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https://www.readbyqxmd.com/read/28924597/endoscopic-sleeve-gastroplasty-the-learning-curve
#1
Christine Hill, Mohamad El Zein, Abhishek Agnihotri, Margo Dunlap, Angela Chang, Alison Agrawal, Sindhu Barola, Saowanee Ngamruengphong, Yen-I Chen, Anthony N Kalloo, Mouen A Khashab, Vivek Kumbhari
BACKGROUND AND STUDY AIMS:  Endoscopic sleeve gastroplasty (ESG) is gaining traction as a minimally invasive bariatric treatment. Concern that the learning curve may be slow, even among those proficient in endoscopic suturing, is a barrier to widespread implementation of the procedure. Therefore, we aimed to define the learning curve for ESG in a single endoscopist experienced in endoscopic suturing who participated in a 1-day ESG training program. PATIENTS AND METHODS:  Consecutive patients who underwent ESG between February 2016 and November 2016 were included...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28895037/management-of-acute-sleeve-gastrectomy-leaks-by-conversion-to-roux-en-y-gastric-bypass-a-small-case-series
#2
Kutay Saglam, Aydin Aktas, Ersin Gundogan, Ismail Ertugrul, Ali Tardu, Servet Karagul, Serdar Kirmizi, Fatih Sumer, Veysel Ersan, Cuneyt Kayaalp
Management of early sleeve gastrectomy leak remains challenging. The recommended approach is endoscopic stenting and abdominal drainage. Conversion to a Roux-en-Y gastric bypass (RYGB) is a common procedure used for late fistulas with distal obstruction. Here, we have presented three cases of early staple line leaks treated by conversion to RYGB. These patients had uncontrolled abdominal infections despite intensive medical treatments, and surgery was elected for abdominal drainage as well as to control the source of sepsis...
September 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28853590/pedunculated-well-differentiated-liposarcoma-of-the-oesophagus-mimicking-giant-fibrovascular-polyp
#3
A S Mehdorn, F Schmidt, K Steinestel, E Wardelmann, B Greulich, D Palmes, N Senninger
We present a rare case of a big oesophageal liposarcoma causing dysphagia and weight loss in a 75-year-old patient. Endoscopically, a pedunculated lesion with subtotal obstruction of the oesophageal lumen had been detected and thoracoabdominal oesophageal resection with gastric sleeve reconstruction was performed. Surprisingly, a liposarcoma of the oesophagus was revealed on histopathological analysis, showing MDM2 overexpression. Oncological follow-up has been uneventful and the patient remains in good clinical shape at 15 months after surgery...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28843586/a-single-operator-learning-curve-analysis-for-the-endoscopic-sleeve-gastroplasty
#4
Monica Saumoy, Yecheskel Schneider, Xi Kathy Zhou, Alpana Shukla, Michel Kahaleh, Louis Aronne, Reem Z Sharaiha
BACKGROUND AND AIMS: Endoscopic sleeve gastroplasty (ESG) is a novel, incisionless technique for gastric volume reduction to promote weight loss. Our aim was to describe the learning curve for performing ESG using a prospective case series. METHODS: Using a prospective case series design, we analyzed the first 128 consecutive patients at a tertiary-care academic medical center who underwent ESG performed by a single operator from August 2013 to December 2016. Efficiency (refining performance to decrease procedure time) and mastery (absence of outliers) for performing the ESG was evaluated by using a penalized basis-spline regression and cumulative sum (CUSUM) analysis...
August 23, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28832360/gastric-interventional-endoscopy
#5
Mohamed Mahmoud, Erik Holzwanger, Wahid Wassef
PURPOSE OF REVIEW: To review new advances in gastric interventional endoscopy. RECENT FINDINGS: Implementation of gastric endoscopy as a therapeutic option in obesity, gastric cancer, and gastroparesis. SUMMARY: Less invasive new gastric endoscopic procedures can potentially replace currently offered laparoscopic approaches in many fields. In this article, we will review the use of endoscopic sleeve gastroplasty as a weight loss procedure, endoscopic submucosal dissection in treatment of early gastric cancer, and gastric per-oral endoscopic myotomy in treatment of refractory gastroparesis...
August 21, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28815402/covered-esophageal-stenting-is-effective-for-symptomatic-gastric-lumen-narrowing-and-related-complications-following-laparoscopic-sleeve-gastrectomy
#6
Murad A Aburajab, Joshua B Max, Mel A Ona, Kapil Gupta, Miguel Burch, F Michael Feiz, Simon K Lo, Laith H Jamil
BACKGROUND AND STUDY AIMS: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity in treating morbid obesity. Prior studies showed a 3.5% risk of gastric sleeve stenosis (GSS). There is no consensus on how to treat these patients, and the role of endoscopic therapy has been addressed in only a few studies. We aim to assess the efficacy and safety of endoscopic stenting in the management of GSS following LSG. PATIENTS AND METHODS: Retrospective data were reviewed from July 2009 to November 2013...
August 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28815383/a-5-year-follow-up-study-of-laparoscopic-sleeve-gastrectomy-among-morbidly-obese-adolescents-does-it-improve-body-image-and-prevent-and-treat-diabetes
#7
Moamena Ahmed El-Matbouly, Nesreen Khidir, Hussien Aly Touny, Walid El Ansari, Mohammed Al-Kuwari, Moataz Bashah
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is widely used, and it is important to examine its physiologic and psychological efficacy among adolescents. We assessed LSG's efficacy for weight loss, its short- and long-term effects on resolving and improving obesity-related comorbidities, and its psychological outcomes among morbidly obese adolescents. METHODS: We retrospectively analyzed the medical records of 91 morbidly obese adolescents in Qatar who underwent LSG (2011-2014), with 1- and 5-year follow-ups...
August 17, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28811552/deregulation-of-transcription-factors-controlling-intestinal-epithelial-cell-differentiation-a-predisposing-factor-for-reduced-enteroendocrine-cell-number-in-morbidly-obese-individuals
#8
Bettina K Wölnerhanssen, Andrew W Moran, Galina Burdyga, Anne Christin Meyer-Gerspach, Ralph Peterli, Michael Manz, Miriam Thumshirn, Kristian Daly, Christoph Beglinger, Soraya P Shirazi-Beechey
Morbidly obese patients exhibit impaired secretion of gut hormones that may contribute to the development of obesity. After bariatric surgery there is a dramatic increase in gut hormone release. In this study, gastric and duodenal tissues were endoscopically collected from lean, and morbidly obese subjects before and 3 months after laparoscopic sleeve gastrectomy (LSG). Tissue morphology, abundance of chromogranin A, gut hormones, α-defensin, mucin 2, Na(+)/glucose co-transporter 1 (SGLT1) and transcription factors, Hes1, HATH1, NeuroD1, and Ngn3, were determined...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28776154/sleeve-gastrectomy-after-liver-transplantation-feasibility-and-outcomes
#9
Michael Osseis, Andrea Lazzati, Chady Salloum, Concepcion Gomez Gavara, Philippe Compagnon, Cyrille Feray, Chetana Lim, Daniel Azoulay
BACKGROUND: Knowledge regarding the feasibility and safety of sleeve gastrectomy (SG) in obese liver transplant recipients is scarce. We report our experience of sleeve gastrectomy following liver transplantation (LT). METHODS: All patients who had undergone LT and subsequently underwent SG at our institution were retrospectively reviewed. Surgical outcomes, liver and kidney function tests, outcomes of obesity-related comorbidities, and excess weight loss were analyzed...
August 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28750839/endoscopic-treatment-of-fistulas-after-sleeve-gastrectomy-a-comparison-of-internal-drainage-versus-closure
#10
Diane Lorenzo, Théophile Guilbaud, Jean Michel Gonzalez, Alban Benezech, Anne Dutour, Sandrine Boullu, Stéphane Berdah, Thierry Bège, Marc Barthet
BACKGROUND AND AIMS: Post-sleeve gastrectomy fistulas (PSGF) are major adverse events of bariatric surgery. The endoscopic management strategy evolved from closure to internal drainage (ID) after 2013. The main objective was to evaluate and compare these different approaches. METHODS: This retrospective study included all patients treated for PSGF in a referral center. "Closure" management was defined as initial treatment using covered-metal-stent and/or endoclips...
July 24, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#11
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#12
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28709560/an-alternative-view-on-the-necessity-of-egd-before-sleeve-gastrectomy
#13
Kivanc Derya Peker, Nuri Alper Sahbaz, Hakan Seyit, Osman Kones, Alpen Yahya Gumusoglu, Halil Alis
BACKGROUND: Esophagogastroduodenoscopy (EGD) is particularly recommended for choosing a surgical method to be used with asymptomatic patients and for the assessment of symptomatic patients prior to sleeve gastrectomy. The presence of hiatal hernia, for instance, is a relative contraindication. EGD is used for malignancy scanning as well as surgical planning, but seems inefficient in determining postoperative complications. OBJECTIVE: Our aim was to investigate the effectiveness of the pathological evaluation of endoscopic biopsies obtained with esophagogastroduodenoscopy (EGD) according to Sydney classification prior to sleeve gastrectomy in identifying the risk of staple line leak, independently of clinical diagnosis...
June 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28702740/large-bariatric-specific-stents-and-over-the-scope-clips-in-the-management-of-post-bariatric-surgery-leaks
#14
Hany Shehab, Emad Abdallah, Khaled Gawdat, Inas Elattar
BACKGROUND: Endoscopic stents are successful in the management of surgical leaks; however, stent migration remains a significant problem. In this study, we present our approach depending on a large bariatrics-specific stent (Mega stent) and over-the-scope clips in the management of post-bariatric surgery leaks. METHODS: A retrospective analysis of all patients with post-bariatric surgery leaks treated at our institution using an approach reliant on Mega stents and over-the-scope clips was conducted...
July 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695460/inversion-technique-for-the-removal-of-partially-covered-self-expandable-metallic-stents
#15
Christine Hill, Bassem K Khalil, Sindhu Barola, Abhishek Agnihotri, Robert A Moran, Yen-I Chen, Saowanee Ngamruengphong, Vikesh K Singh, Leigh A Frame, Michael A Schweitzer, Thomas H Magnuson, Mouen A Khashab, Patrick I Okolo, Vivek Kumbhari
BACKGROUND AND AIMS: Partially covered self-expandable metallic stents (PCSEMS), although an effective treatment for anastomotic/staple line leaks and strictures, can be difficult to remove. This study examines the effectiveness of the inversion technique for the removal of PCSEMS in the treatment of leaks and strictures that occurred post-sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). METHODS: Consecutive patients who underwent PCSEMS removal for a leak and/or stricture post-SG or RYGB between July 2013 and December 2016 at the Johns Hopkins Medical Institutions were reviewed...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695459/endoscopic-vacuum-therapy-evt-a-new-concept-for-complication-management-in-bariatric-surgery
#16
Fabian Schmidt, Rudolf Mennigen, Thorsten Vowinkel, Philipp A Neumann, Norbert Senninger, Daniel Palmes, Mike G Laukoetter
BACKGROUND: Bariatric surgery is the most efficient therapy for morbid obesity. Staple line and anastomotic leakage are the most feared postoperative complications after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy (LSG). Traditional treatment options like revisional surgery and endoscopic stent placement are associated with high morbidity and mortality as well as variable success rates. Endoscopic vacuum therapy (EVT) has shown to be a new successful and feasible treatment option for leaks of different etiology after major gastro-esophageal surgery...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28690770/utility-of-the-balloon-overtube-assisted-modified-over-the-wire-stenting-technique-to-treat-post-sleeve-gastrectomy-complications
#17
Ana Ponte, Rolando Pinho, Luísa Proença, Joana Silva, Jaime Rodrigues, Mafalda Sousa, João Carlos Silva, João Carvalho
AIM: To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications. METHODS: Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described...
June 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28668407/current-and-cutting-edge-interventions-for-the-treatment-of-obese-patients
#18
REVIEW
Jenanan Vairavamurthy, Lawrence J Cheskin, Dara L Kraitchman, Aravind Arepally, Clifford R Weiss
The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current "gold standard" therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28622478/novel-nonsurgical-endoscopic-approaches-for-the-treatment-of-obesity
#19
Ryan T Hurt, Thomas H Frazier, Manpreet S Mundi
Globally, obesity is a leading cause of preventable death and is associated with >60 comorbid medical conditions, including 10 types of cancer that are strongly associated with body mass index. There are a number of traditional obesity treatments-for example, lifestyle management (eg, decreased caloric intake and increased expenditure), pharmacotherapy, and bariatric surgery. Recently, endoscopic approaches have emerged as a viable alternative for weight loss. Endoscopically placed intragastric balloons were introduced in the early 1980s for the treatment of medically complicated obesity but, unfortunately, had high rates of complications, such as premature deflation leading to obstruction...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28613044/for-debate-should-bariatric-surgery-be-performed-in-children-and-adolescents-with-hypothalamic-obesity
#20
EDITORIAL
Sarka Stolbova, Marek Benes, Lenka Petruzelkova, Jan Lebl, Stanislava Kolouskova
Hypothalamic dysfunction leading to severe obesity is a serious long-term consequence of paediatric craniopharyngioma. It compromises quality of life, leads to long-term metabolic hazards, and may shorten life expectancy. Therefore, a proactive approach is required. Conventional treatment of hypothalamic obesity is difficult and hardly successful. Experience with bariatric surgery is limited, especially in younger patients. Two retrospective studies recently reported on classic bariatric surgery in a small series of individuals after craniopharyngioma...
June 2017: Pediatric Endocrinology Reviews: PER
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