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1.
Obes Surg ; 33(9): 2758-2761, 2023 09.
Article in English | MEDLINE | ID: mdl-37470955

ABSTRACT

PURPOSE: The incidence of nocturia is increased in obesity, which causes significant negative impact on quality of life. Bariatric surgery is a reliable method in which to achieve major weight loss and this study aims to determine the effect of bariatric surgery on nocturia and other lower urinary tract symptoms (LUTS) in men and women. MATERIALS AND METHODS: Retrospective study of patients undergoing bariatric surgery had pre- and post-operative questionnaires using the validated International Prostate Symptoms Score (IPSS) to assess nocturia between 2018 and 2021. The primary outcome was effect of bariatric surgery on nocturia RESULTS: A total of 99 patients were included with median age of 52.9 (44.9-60.2) and 83.8% being female. The median weight was 129.9kg (110-151.9) and median BMI was 45.5 (41.4-53.4). Improvements were demonstrated in all criteria assessed in IPSS and nocturia significantly improved with a decrease in 1.14 points (p < 0.05). Linear regression analysis showed that, in the post operative period assessed, there were no significant effect on variables measured such as obstructive sleep apnoea, type 2 diabetes on the effect of IPSS post-bariatric surgery within the follow-up period of 4-6 months. CONCLUSION: Bariatric surgery can have significant improvements on nocturia symptoms in men and women with obesity. This is another means in how bariatric surgery can reduce morbidity and improve quality of life.


Subject(s)
Bariatric Surgery , Diabetes Mellitus, Type 2 , Nocturia , Obesity, Morbid , Male , Humans , Female , Nocturia/epidemiology , Nocturia/etiology , Retrospective Studies , Quality of Life , Diabetes Mellitus, Type 2/complications , Obesity, Morbid/surgery , Bariatric Surgery/adverse effects , Obesity/complications
2.
Obes Surg ; 33(8): 2546-2556, 2023 08.
Article in English | MEDLINE | ID: mdl-37314649

ABSTRACT

Preoperative oesophagogastroduodenoscopy (OGD) in bariatric surgery remains a controversial topic, with a large variety in practice globally. An electronic database search of Medline, Embase and PubMed was performed in an aim to categorise the findings of preoperative endoscopies in bariatric patients. A total of 47 studies were included in this meta-analysis resulting in 23,368 patients being assessed. Of patients assessed, 40.8% were found to have no novel findings, 39.7% had novel findings which did not affect surgical planning, 19.8% had findings that affected their surgery and 0.3% were ruled to not be suitable for bariatric surgery. Preoperative OGD is altering surgical planning in one-fifth of patients; however, further comparative studies are required to determine if each patient should undergo this procedure especially if asymptomatic.


Subject(s)
Bariatric Surgery , Bariatrics , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Bariatric Surgery/methods , Preoperative Care , Endoscopy, Digestive System
3.
Obes Surg ; 33(7): 2229-2236, 2023 07.
Article in English | MEDLINE | ID: mdl-37162714

ABSTRACT

Internal hernias are a worrying complication from laparoscopic Roux-en-Y gastric bypass (LRGB), with potential small bowel necrosis and obstruction. An electronic database search of Medline, Embase, and Pubmed was performed. All studies investigating the internal hernia rates in patients whose mesenteric defects were closed vs. not closed during LRGB were analysed. Odds ratios were calculated to assess the difference in internal hernia rate. A total of 14 studies totalling 20,553 patients undergoing LRGB were included. Internal hernia rate (220/12,445 (2%) closure vs. 509/8108 (6%) non-closure) and re-operation for small bowel obstruction (86/5437 (2%) closed vs. 300/3132 (10%) non-closure) were reduced when defects were closed. There was no difference observed when sutures were used to close the defects compared to clips/staples.


Subject(s)
Gastric Bypass , Hernia, Abdominal , Laparoscopy , Obesity, Morbid , Humans , Gastric Bypass/adverse effects , Obesity, Morbid/surgery , Retrospective Studies , Postoperative Complications/surgery , Postoperative Complications/etiology , Hernia, Abdominal/etiology , Hernia, Abdominal/surgery , Laparoscopy/adverse effects , Mesentery/surgery , Internal Hernia/complications , Internal Hernia/surgery
4.
J Public Health (Oxf) ; 42(4): 712-716, 2020 11 23.
Article in English | MEDLINE | ID: mdl-32930797

ABSTRACT

BACKGROUND: In April 2020, Covid-19 brought NHS elective procedures to a halt. The aim of this paper is to produce accurate forecasts on the building backlog, highlight the state of waiting lists currently and propose solutions required to prevent a public health crisis. METHOD: Using data published by NHS digital and NHS England on previous years, we have analysed and used this to produce estimates of cancellations and missed cases. We also analyse government data on waiting lists and show compliance or lack of with these. RESULTS: We show that compliance with waiting list times pre pandemic was falling year on year (83.2% in 2020 down from 87% in 2019). Every month that passes we estimate that 400 000 cases are not being performed. This may include urgent cancer care work in some trusts. CONCLUSIONS: Waiting lists have been governed by strict rules since 2004. Given falling compliance with 18-week intention to treat we believe the scale of the backlog combined with NHS capacity diminished due to Covid-19 precautions is a public health crisis waiting to occur. We identify difficulties in resuming elective work and suggest strategies that could be employed to avoid a public health crisis.


Subject(s)
Appointments and Schedules , COVID-19/epidemiology , Delivery of Health Care/organization & administration , Waiting Lists , Delivery of Health Care/statistics & numerical data , England/epidemiology , Humans , Pandemics , SARS-CoV-2 , State Medicine
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