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Published byAlbert Ryan Modified over 9 years ago
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Dr. M. Talebpour Advanced Laparoscopic Fellowship Tehran Medical University
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Disease Diet & Exercise: <10% Surgery: Restrictive (Total vertical gastric plication) Variation of results: EWL was 28% to 95% after 6 month Range of response in other restrictive techniques: 30% to 100% Aim: To find out effective factors in EWL
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200 cases during 4.5 years (02 to 07) 163 cases followed by standard control visits EWL : 28% to 95% (6 months), wide range 59% (137 cases) after 6 months 63% (105 cases) after 1 year 60% (64 cases) after 2 years 57% (41 cases) after 3 years 55% (26 cases) after 4 years
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BMI>40 or 35 and comorbidity Cases over 70% EWL (until 2 years) included Follow up: Every week (first month) Every two weeks (next 5 months) Every month (next 18 months) 10 factors: Age Sex Marriage Appetite Job Relatives Group club Pain during eating Comorbidity Volume residue
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40 cases 90 cases Comparison Sex: 38/2 90/12 5.2% to 13% M Age: 24 (18 – 30) 34(18 – 52) Co morbidity: 3 9 7.5% to 10% Marriage: 34 S 41 S 85% to 45% Appetite: 3 10 7.5% to 11%
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40 cases 90 cases Comparison Residue: 35 69 87% to 76% Job: 15 38 37% to 42% Relatives: 36 78 90% to 86% Pain: 38 80 95% to 88% Group club: 25 30 62% to 33%
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Young Female Single Group club
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Surgery is indicated in morbid obesity Gaining the best result is not essentially related to the form of operation It is secondary to some other factors that increase the interest of patient to use diet and exercise (incentive)
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PATIENT WITH THE MOST MOTIVATION ROLE OF DIFFERENT RESTRICTIVE METHODS??
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