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E E Mason

Publications and source records attributed to E E Mason.

At least 37 records · Page 2Linked to original sources
PubMed1992

Depression and other mental disorders in the relatives of morbidly obese patients.

The authors systematically interviewed 88 bariatric clinic patients presenting for vertical banded gastroplasty. The typical subject was middle-aged, female and of low socioeconomic status as indicated by his or her method of payment. Morbidly obese subjects were more likely than a comparison group to have first-degree relatives with a history of depression, bipolar disorder, antisocial personality, and other psychiatric disorders. These data indicate that relatives of morbidly obese subjects are frequently emotionally disturbed. Reasons for the findings are discussed.

Adult↗
PubMed1992

Gastric surgery for morbid obesity.

Patients with 100 pounds of excess weight (BMI greater than 40) have sufficient risk of complications and impairment of function to warrant an operation. There is no operation that will bring all patients to a normal weight without risk. More complex operations may provide greater weight reduction, at least until compensatory changes occur that permit improved digestion and absorption of food. The more complicated the operation, the greater the risk of undesirable side effects. Vertical banded gastroplasty has evolved over the last 35 years as a simple, safe, and effective way to control excessive weight with a minimum risk. This simple operation will produce a normal weight in about 30% of patients and satisfactory weight control in 80% of patients, without need for revision surgery. Optimum results depend on intraoperative measurement of pouch volume and outlet reinforcement, education of patients in the care of their operation, and continual evaluation of the early and long-term effects of these operations.

Gastric Bypass↗
PubMed1992

Perioperative risks and safety of surgery for severe obesity.

The National Bariatric Surgery Registry (NBSR) results reflect low perioperative risk for obesity surgery. Five deaths occurred within 40 d of operation in 5178 patients (0.1%). A subset of 3174 patients with complete information for complication and postoperative hospital stay was further studied. Females comprised 87% of the data set. Median values were determined for age, 37 y (18-70 y); operative weight, 121 kg (77-288 kg); and operative body mass index (BMI), 44 kg/m2 (29-91 kg/m2). Patients with no complications (89.7%) were reported to have a median postoperative stay of 4 d (2-23 d). The most severe complications were deep venous thrombosis (0.3%) and gastrointestinal leak (0.6%), with median postoperative hospital stay of 12 d (ranges 2-27 and 4-59 d, respectively). The most frequent complication reported was respiratory (4.5%), with median postoperative stay of 6 d (3-34 d). Median postoperative hospital stay for wound infection (1.6%) was 5 d.

Adolescent↗
PubMed1992

Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients.

OBJECTIVE: The authors sought to determine the association between mental disorder and morbid obesity, defined as weight at least 100% or 100 lb over ideal body weight. METHOD: Eighty-eight morbidly obese subjects who had come to a tertiary care center surgery clinic requesting vertical banded gastroplasty were systematically interviewed with the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and the Structured Interview for DSM-III Personality Disorders. A comparison group of 76 psychiatrically normal subjects who were matched in age (within 5 years) and gender to the morbidly obese subjects were also interviewed. RESULTS: Most of the morbidly obese subjects were women, were of low socioeconomic status as indicated by method of payment for medical care, weighed more than 300 lb, and had been obese for more than 14 years. The morbidly obese subjects were more likely than the comparison group to have a lifetime history of mood disorders, anxiety disorders, bulimia, and tobacco dependence. The morbidly obese subjects were also more likely to meet diagnostic criteria for one or more personality disorders. CONCLUSIONS: Substantial psychopathology exists in morbidly obese individuals requesting gastroplasty, a finding that has important clinical implications.

Comorbidity↗
PubMed1991

Reoperation for failed gastric bypass procedures for obesity.

Reoperation is worthwhile when there is an obvious defect in the gastric reduction operation that has failed to control weight. Reoperation occasionally is necessary to correct a complication of gastric bypass. Vertical banded gastroplasty is the operation of choice for reoperations, as it provides weight control while eliminating the problems of bypass. Conversion of a horizontal to a vertical pouch is safe but requires careful attention to the technique to avoid injury to the other organs in the area and preservation of blood supply to the stomach. The gastrogastrostomy across the old horizontal staple line in the vertical pouch can be constructed in a way that will minimize the risk of obstruction. Vertical banded gastroplasty is now the only operation in use at UIHC for the treatment of obesity and is used not only as the primary operation but in all reoperations. Bypass of the stomach and duodenum is not necessary for weight control and adds some risk of malabsorption and duodenal and stomal ulcer plus a lifetime of inaccessibility of the excluded areas for diagnostic and therapeutic measures.

Animals↗
PubMed1989

Balloon dilatation of gastro-gastrostomy strictures in gastroplasty revisions.

Several gastric operations have been developed for the control of morbid obesity. Further surgical intervention may be necessary because of failure to lose weight or complications associated with the previous operation such as intolerable reflux symptoms. Revision from a horizontal to a vertical staple line may result in a stenosis at the site of the gastro-gastrostomy. This study examines the authors' experience with balloon dilation of these strictures. Between May, 1981 and September, 1987, 12 of 113 patients who had revision of previous gastric reduction procedures developed either gastro-gastrostomy stenosis or stenosis above the Marlex collar (2 patients). Endoscopic balloon dilatation was attempted in all 12 patients. Eight females and four males (average age, 42 years) had undergone either a previous vertical banded gastroplasty (VBG) (2 patients), gastric bypass, or horizontal gastroplasty as their initial operation. Revision was performed for failure of the initial operation to control weight, obstructive symptoms, or gastroesophageal reflux. Balloon dilatation was possible in 11 of 12 patients. The majority required less than four dilations to alleviate obstructive symptoms. Balloon dilatation is effective in the management of gastro-gastrostomy stenosis following revision of gastric stapling procedures.

Adult↗
PubMed1987

Morbid obesity: use of vertical banded gastroplasty.

Vertical banded gastroplasty has evolved from gastric bypass and earlier forms of gastroplasty as a safe and effective gastric reduction procedure for the treatment of morbid obesity. This article provides a step-by-step description of the technique. Spatial orientation by use of landmarks such as an Ewald tube in the esophagus, the angle of His, and a Penrose drain around the esophagus is important in avoiding injury to adjacent structures. Careful measurement of the pouch volume at a pressure of 70 cm H2O is necessary. For patients between 170 and 225 per cent of ideal weight, a 5.0 cm circumference collar is used around the outlet. For heavier patients, a 4.5 cm collar is used. Bypass is not necessary because weight control depends on a small pouch and stoma.

Humans↗
PubMed1987

Super obesity and gastric reduction procedures.

Identification and designation of those patients whose estimated ideal weight exceeds 225 per cent as super obese has improved our evaluation of operations designed for treatment of obesity. It has also allowed a more realistic prediction of results, and provided a basis for further study of both the need for, and effectiveness of, further modification of operative treatment of these extremely heavy people. The super obese patient provides a severe test for operative weight control. Much has been accomplished with purely restrictive operations in the super obese group and it is possible that the 50 per cent reduction of excess weight achieved by VBG among these patients is sufficient to prevent the more serious medical complications from extreme obesity.

Adolescent↗
PubMed1987

The utility of MMPI subtypes for the prediction of weight loss after bariatric surgery. Minnesota Multiphasic Personality Inventory.

In this paper we report a study designed to improve the ability to predict postoperative weight loss employing methods dictated by the premise that substantial psychological homogeneity is necessary within subsets of patients before similar weight losses can be observed within those subsets. Subjects were 138 women who completed the MMPI prior to undergoing vertical banded gastroplasty. Cluster analysis of the MMPI profiles identified 10 predictive MMPI types. Fifty-six percent of the patients were classified into the 10 types, the remainder were grouped into a residual category. Analysis of covariance revealed that MMPI type accounted for 50 percent of the variance in 12-month weight loss after covarying for initial weight and pre-operative percentage of ideal weight. Variables that added significantly to the prediction of weight loss were age and MMPI scale Pd. In general, the prototypic profiles indicative of the greatest disturbance predicted poor weight loss. In contrast to the 10 MMPI types described in this study, an alternative clustering of patients into fewer groups with much less psychological homogeneity was not predictive of outcome.

Adult↗
PubMed1982

Vertical banded gastroplasty for obesity.

Vertical banded gastroplasty combines the best that has been learned about gastric reduction operations with another feature: a window through both walls of the stomach just above the crow's foot and next to the outlet along the lesser curvature. This window allows the application of staples up to the His' angle to create a small pouch (less than 50 mL). In addition, the outlet can be banded with a polypropylene mesh collar that is sutured to itself but not to the stomach. This banding provides an outlet diameter that remains constant. In experience with 42 patients during a one-year period, there were fewer complications and greater weight loss than have been obtained with any other operation for obesity, to my knowledge.

Body Weight↗
PubMed1981

Gastric bypass criteria for effectiveness.

Weight loss patterns and revision rates in three sequential groups of patients with gastric bypasses and loop gastroenterostomies between 1965 and 1978 demonstrate the importance of a 50 ml volume of the upper segment measured at 25 to 30 cm water luminal pressure and a 10 to 12 mm diameter stoma. The need for a secure partition is well known. Reinforcement of the stoma to prevent dilation has contributed greatly to the success of gastroplasty and should be studied in gastric bypass. The importance of quality control and of both revision rate and weight patterns over five to ten years is emphasized.

Body Weight↗