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These endocrine alterations may have consequences in the health and quality of life of obese men since they may result in impaired fertility and poor sexual life. As many clinical reports suggest, weight loss can ameliorate hypogonadism and, more generally, alterations in sex hormones. This effect is evident even when weight loss is induced by bariatric surgery. The evidence that hypogonadism in morbidly obese patients can regress after bariatric surgery should lead us to consider it as a modifiable comorbidity associated to obesity. This would have as a consequence that obese male patients with symptomatic hypogonadism could be candidates for bariatric surgery even with a BMI \u003C 40 kg\u002Fm2. Controlled clinical trials, involving obese hypogonadal males, should be encouraged.",{"EN":1563},"Hypogonadism as a New Comorbidity in Male Patient's Selection for Bariatric Surgery: Towards an Extended Concept of Metabolic Surgery?",{"VOID":1565},"10.1007\u002Fs11695-013-1000-5","https:\u002F\u002Flink.springer.com\u002Farticle\u002F10.1007\u002Fs11695-013-1000-5",[1568,1583],{"id":1569,"sortIndex":21,"researcher":20,"roles":1570,"affiliations":1571,"properties":1580},"a9e24136-17dc-46f5-a05a-5de7bb30f38c",[258],[1572],{"id":20,"sortIndex":21,"affiliation":1573,"properties":20},{"id":1574,"createTime":1575,"updateTime":1575,"relativeEntities":1576,"slug":20,"properties":1577,"entityType":56,"verifyStatus":19,"verifyTime":20,"verifyNote":20,"syncStatus":19,"languages":20,"translateLanguages":20,"viewCount":21},"d31d1933-0ddd-4a8c-abf9-5f960720b463","2024-01-20T14:11:48.168+00:00",[],{"title":1578},{"VI":1579},"Bariatric and Metabolic Surgery Unit, Careggi University Hospital in Florence, Florence, Italy",{"title":1581},{"VI":1582},"M. 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Biliopancreatic diversion with a duodenal switch. ObesSurg. 1998;8:267–82.\nMarceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22:947–54.\nTrelles N, Gagner M. Sleeve gastrectomy. Oper Tech Gen Surg. 2007;9:123–31.\nRosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8:8–19.\nDeitel M, Crosby RD, Gagner M. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25-27, 2007. ObesSurg. 2008;18:487–96.\nGagner M, Deitel M, Kalberer TL, et al. The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009. SurgObesRelatDis. 2009;5:476–85.\nDeitel M, Gagner M, Erickson AL, et al. Third International Summit: current status of sleeve gastrectomy. SurgObesRelatDis. 2011;7:749–59.\nGagner M, Deitel M, Erickson AL, et al. Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. ObesSurg. 2013;23:2013–7.\nGagner M, Hutchinson C, Rosenthal R. Fifth International Consensus Conference: current status of sleeve gastrectomy. SurgObesRelatDis. 2016;12:750–6.\nClinical Issues Committee of American Society for Metabolic and Bariatric Surgery. Sleeve gastrectomy as a bariatric procedure. SurgObesRelatDis. 2007;3:573–6.\nASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2012;8:e21–6.\nFerrer-Marquez M, Belda-Lozano R, Solvas-Salmeron MJ, et al. Revisional surgery after laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2015;25:6–9.\nBrethauer SA, Kothari S, Sudan R, et al. Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis. 2014;10:952–72.\nHoman J, Betzel B, Aarts EO, et al. Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis. 2015;11:771–7.\nSanchez-Pernaute A, Rubio MA, Cabrerizo L, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015;11:1092–8.\nNoel P, Nedelcu M, Nocca D, et al. Revised sleeve gastrectomy: another option for weight loss failure after sleeve gastrectomy. Surg Endosc. 2014;28:1096–102.\nBruzzi M, Voron T, Zinzindohoue F, et al. Revisional single-anastomosis gastric bypass for a failed restrictive procedure: 5-year results. Surg Obes Relat Dis. 2016;12:240–5.\nUser Guide for the 2015 ACS NSQIP Procedure Targeted Participant Use Data File (PUF). American College of Surgeons National Surgical Quality Improvement Program. 2016.\nMangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital infection control practices advisory committee. Infect Control Hosp Epidemiol. 1999;20:250–78. quiz 279–80\nHarris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.\nBrethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11:489–506.\nSilecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.\nFrezza EE. Laparoscopic vertical sleeve gastrectomy for morbid obesity. The future procedure of choice? Surg Today. 2007;37:275–81.\nBoza C, Salinas J, Salgado N, et al. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22:866–71.\nEstimate of Bariatric Surgery Numbers, 2011–2015 [Internet]. Available from: https:\u002F\u002Fasmbs.org\u002Fresources\u002Festimate-of-bariatric-surgery-numbers.\nvan Rutte PW, Smulders JF, de Zoete JP, et al. Indications and short-term outcomes of revisional surgery after failed or complicated sleeve gastrectomy. Obes Surg. 2012;22:1903–8.\nArman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:1778–86.\nShabino PJ, Khoraki J, Elegbede AF, et al. Reduction of surgical site infections after laparoscopic gastric bypass with circular stapled gastrojejunostomy. Surg Obes Relat Dis. 2016;12:4–9.\nYorke E, Sheppard C, Switzer NJ, et al. Revision of sleeve gastrectomy to Roux-en-Y gastric bypass: a Canadian experience. Am J Surg. 2017;213:970–4.\nQuezada N, Hernandez J, Perez G, et al. Laparoscopic sleeve gastrectomy conversion to Roux-en-Y gastric bypass: experience in 50 patients after 1 to 3 years of follow-up. Surg Obes Relat Dis. 2016;12:1611–5.\nCarmeli I, Golomb I, Sadot E, et al. Laparoscopic conversion of sleeve gastrectomy to a biliopancreatic diversion with duodenal switch or a Roux-en-Y gastric bypass due to weight loss failure: our algorithm. Surg Obes Relat Dis. 2015;11:79–85.\nPrachand VN, Ward M, Alverdy JC. Duodenal switch provides superior resolution of metabolic comorbidities independent of weight loss in the super-obese (BMI > or = 50 kg\u002Fm2) compared with gastric bypass. J Gastrointest Surg. 2010;14:211–20.\nDapri G, Cadiere GB, Himpens J. Laparoscopic repeat sleeve gastrectomy versus duodenal switch after isolated sleeve gastrectomy for obesity. Surg Obes Relat Dis. 2011;7:38–43.\nRebibo L, Fuks D, Verhaeghe P, et al. Repeat sleeve gastrectomy compared with primary sleeve gastrectomy: a single-center, matched case study. Obes Surg. 2012;22:1909–15.\nCohen R, Pinheiro JS, Correa JL, et al. Laparoscopic revisional bariatric surgery: myths and facts. Surg Endosc. 2005;19:822–5.\nMoon R, Teixeira A, Potenza K, et al. Routine gastrostomy tube placement in gastric bypass patients: impact on length of stay and 30-day readmission rate. Obes Surg. 2013;23:216–21.",{"EN":1644},"A subset of patients undergoing laparoscopic sleeve gastrectomy (SG) require eventual conversion to Roux-en-Y gastric bypass (RYGB) due to complications from SG or to enhance weight loss. The aim of this study is to characterize the indications for conversion and perioperative outcomes in a large cohort of these patients at a single institution. Patients who underwent revisional surgery to convert SG to RYGB at our institution from January 2008 through January 2017 were retrospectively reviewed. Eighty-nine patients with previous SG underwent conversion to RYGB as part of a planned two-stage approach to gastric bypass (n = 36), for weight recidivism (n = 11), or for complications related to SG (n = 42). Complications from SG that warranted conversion included refractory GERD (40.5%), sleeve stenosis (31.0%), gastrocutaneous (16.7%), or gastropleural (7.1%) fistula, and gastric torsion (4.1%). The mean (SD) age was 47.2 years (11.4 years) and median BMI at the time of revision was 43.2 kg\u002Fm2. A laparoscopic approach was successfully completed in 76 patients (85.4%), with an additional of four completed robotically (4.5%). The median length of stay was 3 days. Twenty-eight patients (31.5%) had complications which included surgical site infection (20.2%), re-operation (6.7%), anastomotic stricture (3.4%), and one pulmonary embolism. There were no mortalities with a median follow-up of 15 months. Conversion of SG to RYGB is safe and technically feasible when performed for complications of SG or to enhance weight loss. This operation can be successfully performed laparoscopically with a low rate of conversion and reasonable complication profile.",{"EN":1646},"Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass",{"VOID":1648},"10.1007\u002Fs11695-018-3435-1","https:\u002F\u002Flink.springer.com\u002Farticle\u002F10.1007\u002Fs11695-018-3435-1",[1651,1687,1699,1719,1738,1757,1776,1795],{"id":1652,"sortIndex":1653,"researcher":20,"roles":1654,"affiliations":1655,"properties":1684},"cdc40844-c39b-423c-9f3a-ba2284070b38",7,[258],[1656,1664,1674],{"id":20,"sortIndex":21,"affiliation":1657,"properties":20},{"id":1658,"createTime":1659,"updateTime":1659,"relativeEntities":1660,"slug":20,"properties":1661,"entityType":56,"verifyStatus":19,"verifyTime":20,"verifyNote":20,"syncStatus":19,"languages":20,"translateLanguages":20,"viewCount":21},"d6e12b49-644a-41ed-9f66-d77bb74f3b2c","2024-01-12T23:46:07.331+00:00",[],{"title":1662},{"VI":1663},"Department of General Surgery, Cleveland Clinic Foundation, Cleveland, USA",{"id":1665,"sortIndex":352,"affiliation":1666,"properties":1673},"58596036-cb46-47a1-b581-7c49cca04514",{"id":1667,"createTime":1668,"updateTime":1668,"relativeEntities":1669,"slug":20,"properties":1670,"entityType":56,"verifyStatus":19,"verifyTime":20,"verifyNote":20,"syncStatus":19,"languages":20,"translateLanguages":20,"viewCount":21},"adbfff0f-158e-417d-bbbe-2f0b9f871919","2023-12-12T14:00:33.571+00:00",[],{"title":1671},{"VI":1672},"Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates",{},{"id":1675,"sortIndex":195,"affiliation":1676,"properties":1683},"cb22c317-f62b-40cc-8cb7-a83bdce92b83",{"id":1677,"createTime":1678,"updateTime":1678,"relativeEntities":1679,"slug":20,"properties":1680,"entityType":56,"verifyStatus":19,"verifyTime":20,"verifyNote":20,"syncStatus":19,"languages":20,"translateLanguages":20,"viewCount":21},"c99bc8f3-48b7-4e6c-8875-907a9a224ccd","2023-12-13T21:09:25.131+00:00",[],{"title":1681},{"VI":1682},"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, USA",{},{"title":1685},{"VI":1686},"Matthew D. 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Objective evidence that bariatric surgery improves obesity-related obstructive sleep apnea. Surgery. 2007;141:354–8.\nO'Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg. 2004;14:23–6.\nRasheid S, Banasiak M, Gallagher SF, et al. Gastric bypass is an effective treatment for obstructive sleep apnea in patients with clinically significant obesity. Obes Surg. 2003;13:58–61.\nRechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subject. Los Angeles: Univ. of California; 1968.\nJohns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14:540–5.\nJohns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep. 1992;15:376–81.\nMaislin G, Pack AI, Kribbs NB, et al. A survey screen for prediction of apnea. Sleep. 1995;18:158–66.\nDancey DR, Hanly PJ, Soong C, et al. Impact of menopause on the prevalence and severity of sleep apnea. Chest. 2001;120:151–5.\nMcKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas. 1992;14:103–15.\nYoung T, Finn L, Austin D, et al. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2003;167:1181–5.\nResta O, Caratozzolo G, Pannacciulli N, et al. Gender, age and menopause effects on the prevalence and the characteristics of obstructive sleep apnea in obesity. Eur J Clin Invest. 2003;33:1084–9.\nResta O, Bonfitto P, Sabato R, et al. Prevalence of obstructive sleep apnoea in a sample of obese women: effect of menopause. Diabetes Nutr Metab. 2004;17:296–303.\nDaltro C, Gregorio PB, Alves E, et al. Prevalence and severity of sleep apnea in a group of morbidly obese patients. Obes Surg. 2007;17:809–14.\nRedline S, Tishler PV, Hans MG, et al. Racial differences in sleep-disordered breathing in African–Americans and Caucasians. Am J Respir Crit Care Med. 1997;155:186–92.\nHwang D, Shakir N, Limann B, et al. Association of sleep-disordered breathing and postoperative complications. Chest. 2008;133:1128–34.",{"EN":1851},"The patient population that is evaluated for bariatric surgery is characterized by a very high body mass index (BMI). Since obesity is the most important risk factor for obstructive sleep apnea (OSA), sleep disordered breathing is highly prevalent in this population. If undiagnosed before bariatric surgery, untreated OSA can lead to perioperative and postoperative complications. Debate exists whether all patients that are considered for bariatric surgery should undergo polysomnography (PSG) evaluation and screening for OSA as opposed to only those patients with clinical history or examination concerning sleep disordered breathing. We examined the prevalence and severity of OSA in all patients that were considered for bariatric surgery. We hypothesized that, by utilizing preoperative questionnaires (regarding sleepiness and OSA respiratory symptoms) in combination with menopausal status and BMI data, we would be able to predict which subjects did not have sleep apnea without the use of polysomnography. In addition, we hypothesized that we would be able to predict which subjects had severe OSA (apnea–hypopnea index (AHI) > 30). Three hundred forty-two consecutive subjects, evaluated for bariatric surgery from November 1, 2005 to January 31, 2007 underwent overnight polysomnography and completed questionnaires regarding sleepiness, menopausal status, and respiratory symptoms related to OSA. Apneas and hypopneas were classified as follows: mild apnea 5 ≤ AHI ≤ 15, moderate apnea 15 \u003C AHI ≤ 30, and severe apnea AHI > 30. The overall sample prevalence of OSA was 77.2%. Of these, 30.7% had mild OSA; 19.3% had moderate OSA, and 27.2% had severe OSA. Among men, the prevalence of OSA was 93.6% and 73.5% among women. The mean AHI (events per hour) for men with OSA was 49.2 ± 35.5 and 26.3 ± 28.3 for women with OSA. Separate logistic regression models were developed for the following three outcomes: AHI ≥ 5 events per hour, AHI > 15 events per hour, and AHI > 30 events per hour. When predicting these three levels of OSA severity, the area under the curve (AUC) values were: 0.8, 0.72, and 0.8, respectively. The negative predictive value for the presence of sleep apnea (AHI ≥ 5) was 75% when using the most stringent possible cutoff for the prediction model. The prevalence of OSA in all patients considered for bariatric surgery was greater than 77%, irrespective of OSA symptoms, gender, menopausal status, age, or BMI. The prediction model that we developed for the presence of OSA (AHI ≥ 5 events per hour) has excellent discriminative ability (evidenced by an AUC value of 0.8). However, the negative prediction values for the presence of OSA were too low to be clinically useful due to the high prevalence of OSA in this high-risk group. We demonstrated that, by utilizing even the most stringent possible cutoff values for the prediction model, OSA cannot be predicted with enough certainty. Therefore, we advocate routine PSG testing for all patients that are considered for bariatric surgery.",{"EN":1853},"Obstructive Sleep Apnea in Patients Undergoing Bariatric Surgery—A Tertiary Center Experience",{"VOID":1855},"10.1007\u002Fs11695-009-9928-1","https:\u002F\u002Flink.springer.com\u002Farticle\u002F10.1007\u002Fs11695-009-9928-1",[1858,1873,1890,1902,1914,1926,1938,1950,1962],{"id":1859,"sortIndex":285,"researcher":20,"roles":1860,"affiliations":1861,"properties":1870},"635c073a-a714-4463-9d91-b5e5902997e6",[258],[1862],{"id":20,"sortIndex":21,"affiliation":1863,"properties":20},{"id":1864,"createTime":1865,"updateTime":1865,"relativeEntities":1866,"slug":20,"properties":1867,"entityType":56,"verifyStatus":19,"verifyTime":20,"verifyNote":20,"syncStatus":19,"languages":20,"translateLanguages":20,"viewCount":21},"f98f3a03-92a7-4ead-b21e-0c01e077f500","2024-01-05T23:58:46.092+00:00",[],{"title":1868},{"VI":1869},"Department of Gastrointestinal Surgery, University of Pennsylvania, Philadelphia, USA",{"title":1871},{"VI":1872},"Steven E. 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