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[Accelerating development of bariatric surgery in Sweden].

https://arctichealth.org/en/permalink/ahliterature125605
Source
Lakartidningen. 2011 Dec 7-13;108(49):2574-7
Publication Type
Article

Alcohol consumption and alcohol problems after bariatric surgery in the Swedish obese subjects study.

https://arctichealth.org/en/permalink/ahliterature115320
Source
Obesity (Silver Spring). 2013 Dec;21(12):2444-51
Publication Type
Article
Date
Dec-2013
Author
Per-Arne Svensson
Åsa Anveden
Stefano Romeo
Markku Peltonen
Sofie Ahlin
Maria Antonella Burza
Björn Carlsson
Peter Jacobson
Anna-Karin Lindroos
Hans Lönroth
Cristina Maglio
Ingmar Näslund
Kajsa Sjöholm
Hans Wedel
Bo Söderpalm
Lars Sjöström
Lena M S Carlsson
Author Affiliation
Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, SE-41345 Gothenburg, Sweden.
Source
Obesity (Silver Spring). 2013 Dec;21(12):2444-51
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects
Alcohol-Related Disorders - epidemiology
Body mass index
Case-Control Studies
Female
Follow-Up Studies
Gastric Bypass
Gastroplasty
Humans
Incidence
Male
Middle Aged
Obesity - surgery
Postoperative Care
Prospective Studies
Sweden - epidemiology
Abstract
Increased sensitivity to alcohol after gastric bypass has been described. The aim of this study was to investigate whether bariatric surgery is associated with alcohol problems.
The prospective, controlled Swedish Obese Subjects (SOS) study enrolled 2,010 obese patients who underwent bariatric surgery (68% vertical banded gastroplasty (VBG), 19% banding, and 13% gastric bypass) and 2,037 matched controls. Patients were recruited between 1987 and 2001. Data on alcohol abuse diagnoses, self-reported alcohol consumption, and alcohol problems were obtained from the National Patient Register and questionnaires. Follow-up time was 8-22 years.
During follow-up, 93.1% of the surgery patients and 96.0% of the controls reported alcohol consumption classified as low risk by the World Health Organization (WHO). However, compared to controls, the gastric bypass group had increased risk of alcohol abuse diagnoses (adjusted hazard ratio [adjHR] = 4.97), alcohol consumption at least at the WHO medium risk level (adjHR = 2.69), and alcohol problems (adjHR = 5.91). VBG increased the risk of these conditions with adjHRs of 2.23, 1.52, and 2.30, respectively, while banding was not different from controls.
Alcohol consumption, alcohol problems, and alcohol abuse are increased after gastric bypass and VBG.
PubMed ID
23520203 View in PubMed
Less detail

Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications.

https://arctichealth.org/en/permalink/ahliterature104186
Source
JAMA. 2014 Jun 11;311(22):2297-304
Publication Type
Article
Date
Jun-11-2014
Author
Lars Sjöström
Markku Peltonen
Peter Jacobson
Sofie Ahlin
Johanna Andersson-Assarsson
Åsa Anveden
Claude Bouchard
Björn Carlsson
Kristjan Karason
Hans Lönroth
Ingmar Näslund
Elisabeth Sjöström
Magdalena Taube
Hans Wedel
Per-Arne Svensson
Kajsa Sjöholm
Lena M S Carlsson
Author Affiliation
Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Source
JAMA. 2014 Jun 11;311(22):2297-304
Date
Jun-11-2014
Language
English
Publication Type
Article
Keywords
Adult
Bariatric Surgery
Blood glucose
Case-Control Studies
Diabetes Complications - prevention & control
Diabetes Mellitus, Type 2 - complications - surgery
Female
Humans
Male
Middle Aged
Obesity - complications - surgery
Prospective Studies
Recurrence
Sweden
Treatment Outcome
Weight Loss
Abstract
Short-term studies show that bariatric surgery causes remission of diabetes. The long-term outcomes for remission and diabetes-related complications are not known.
To determine the long-term diabetes remission rates and the cumulative incidence of microvascular and macrovascular diabetes complications after bariatric surgery.
The Swedish Obese Subjects (SOS) is a prospective matched cohort study conducted at 25 surgical departments and 480 primary health care centers in Sweden. Of patients recruited between September 1, 1987, and January 31, 2001, 260 of 2037 control patients and 343 of 2010 surgery patients had type 2 diabetes at baseline. For the current analysis, diabetes status was determined at SOS health examinations until May 22, 2013. Information on diabetes complications was obtained from national health registers until December 31, 2012. Participation rates at the 2-, 10-, and 15-year examinations were 81%, 58%, and 41% in the control group and 90%, 76%, and 47% in the surgery group. For diabetes assessment, the median follow-up time was 10 years (interquartile range [IQR], 2-15) and 10 years (IQR, 10-15) in the control and surgery groups, respectively. For diabetes complications, the median follow-up time was 17.6 years (IQR, 14.2-19.8) and 18.1 years (IQR, 15.2-21.1) in the control and surgery groups, respectively.
Adjustable or nonadjustable banding (n = 61), vertical banded gastroplasty (n = 227), or gastric bypass (n = 55) procedures were performed in the surgery group, and usual obesity and diabetes care was provided to the control group.
Diabetes remission, relapse, and diabetes complications. Remission was defined as blood glucose
PubMed ID
24915261 View in PubMed
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Association of Maternal Gastric Bypass Surgery With Offspring Birth Defects.

https://arctichealth.org/en/permalink/ahliterature308643
Source
JAMA. 2019 10 15; 322(15):1515-1517
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
10-15-2019

Bariatric surgery and long-term cardiovascular events.

https://arctichealth.org/en/permalink/ahliterature128246
Source
JAMA. 2012 Jan 4;307(1):56-65
Publication Type
Article
Date
Jan-4-2012
Author
Lars Sjöström
Markku Peltonen
Peter Jacobson
C David Sjöström
Kristjan Karason
Hans Wedel
Sofie Ahlin
Åsa Anveden
Calle Bengtsson
Gerd Bergmark
Claude Bouchard
Björn Carlsson
Sven Dahlgren
Jan Karlsson
Anna-Karin Lindroos
Hans Lönroth
Kristina Narbro
Ingmar Näslund
Torsten Olbers
Per-Arne Svensson
Lena M S Carlsson
Author Affiliation
Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. lars.v.sjostrom@medfak.gu.se
Source
JAMA. 2012 Jan 4;307(1):56-65
Date
Jan-4-2012
Language
English
Publication Type
Article
Keywords
Adult
Bariatric Surgery
Cardiovascular Diseases - mortality - prevention & control
Case-Control Studies
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - mortality - prevention & control
Obesity - surgery
Prospective Studies
Stroke - mortality - prevention & control
Sweden - epidemiology
Weight Loss
Abstract
Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking.
To study the association between bariatric surgery, weight loss, and cardiovascular events.
The Swedish Obese Subjects (SOS) study is an ongoing, nonrandomized, prospective, controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden of 2010 obese participants who underwent bariatric surgery and 2037 contemporaneously matched obese controls who received usual care. Patients were recruited between September 1, 1987, and January 31, 2001. Date of analysis was December 31, 2009, with median follow-up of 14.7 years (range, 0-20 years). Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women. Exclusion criteria were identical in surgery and control patients. Surgery patients underwent gastric bypass (13.2%), banding (18.7%), or vertical banded gastroplasty (68.1%), and controls received usual care in the Swedish primary health care system. Physical and biochemical examinations and database cross-checks were undertaken at preplanned intervals.
The primary end point of the SOS study (total mortality) was published in 2007. Myocardial infarction and stroke were predefined secondary end points, considered separately and combined.
Bariatric surgery was associated with a reduced number of cardiovascular deaths (28 events among 2010 patients in the surgery group vs 49 events among 2037 patients in the control group; adjusted hazard ratio [HR], 0.47; 95% CI, 0.29-0.76; P = .002). The number of total first time (fatal or nonfatal) cardiovascular events (myocardial infarction or stroke, whichever came first) was lower in the surgery group (199 events among 2010 patients) than in the control group (234 events among 2037 patients; adjusted HR, 0.67; 95% CI, 0.54-0.83; P
Notes
Comment In: Nat Rev Endocrinol. 2012 Mar;8(3):13022271190
Comment In: JAMA. 2012 Apr 18;307(15):1577; author reply 1577-822511678
Comment In: Nat Rev Cardiol. 2012 Mar;9(3):12622271018
Comment In: Praxis (Bern 1994). 2012 May 9;101(10):673-522565560
Comment In: JAMA. 2012 Jan 4;307(1):88-922215170
PubMed ID
22215166 View in PubMed
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Bleeding during laparoscopic gastric bypass surgery as a risk factor for less favorable outcome. A cohort study from the Scandinavian Obesity Surgery Registry.

https://arctichealth.org/en/permalink/ahliterature292621
Source
Surg Obes Relat Dis. 2017 Oct; 13(10):1735-1740
Publication Type
Comparative Study
Journal Article
Date
Oct-2017
Author
Erik Stenberg
Eva Szabo
Ingmar Näslund
Johan Ottosson
Author Affiliation
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. Electronic address: erik.stenberg@regionorebrolan.se.
Source
Surg Obes Relat Dis. 2017 Oct; 13(10):1735-1740
Date
Oct-2017
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Adult
Blood Loss, Surgical - statistics & numerical data
Cohort Studies
Female
Gastric Bypass - adverse effects
Humans
Laparoscopy - adverse effects
Male
Obesity - epidemiology - surgery
Postoperative Complications - epidemiology - etiology
Quality of Life
Registries
Risk factors
Sweden - epidemiology
Treatment Outcome
Abstract
Intraoperative adverse events are known to be associated with postoperative complications; however, little is known about whether or not blood loss during laparoscopic gastric bypass surgery affects the outcome.
To see if intraoperative bleeding was associated with a less favorable outcome, and to identify patient-specific risk factors for intraoperative bleeding.
Nationwide, Sweden.
Patients who underwent laparoscopic gastric bypass surgery between January 8, 2007, and September 15, 2015, were included in the study. The volume of intraoperative blood loss was compared with data from follow-up at day 30 and 1 and 2 years after surgery. Patient-specific factors were analyzed as potential risk factors for intraoperative bleeding.
The study included 43,157 patients. Intraoperative bleeding was associated with an increased risk for postoperative complication (100-499 mL, odds ratio [OR] 2.97, 95% confidence interval [95%CI] 2.53-3.50;>500 mL OR 3.34, 95%CI 2.05-5.44), lower weight loss (500 mL 76.9±23.89 %EBMIL, P = .063) and lower reported quality-of-life 2 years after surgery (500 mL, OP 25.2±24.46, P = .272). Diabetes (OR 1.30, 95%CI 1.08-1.58), age (OR 1.02, 95%CI 1.02-1.03), and body mass index (OR 1.03, 95%CI 1.02-1.05) were patient-specific risk factors for intraoperative bleeding=100 mL, whereas intentional preoperative weight loss was associated with a lower risk (OR .50, 95%CI .43-.57).
Intraoperative bleeding was associated with less favorable outcome after laparoscopic gastric bypass surgery. Age, body mass index, and diabetes were risk factors for intraoperative bleeding, while preoperative weight reduction seems to be protective.
Notes
CommentIn: Surg Obes Relat Dis. 2017 Oct;13(10 ):1741-1742 PMID 28826794
PubMed ID
28688860 View in PubMed
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Cardiovascular disease and mortality in patients with type 2 diabetes after bariatric surgery in Sweden: a nationwide, matched, observational cohort study.

https://arctichealth.org/en/permalink/ahliterature275224
Source
Lancet Diabetes Endocrinol. 2015 Nov;3(11):847-54
Publication Type
Article
Date
Nov-2015
Author
Björn Eliasson
Vasileios Liakopoulos
Stefan Franzén
Ingmar Näslund
Ann-Marie Svensson
Johan Ottosson
Soffia Gudbjörnsdottir
Source
Lancet Diabetes Endocrinol. 2015 Nov;3(11):847-54
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cardiovascular Diseases - complications - mortality - surgery
Child
Child, Preschool
Cohort Studies
Diabetes Mellitus, Type 2 - complications - surgery
Female
Gastric Bypass
Humans
Infant
Infant, Newborn
Kaplan-Meier Estimate
Male
Middle Aged
Obesity - complications - surgery
Proportional Hazards Models
Risk factors
Sweden
Treatment Outcome
Young Adult
Abstract
In patients with diabetes and obesity specifically, no studies have examined mortality after bariatric surgery. We did a nationwide study in Sweden to examine risks of cardiovascular disease and mortality in patients with obesity and diabetes who had undergone bariatric surgery (Roux-en-Y gastric bypass [RYGB]).
In this nationwide, matched, observational cohort study, we merged data for patients who had undergone RYGB registered in the Scandinavian Obesity Surgery Registry with other national databases, and identified matched controls (on the basis of sex, age, BMI, and calendar time [year]) who had not undergone bariatric surgery from the National Diabetes Registry. We assessed risks of cardiovascular disease and death using a Cox proportional-hazards regression model and other methods to examine the treatment effect while accounting for residual confounding. Primary outcomes were total mortality, cardiovascular death, and fatal or non-fatal myocardial infarction.
Between Jan 1, 2007, and Dec 31, 2014, we obtained data for 6132 patients who had undergone RYGB and 6132 control patients who had not. Median follow-up was 3·5 years (IQR 2·1-4·7). We noted a 58% relative risk reduction (hazard ratio [HR] 0·42, 95% CI 0·30-0·57; p
Notes
Comment In: Lancet Diabetes Endocrinol. 2015 Nov;3(11):828-926429403
PubMed ID
26429401 View in PubMed
Less detail

Closure of mesenteric defects in laparoscopic gastric bypass: a multicentre, randomised, parallel, open-label trial.

https://arctichealth.org/en/permalink/ahliterature273128
Source
Lancet. 2016 Apr 2;387(10026):1397-404
Publication Type
Article
Date
Apr-2-2016
Author
Erik Stenberg
Eva Szabo
Göran Ågren
Johan Ottosson
Richard Marsk
Hans Lönroth
Lars Boman
Anders Magnuson
Anders Thorell
Ingmar Näslund
Source
Lancet. 2016 Apr 2;387(10026):1397-404
Date
Apr-2-2016
Language
English
Publication Type
Article
Keywords
Adult
Female
Gastric Bypass - adverse effects
Hernia, Abdominal - epidemiology
Humans
Intestinal Obstruction - epidemiology - surgery
Jejunostomy
Jejunum - surgery
Laparoscopy - adverse effects
Male
Mesentery - injuries - surgery
Middle Aged
Operative Time
Postoperative Complications - epidemiology
Reoperation - statistics & numerical data
Sweden - epidemiology
Wound Closure Techniques
Abstract
Small bowel obstruction due to internal hernia is a common and potentially serious complication after laparoscopic gastric bypass surgery. Whether closure of surgically created mesenteric defects might reduce the incidence is unknown, so we did a large randomised trial to investigate.
This study was a multicentre, randomised trial with a two-arm, parallel design done at 12 centres for bariatric surgery in Sweden. Patients planned for laparoscopic gastric bypass surgery at any of the participating centres were offered inclusion. During the operation, a concealed envelope was opened and the patient was randomly assigned to either closure of mesenteric defects beneath the jejunojejunostomy and at Petersen's space or non-closure. After surgery, assignment was open label. The main outcomes were reoperation for small bowel obstruction and severe postoperative complications. Outcome data and safety were analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01137201.
Between May 1, 2010, and Nov 14, 2011, 2507 patients were recruited to the study and randomly assigned to closure of the mesenteric defects (n=1259) or non-closure (n=1248). 2503 (99·8%) patients had follow-up for severe postoperative complications at day 30 and 2482 (99·0%) patients had follow-up for reoperation due to small bowel obstruction at 25 months. At 3 years after surgery, the cumulative incidence of reoperation because of small bowel obstruction was significantly reduced in the closure group (cumulative probability 0·055 for closure vs 0·102 for non-closure, hazard ratio 0·56, 95% CI 0·41-0·76, p=0·0002). Closure of mesenteric defects increased the risk for severe postoperative complications (54 [4·3%] for closure vs 35 [2·8%] for non-closure, odds ratio 1·55, 95% CI 1·01-2·39, p=0·044), mainly because of kinking of the jejunojejunostomy.
The results of our study support the routine closure of the mesenteric defects in laparoscopic gastric bypass surgery. However, closure of the mesenteric defects might be associated with increased risk of early small bowel obstruction caused by kinking of the jejunojejunostomy.
Örebro County Council, Stockholm City Council, and the Erling-Persson Family Foundation.
Notes
Comment In: Lancet. 2016 Apr 2;387(10026):1351-226895676
PubMed ID
26895675 View in PubMed
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[Current patient records systems not sufficient as a basis for ranking lists].

https://arctichealth.org/en/permalink/ahliterature147250
Source
Lakartidningen. 2009 Oct 7-13;106(41):2623
Publication Type
Article
Author
Britta Ryttberg
Elizabeth Nyström
Agneta Stenberg
Katarina Palm
Ingmar Näslund
Author Affiliation
Kardiologiska Kliniknen, Universitetssjukhuset, Orebro. britta.ryttberg@orebroll.se
Source
Lakartidningen. 2009 Oct 7-13;106(41):2623
Language
Swedish
Publication Type
Article
Keywords
Databases, Factual - standards
Humans
Medical Records - standards
Myocardial Infarction - diagnosis - mortality
Quality Assurance, Health Care
Registries - standards
Sweden - epidemiology
Notes
Comment In: Lakartidningen. 2009 Nov 11-17;106(46):309119998614
Comment On: Lakartidningen. 2009 Oct 7-13;106(41):2622-319927928
PubMed ID
19927929 View in PubMed
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Delivery outcomes in term births after bariatric surgery: Population-based matched cohort study.

https://arctichealth.org/en/permalink/ahliterature299324
Source
PLoS Med. 2018 09; 15(9):e1002656
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Olof Stephansson
Kari Johansson
Jonas Söderling
Ingmar Näslund
Martin Neovius
Author Affiliation
Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
Source
PLoS Med. 2018 09; 15(9):e1002656
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adult
Bariatric Surgery
Body mass index
Cesarean Section
Cohort Studies
Delivery, Obstetric
Female
Humans
Infant, Newborn
Male
Obesity - complications - pathology - surgery
Pregnancy
Pregnancy Complications - pathology
Pregnancy outcome
Prospective Studies
Sweden
Term Birth
Weight Loss
Abstract
Obesity increases the risk of adverse delivery outcomes. Whether weight loss induced by bariatric surgery influences these risks remains to be determined. The objective was to investigate the risk of adverse delivery outcomes among post-surgery women compared with women without bariatric surgery history but with similar characteristics.
We identified 801,443 singleton live-born term births (=37 gestational weeks) in the Swedish Medical Birth Register between 1 January 2006 and 31 December 2013, of which 1,929 were in women with a history of bariatric surgery and a pre-surgery weight available from the Scandinavian Obesity Surgery Registry. For each post-surgery delivery, up to 5 control deliveries were matched by maternal pre-surgery BMI (early-pregnancy BMI used for controls), age, parity, smoking, education, height, country of birth, and delivery year (N post-surgery deliveries:matched controls = 1,431:4,476). The main outcome measures were mode of delivery, induction of labor, post-term pregnancy (=42 + 0 gestational weeks), epidural analgesia, fetal distress, labor dystocia, peripartum infection, obstetric anal sphincter injury (perineal tear grade III-IV), and postpartum hemorrhage. Among the women with a history of bariatric surgery, the mean pre-surgery BMI was 42.6 kg/m2, the median surgery-to-conception interval was 1.4 years, and the mean BMI loss between surgery and early pregnancy was 13.5 kg/m2 (38 kg). Compared to matched control women, post-surgery women were less likely to have cesarean delivery (18.2% versus 25.0%, risk ratio [RR] 0.70, 95% CI 0.60-0.80), especially emergency cesarean (6.8% versus 15.1%, RR 0.40, 95% CI 0.31-0.51). Post-surgery women also had lower risks of instrumental delivery (5.0% versus 6.5%, RR 0.73, 95% CI 0.53-0.98), induction of labor (23.4% versus 34.0%, RR 0.68, 95% CI 0.59-0.78), post-term pregnancy (4.2% versus 10.3%, RR 0.40, 95% CI 0.30-0.53), obstetric anal sphincter injury (1.5% versus 2.9%, RR 0.46, 95% CI 0.25-0.81), and postpartum hemorrhage (4.6% versus 8.0%, RR 0.58, 95% CI 0.44-0.76). Since this study was not randomized, a limitation is the possibility of selection bias, despite our efforts using careful matching.
Bariatric-surgery-induced weight loss was associated with lower risks for adverse delivery outcomes in term births.
PubMed ID
30256796 View in PubMed
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30 records – page 1 of 3.