division (frenotomy) in affected infants with breastfeeding problems yields objective improvements in milk production and breastfeeding characteristics, including objective scoring measures, weight gain and reductions in maternal pain. For the majority of mothers, frenotomy appears to enhance maintenance of breastfeeding. Tongue tie division is a safe procedure with minimal complications. The commonest complication is minor bleeding. Recurrence leading to redivision occurs with rates of 0.003-13% reported; this appears to be more common with posterior than anterior ties. There are limited reports indicating that prophylactic frenotomy may promote subsequent speech development; however, evidence is currently insufficient to condone this practice and further good quality research into this area is warranted.