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https://www.readbyqxmd.com/read/27844255/a-vertically-placed-clip-for-weight-loss-a-39-month-pilot-study
#1
Moises Jacobs, Natan Zundel, Gustavo Plasencia, Prospero Rodriguez-Pumarol, Eddie Gomez, James Leithead
BACKGROUND: Morbid obesity remains one of society's significant medical dilemmas. It is rapidly worsening and expected to affect 35% of the US population by the year 2020. Common current bariatric procedures exist and include, but not limited to, the adjustable gastric band, gastric bypass, and the sleeve gastrectomy. Although beneficial to morbidly obese patients, they also alter the patient's anatomy and involve resections, or require maintenance. The goal of the trial is to show a new minimally invasive vertical gastric clip technique that produces significant weight loss but requires no resection, no change in anatomy, and is reversible...
November 14, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27829412/gastric-bypass-surgery-reveals-independency-of-obesity-and-diabetes-melitus-type-2
#2
Mogens Fenger, Dorte Lindqvist Hansen, Dorte Worm, Lisbeth Hvolris, Viggo B Kristiansen, Elin Rebecka Carlsson, Sten Madsbad
BACKGROUND: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but the observation may suggest that the fate obesity and diabetes is only partly linked after surgery. METHODS: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects with and without diabetes were evaluated...
November 9, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27812408/comparative-internal-anatomy-of-staurozoa-cnidaria-with-functional-and-evolutionary-inferences
#3
Lucília S Miranda, Allen G Collins, Yayoi M Hirano, Claudia E Mills, Antonio C Marques
Comparative efforts to understand the body plan evolution of stalked jellyfishes are scarce. Most characters, and particularly internal anatomy, have neither been explored for the class Staurozoa, nor broadly applied in its taxonomy and classification. Recently, a molecular phylogenetic hypothesis was derived for Staurozoa, allowing for the first broad histological comparative study of staurozoan taxa. This study uses comparative histology to describe the body plans of nine staurozoan species, inferring functional and evolutionary aspects of internal morphology based on the current phylogeny of Staurozoa...
2016: PeerJ
https://www.readbyqxmd.com/read/27808040/endobarrier-gastrointestinal-liner-delineation-of-underlying-mechanisms-and-clinical-effects
#4
Ulrich Rohde
Bariatric surgery (e.g. Roux-en-Y gastric bypass (RYGB)) has proven the most effective way of achieving sustainable weight losses and remission of type 2 diabetes (T2D). Studies indicate that the effectiveness of RYGB is mediated by an altered gastrointestinal tract anatomy, which in particular favours release of the gut incretin hormone glucagon-like peptide-1 (GLP-1). The EndoBarrier gastrointestinal liner or duodenal-jejunal bypass sleeve (DJBS) is an endoscopic deployable minimally invasive and fully reversible technique designed to mimic the bypass component of the RYGB...
November 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27738969/one-anastomosis-jejunal-interposition-with-gastric-remnant-resection-branco-zorron-switch-for-severe-recurrent-hyperinsulinemic-hypoglycemia-after-gastric-bypass-for-morbid-obesity
#5
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27716860/safety-and-effectiveness-of-a-long-partially-covered-metal-stent-for-endoscopic-ultrasound-guided-hepaticogastrostomy-in-patients-with-malignant-biliary-obstruction
#6
Yousuke Nakai, Hiroyuki Isayama, Natsuyo Yamamoto, Saburo Matsubara, Yukiko Ito, Naoki Sasahira, Ryunosuke Hakuta, Gyotane Umefune, Naminatsu Takahara, Tsuyoshi Hamada, Suguru Mizuno, Hirofumi Kogure, Minoru Tada, Kazuhiko Koike
Background and study aims: Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is potentially complicated by bile leak and stent migration. The aim of this study was to evaluate the safety and effectiveness of a long (≥ 10 cm), partially covered metal stent (LP-CMS) for EUS-guided hepaticogastrostomy (EUS-HGS) for malignant biliary obstruction. Both the stent length and the uncovered portion at the proximal end of the LP-CMS are designed to prevent stent migration. Patients and methods: A total of 33 patients undergoing EUS-HGS using an LP-CMS in four centers were retrospectively studied...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27697984/multimodality-therapy-of-localized-gastric-adenocarcinoma
#7
REVIEW
Brian Badgwell
Surgical resection is the primary method of obtaining a potential cure for patients with gastric adenocarcinoma. However, chemotherapy or chemoradiotherapy offer significant improvement in survival over surgery alone. Much of the difficulty in deciding the optimal treatment strategy is choosing between perioperative chemotherapy or adjuvant chemoradiotherapy. Adding to the complexity is the potential for incorporating treatment strategies based on clinical trials performed in Asia. There is likely a difference in tumor biology between Eastern and Western patients with gastric adenocarcinoma, in addition to the clear differences in screening, pathologic assessment, and surgical technique...
October 2016: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/27683794/from-complex-evolving-to-simple-current-revisional-and-endoscopic-procedures-following-bariatric-surgery
#8
Ricardo Zorron, Manoel Passos Galvão-Neto, Josemberg Campos, Alcides José Branco, José Sampaio, Tido Junghans, Claudia Bothe, Christian Benzing, Felix Krenzien
Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27683770/intestinal-malrotation-in-patients-undergoing-bariatric-surgery
#9
Eduardo Arevalo Vidal, Francisco Abarca Rendon, Trino Andrade Zambrano, Yudoco Andrade García, Mario Ferrin Viteri, Josemberg Marins Campos, Manoela Galvão Ramos, Almino Cardoso Ramos
Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27659179/determination-of-porto-azygos-shunt-anatomy-in-dogs-by-computed-tomography-angiography
#10
Matan Or, Kumiko Ishigaki, Hilde de Rooster, Kenji Kutara, Kazushi Asano
OBJECTIVE: To describe the morphology of porto-azygos shunts in a large series of dogs using computed tomography (CT) angiography. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=36) with porto-azygos shunts. METHODS: CT angiography was performed in dogs subsequently proven to have a porto-azygos shunt. The origin and insertion of the shunts were assessed on native images. The diameter of the porto-azygos shunt and the portal vein, cranial and caudal to the shunt origin, were measured...
September 23, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27651917/case-report-of-eus-guided-endoscopic-transduodenal-necrosectomy-in-a-patient-with-sleeve-gastrectomy
#11
Avik Sarkar, Ragui Sadek, Matthew Lissauer, Swati Pawa
BACKGROUND: After an acute attack of pancreatitis, walled-off pancreatic fluid collections (PFC) occur in approximately 10 % of cases. Drainage of the cavity is recommended when specific indications are met. Endoscopic drainage has been adopted as the main intervention for symptomatic walled-off PFC. Altered gastric anatomy in these patients poses an interesting challenge. We present the first case of a patient with sleeve gastrectomy who underwent successful endoscopic transduodenal necrosectomy (TDN)...
2016: BMC Obesity
https://www.readbyqxmd.com/read/27614616/laparoscopy-assisted-trans-gastric-rendez-vous-for-the-treatment-of-common-bile-duct-stones-in-patients-with-prior-roux-en-y-gastric-bypass
#12
Ricardo Mejía, Pablo Achurra, Mauricio Gabrielli, Eduardo Briceño, Rolando Rebolledo, Alberto Torres, Allan Sharp, Fernando Pimentel, Fernando Crovari
BACKGROUND: Common bile duct (CBD) stones in a Roux-en-Y gastric bypass (RYGB) represent a major challenge for ERCP due to long-limb anatomy. Trans-gastric approach has been proposed but entails high ERCP-related risks. Laparoscopy assisted trans-gastric rendez-vous (LATG-RV) is a one-step procedure that may lower the risks of these patients. METHODS: We describe our initial experience in four patients with past history of RYGB and CBD stones. RESULTS: All patients underwent LATG-RV and had successful CBD stone clearance...
September 10, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27597144/the-dynamic-gastric-environment-and-its-impact-on-drug-and-formulation-behaviour
#13
Jens Van Den Abeele, Jari Rubbens, Joachim Brouwers, Patrick Augustijns
Before being absorbed in the small intestine and/or colon, orally administered drugs inevitably need to pass through the stomach. Hence, it seems reasonable that the residence of a dosage form in the gastric environment, however brief it may be, may influence drug disposition further down the gastrointestinal tract and may potentially impact systemic exposure to a drug of interest. However, research efforts in the past mainly focused on drug disposition at the level of the intestine, i.e. the main site of absorption, hereby disregarding or oversimplifying the stomach's contribution to gastrointestinal drug disposition...
September 3, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27573785/recapitulating-human-gastric-cancer-pathogenesis-experimental-models-of-gastric-cancer
#14
Lin Ding, Mohamad El Zaatari, Juanita L Merchant
This review focuses on the various experimental models to study gastric cancer pathogenesis, with the role of genetically engineered mouse models (GEMMs) used as the major examples. We review differences in human stomach anatomy compared to the stomachs of the experimental models, including the mouse and invertebrate models such as Drosophila and C. elegans. The contribution of major signaling pathways, e.g., Notch, Hedgehog, AKT/PI3K is discussed in the context of their potential contribution to foregut tumorigenesis...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27573512/endoscopic-management-of-vertical-banded-gastroplasty-stricture-feasibility-safety-and-efficacy
#15
Chin Hong Lim, Stuart K Amateau, Sayeed Ikramuddin, Daniel B Leslie
BACKGROUND: Although vertical banded gastroplasty (VBG) is no longer performed in the USA, due to its popularity in 1980s, many patients still possess this anatomy with its inherent complications. The stomal stenosis secondary to tight ring or mesh is traditionally treated with surgical removal of the silastic ring or a complex revision, which was hampered by complications, technical complexity, and invasiveness. We described our experience of endoscopic management of this complex problem and the early outcomes...
August 29, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27526345/surgical-management-of-achalasia-in-a-patient-with-previous-gastric-bypass
#16
Whitney D Johnson, M Blair Marshall
Patients with previous foregut surgery who develop additional foregut pathology can be a challenge. Those who have formerly undergone gastric bypass and later develop achalasia are at increased risk related to previous surgery. In this case report, we describe an alternative approach for the Dor fundoplication after laparoscopic Heller myotomy in the setting of the altered anatomy. The technique and advantages of this approach are detailed in the discussion of this patient.
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27472725/longitudinal-comparison-of-quality-of-life-in-patients-undergoing-laparoscopic-toupet-fundoplication-versus-magnetic-sphincter-augmentation-observational-cohort-study-with-propensity-score-analysis
#17
Emanuele Asti, Gianluca Bonitta, Andrea Lovece, Veronica Lazzari, Luigi Bonavina
Only a minority of patients with gastro-esophageal reflux disease (GERD) are offered a surgical option. This is mostly due to the fear of potential side effects, the variable success rate, and the extreme alteration of gastric anatomy with the current gold standard, the laparoscopic Nissen fundoplication. It has been reported that laparoscopic Toupet fundoplication (LTF) and laparoscopic sphincter augmentation using a magnetic device (LINX) can treat reflux more physiologically and with a lower incidence of side-effects and reoperation rate...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27467321/normal-and-abnormal-physiology-pharmacology-and-anatomy-of-the-gastroesophageal-junction-high-pressure-zone
#18
Larry Miller, Anil Vegesna, Michael Ruggieri, Alan Braverman
The high-pressure zone of the gastroesophageal junction acts as a multifunctional valve that comprises different groups of smooth muscles located in the distal esophagus and the proximal stomach, in addition to the extrinsic crural diaphragm, composed of skeletal muscle. In this review article, we evaluate the current literature with respect to human subjects, discussing the anatomic locations and physiologic and pharmacologic processes controlling these muscles. These muscles work individually and as a group to prevent reflux of gastric contents while allowing anterograde passage of food and liquid and retrograde passage of gas...
July 28, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27440196/sleeve-gastrectomy-and-anti-reflux-procedures
#19
Christopher Crawford, Kyle Gibbens, Daniel Lomelin, Crystal Krause, Anton Simorov, Dmitry Oleynikov
BACKGROUND: Obesity is an epidemic in the USA that continues to grow, becoming a leading cause of premature avoidable death. Bariatric surgery has become an effective solution for obesity and its comorbidities, and one of the most commonly utilized procedures, the sleeve gastrectomy, can lead to an increase in gastroesophageal reflux following the operation. While these data are controversial, sometimes operative intervention can be necessary to provide durable relief for this problem...
July 20, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27423062/achalasia-a-case-report-on-its-effect-during-surgical-decision-making-for-laparoscopic-sleeve-gastrectomy-in-the-young-morbidly-obese-patient
#20
Rodolfo J Oviedo, Chase W Sofiak, Bruce M Dixon
INTRODUCTION: Achalasia is a condition that occurs when the lower esophageal sphincter (LES) fails to properly relax, combined with slowing/failure of esophageal peristalsis. This is seen clinically by not allowing solids and liquids to pass easily into the stomach. Achalasia is not historically associated with morbid obesity, yet dual treatment of morbid obesity and achalasia is becoming more prominent due to the worldwide obesity epidemic. PRESENTATION OF CASE: Achalasia is typically a disease that affects non-obese adults over the age of 55, which makes the discussion of this case report unique in that our patient is a 23 year-old woman who successfully underwent per-oral endoscopic myotomy (POEM) in preparation for a future laparoscopic sleeve gastrectomy...
2016: International Journal of Surgery Case Reports
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