{"title":"Role of Metabolic Surgery in Polycystic Ovarian Disease with Obesity in the Asian Population: A Systematic Narrative Literature Review","authors":"D. Veetil, R. Wadhawan","doi":"10.4103/jbs.jbs_15_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_15_23","url":null,"abstract":"\u0000 Polycystic ovarian syndrome is becoming more prevalent (up to 13%) among young women of reproductive age with obesity. Lifestyle modifications remain the first line of management of obesity in these individuals. Bariatric and metabolic surgery (BMS) has a role in achieving significant and sustained weight loss in cases where lifestyle modifications alone are not effective. A detailed systematic narrative literature review was undertaken to understand the role of BMS in this subset of individuals to help recommend management strategies in women with polycystic ovarian syndrome, obesity, and infertility among the Asian population. BMS has been documented to correct menstrual irregularities (from 81% to 15%, odds ratio = 0.03, 95% confidence interval: 0.01–0.08), hirsutism from 71% to 38% (odds ratio = 0.21, 95% confidence interval: 0.06–0.74), and endocrine abnormalities associated with polycystic ovarian syndrome. Improvement in infertility (high incidence of nearly 58%) was noted with normalization of the body mass index (BMI) postsurgery in some studies. Larger sample size studies with a longer follow-up are required to enable the development of guidelines on the role of BMS in the improvement of infertility in patients with polycystic ovarian syndrome. The superiority of one type of technique of BMS has not been demonstrated for improving the fertility rates (P = 0.9) among the different types of surgical procedures and pregnancy rates. Different regions of the world will need different BMI cutoffs while managing the endocrine abnormalities, menstrual irregularities, and associated infertility of women with polycystic ovarian syndrome and obesity. This systematic narrative literature review is an attempt to study the relevant literature in this field with a special focus on the Asian population.","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139382887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leticia Roque, Gustavo De Assis Mota, C. Nonino, Wilson Salgado Júnior
{"title":"Evaluation of Esophageal Motility in Obese Patients before and after Bariatric Surgery: Role of Multichannel Intraluminal Impedance and High-resolution Manometry","authors":"Leticia Roque, Gustavo De Assis Mota, C. Nonino, Wilson Salgado Júnior","doi":"10.4103/jbs.jbs_17_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_17_23","url":null,"abstract":"\u0000 \u0000 \u0000 A high prevalence of esophageal motor disorders has been reported in obese patients. Roux-en-Y gastric bypass (RYGB) can trigger symptoms of dysphagia by worsening preexisting esophageal motor disorders. Investigation of esophageal motility with multichannel intraluminal impedance (MII) and high-resolution manometry (HRM) is available.\u0000 \u0000 \u0000 \u0000 The aim is to compare the results of MII and HRM of nonobese patients with those of obese patients before and after RYGB to identify possible preoperative predictive factors of postoperative dysphagia.\u0000 \u0000 \u0000 \u0000 Twenty-eight obese patients were evaluated with a questionnaire of symptoms, endoscopy, HRM, and MII in different postures (supine and sitting) before and 6 months after laparoscopic RYGB. They were compared with eleven nonobese subjects. Chicago classification parameters were used to characterize esophageal motility disorders.\u0000 \u0000 \u0000 \u0000 Obese patients evolved with more symptoms of dysphagia after surgery (7.10% preoperatively and 32.10% postoperatively). None had gastrojejunal anastomosis stenosis. After bariatric surgery, there was an increase in distal latency (HRM) and also a decrease in esophageal alimentary bolus progression (MII). Twenty-one percent of obese patients already had some dysmotility before the surgery and 92% of them evolved to dysphagia after the operation.\u0000 \u0000 \u0000 \u0000 Previous esophageal motility disorder is a good predictive factor of postoperative dysphagia. HRM and MII should be performed in some situations, such as bariatric surgery for older adults and before narrowing the gastrojejunal anastomosis as a treatment for weight recidivism.\u0000","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"24 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139383807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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