Bariatric Surgery in the Caribbean Is It Safe in a Low-Volume, Third World Setting英文文献资料.docVIP

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Bariatric Surgery in the Caribbean Is It Safe in a Low-Volume, Third World Setting英文文献资料.doc

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Bariatric Surgery in the Caribbean Is It Safe in a Low-Volume, Third World Setting英文文献资料

HindawiPublishingCorporation MinimallyInvasiveSurgery Volume2012,ArticleID427803,5pages doi:10.1155/2012/427803 ResearchArticle BariatricSurgeryintheCaribbean:IsItSafein aLow-Volume,ThirdWorldSetting? DilipDan,YardeshSingh,VijayNaraynsingh,SeetharamanHariharan, RaviMaharaj,andSurujpalTeelucksingh DepartmentofClinicalSurgicalSciences,TheUniversityoftheWestIndies,St.Augustine,TrinidadandTobago CorrespondenceshouldbeaddressedtoSeetharamanHariharan,uwi.hariharan@ Received16November2011;Revised16January2012;Accepted3February2012 AcademicEditor:KevinReavis Copyright?2012DilipDanetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Bariatricsurgeryisawell-recognizedmodalityofmanagementofobesity.Inadditiontoobesity,ite?ectivelycontrolsdiabetes mellitus,andhypertension.Ithasbeenrecommendedthatbariatricsurgeryshouldbedonein“designatedcenters”ofexcellence wherethereisahighvolumeofcaseturnover.Caribbeannationsarenotsparedfromtheglobalspreadoftheobesityepidemic; however,notmanypatientsgetthebene?tsofbariatricsurgery.Thisstudyaimedtoestablishthatbariatricsurgerycouldbesafely ande?cientlyundertakeninalow-volumecenteroutsidethe“designatedcenters”withcomparablepatientoutcomesevenina thirdworldsetting.Though“patientnumbers”generallyimplybetteroutcome,inanenvironmentwherethesenumberscannot beachieved,patientsshouldnotbedeniedtheaccesstosurgeryoncegoodoutcomesareachieved. 1.Introduction Inthedevelopedworld,bariatricsurgeryisusuallyper- formedatdesignatedcentersofexcellenceonthebasisthat thisleadstobetteroutcomes.However,itisdebatableifbar- iatricsurgeryshouldbelimitedtosuchhigh-volumecenters [10]. In addition to control of obesity, bariatric surgery is also very e?ective in the management of diabetes mellitus andhypertension,whichcommonlya?ictsthispopulation. Sincetheprevalenceofdiabetesmellitusandhypertensionis alsoveryhighintheCaribbeannations,it