Long-term outcome of metabolic surgery
Background and Aims / Part 1
The care of patients who undergo bariatric surgery is complex. These patients are not only severely obese, they are also burdened by the other expressions of the metabolic syndrome including type 2 diabetes, polycystic ovary syndrome, NASH, hypertension among other associated diseases. They pose challenges in selection, in assessment, in preparation for surgery, in post-operative care and, especially, in the management of late complications, including neuropathies due to malnutrition, episodic hypoglycemic attacks, internal hernias and mental health challenges
Methods / Part 2
Review of current approach to bariatric surgery. Comparison with other multidisciplinary centers such as pediatric hospitals, cancer centers, heart institutes
Results / Part 3
Surgeons do not have the resources, the time nor the training to address these issues alone. Interdisciplinary care is required at every stage of the progression before, during and after bariatric surgery.
Accordingly, it is time to follow the successful examples in the care of cancer and heart disease with the establishment of metabolic centers staffed by the various disciplines involved in the care of these complex and challenging patients. This presentation will review the early and long term outcomes of bariatric surgery, the shared pathology of the various expressions of the metabolic syndrome, the organizational structure of the proposed centers and approaches to certification for quality control.