Geriatric Bariatric Surgery: Outcomes at a Single Institution.

Obesity, especially in those over the age of 65, is associated with multiple comorbidities and decreased quality of life. Bariatric surgery is an effective method of weight loss and management of comorbidities and is increasingly utilized in younger and middle-aged populations. A retrospective review was performed of patients ≥65 years old who underwent bariatric surgery between 2018 and 2021 at a single institution to evaluate the safety and efficacy of bariatric surgery in older populations. A total of 11 patients were identified with a mean age of 67.5, ranging from 65 to 78. All patients had obesity-related comorbidities including hypertension (90.9%), obstructive sleep apnea (72.7%), diabetes mellitus (54.5%), hyperlipidemia (45.5%), and others. The mean %EWL at 12 months was 26.1% with improvement in comorbidities and no post-operative complications. Our results demonstrate that bariatric surgery can be safe for the geriatric population with improvement in weight loss and comorbidities.

Optimizing throughput of babies with infantile hypertrophic pyloric stenosis.

BACKGROUND: Definitive surgical care is often delayed in hypertrophic pyloric stenosis (HPS). Our aim is to evaluate the effect modifiable factors in preoperative HPS management have on efficiency of care. METHODS: A retrospective review of all patients undergoing pyloromyotomy for HPS at two US children's hospitals between 2008 and 2018 was performed. RESULTS: 406 patients were included in the study. The majority (310, 76 â€‹%) were adequately resuscitated and ready for surgery upon diagnosis in the ER. However, only 133 patients (43 â€‹%) had surgery on the day of admission. Patients diagnosed between 12pm and 6pm were more likely to have surgery the next day than those diagnosed before noon (67 â€‹% vs 33 â€‹%, p â€‹< â€‹.001), which correlated with a longer length of stay (32 vs 47 â€‹h, p â€‹< â€‹.001). CONCLUSION: The majority of patients presenting with HPS can safely undergo same day surgery. Delaying surgery due to an afternoon diagnosis is common, and leads to a modifiable increased total length of stay.

Laparoscopic Paraesophageal Hernia Repair With Nissen Fundoplication in a Patient With Ancient Schwannoma of the Gastroesophageal Junction.

Schwannomas are mostly benign tumors that originate from Schwann cells and are rarely seen in the gastrointestinal tract. Our patient is a 65-year-old female who was found to have a 1.5 cm lesion at the gastroesophageal junction, which was clipped and excised on endoscopy. Histologic examination demonstrated an ancient schwannoma. Two years afterward, she presented to our clinic for a large type III paraesophageal hernia. We took her to the operating room for a laparoscopic paraesophageal hernia repair and Nissen fundoplication. We performed an upper endoscopy during the case and found no recurrence of the ancient schwannoma. The case progressed well without complications. She was discharged on postoperative day 1 after tolerating a pureed diet and reported no issues in follow-up. In summary, we demonstrate a successful surgical outcome in a patient who had undergone resection of this rare tumor 2 years prior to her surgery.