There are several types of bariatric
surgery (also called gastric bypass or weight-loss surgery), which can be performed as
either open or
laparoscopic procedures. According to the American Society for Bariatric Surgery as well as the National Institutes of
Health, the Roux-en-Y Gastric Bypass is the current "gold standard" procedure for bariatric
surgery; it is one of the most frequently performed weight-loss
procedures in the United States. Other types of bariatric surgery
include gastric
banding, the Duodenal Switch, and the Fobi Pouch.
Regardless of surgery type, a multidisciplinary approach to weight-loss surgery is
advised for
optimum results.
The success of bariatric surgery is defined as achieving loss of 50% or more of excess body weight and maintaining that level for at least five years.
In addition to the substantial weight loss that comes with bariatric
surgery, the procedure has been proven to also curtail diabetes,
reduce high blood pressure and high cholesterol, and improve sleep
apnea in patients.
Special Topics has examined the
literature from the past decade to spot trends in bariatric surgery. The papers cover a wide variety of approaches, from the demonstrated effectiveness of bariatric surgery as therapy for adult-onset diabetes-mellitus to procedures describing laparoscopic adjustable gastric banding.
One highly cited paper is a two-year follow-up of health-related quality-of-life
issues, including eating behavior after gastric surgery for severe obesity. Laparoscopic versus open gastric bypass is discussed, along with a study of outcomes and evaluation of the costs of the different procedures. Another paper on our list focuses in particular on the reduction in incidence of diabetes, hypertension, and lipid disturbances after bariatric surgery. Conversions
and complications in laparoscopic procedures are
the subject in two papers. Rounding out the top 20 (and included in
the map) is Fobi's article on
gastric bypass (Fobi, M., et al., "Gastric bypass operation for
obesity," World Journal Of Surgery 22 [9]: 925-935,
September
1998).
Several of
the top 20 papers published since 2002 have examined medium- and long-term effects of weight loss surgery. Included in these topics are the health, quality of life, and control of morbid obesity. Other papers on the two-year list include the outcomes of severely obese type 2 diabetic subjects, plasma ghrelin levels, complications, and the reversal of gastric bypass. Another highly cited paper deals with the evolution of operative procedures from 1950 to
2000.
Methodology
To construct this database,
papers were extracted based on topic-supplied keywords for Bariatric Surgery. The keywords used were as follows:
- weight loss
surgery
- gastric bypass
- roux-en-y
- gastroplasty
- gastric banding
- bariatric
surgery
- lap band
The baseline time span for this database
is 1994-2004 (fourth bimonthly). The resulting database contained 3,100 (10 years)
and 1,358 (2 years) papers; 8,085 authors; 57 countries; 360 journals; and
1,804 institutions.
Rankings
Once the database was in place,
it was used to generate the lists of top 20 papers (two, and ten years
periods), authors, journals,
institutions, and nations, covering a time span of 1994-2004 (fourth
bimonthly).
The top 20 papers are ranked
according to total cites. Rankings for author, journal, institution,
and country are listed in three ways: according to total cites, total
papers, and total cites/paper. The paper thresholds and corresponding
percentages used to determine
scientist, institution, country, and journal rankings according to
total cites/paper, and total papers respectively are as follows:
| Entity: |
Scientists |
Institutions |
Countries |
Journals |
| Thresholds: |
10 |
14 |
12 |
14 |
| Percentage: |
10% |
20% |
50% |
10% |
