RESUMEN
Bariatric surgery for morbid obesity has been established as an effective treatment method and has been shown to be associated with resolution of co-morbidities. Despite its success, some patients may require revision because of weight regain or mechanical complications. From September 2005 to December 2009, 42 patients underwent revisional Roux-en-Y gastric bypass (RYGB). All procedures were performed by one surgeon. Demographics, indications for revision, complications, and weight loss were reviewed. Thirty-seven patients were treated with laparoscopic (n = 36) or open (n = 1) RYGB after failed laparoscopic adjustable gastric banding. Four patient were treated with laparoscopic (n = 3) or open (n-1) RYGB after failed vertical banded gastroplasty, and one patient underwent open redo RYGB due to large gastric pouch. Conversion rate from laparoscopy to open surgery was 2.5% (one patient). Mean operative time was 145.83 ± 35.19 min, and hospital stay was 3.36 ± 1.20 days. There was no mortality. Early and late complications occurred in six patients (14.2%). The mean follow-up was 15.83 ± 13.43 months. Mean preoperative body mass index was 45.15 ± 7.95 that decreased to 35.23 ± 6.7, and mean percentage excess weight loss was 41.19 ± 20.22 after RYGB within our follow-up period. RYGB as a revisional bariatric procedure is effective to treat complications of restrictive procedures and to further reduce weight in morbidly obese patients.
Asunto(s)
Derivación Gástrica/métodos , Obesidad Mórbida/cirugía , Adulto , Femenino , Humanos , Laparoscopía , Masculino , Persona de Mediana Edad , Reoperación , Estudios Retrospectivos , Insuficiencia del Tratamiento , Pérdida de PesoRESUMEN
OBJECTIVES: To report an unusual presentation of a giant sigmoid diverticulum in the colon. CLINICAL PRESENTATION AND INTERVENTION: The patient presented with an abdominal mass, altered bowel habits, and increasing weight. The provisional diagnosis was made by barium enema and CT scan. The patient underwent laparotomy, revealing a perforated giant sigmoid diverticulum that was excised using Hartmann's procedure. The perforation could have been precipitated by the barium enema study. The histopathology of the resected specimen revealed giant sigmoid diverticulum with no evidence of malignancy. CONCLUSION: CT scan was adequate for diagnosis of the suspected giant sigmoid diverticulum. Surgical intervention was successfully used to excise the diverticulum.