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Gastric surgery

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https://www.readbyqxmd.com/read/28098079/hyperthermic-intraperitoneal-chemotherapy-for-peritoneal-surface-malignancies-a-single-institution-indian-experience
#1
S P Somashekhar, G Prasanna, Rajshekhar Jaka, Amit Rauthan, H S Murthy, Sunil Karanth
BACKGROUND: Cytoreductive surgery followed by hyper- thermic intraperitoneal chemotherapy (HIPEC) has shown better oncological outcomes in peritoneal surface malignancies (PSM). We assessed the feasibility and perioperative outcomes of this procedure in Indian patients. METHODS: In this prospective observational study from February 2013 to April 2015, we included 56 patients (41 females, 73.2%) with PSM. They had a good performance status, were either treatment-naïve or previously treated by surgery and systemic chemotherapy...
September 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28098067/renal-function-in-type-2-diabetes-following-gastric-bypass
#2
Adrian T Billeter, Stefan Kopf, Martin Zeier, Katharina Scheurlen, Lars Fischer, Thilo M Schulte, Hannes G Kenngott, Barbara Israel, Philipp Knefeli, Markus W Büchler, Peter P Nawroth, Beat P Müller-Stich
BACKGROUND: Metabolic surgery for obese patients with type 2 diabetes (T2D) yields short- and long-term remission rates of 60-90%. Its effects on diabetesassociated complications such as neuropathy and nephropathy have not been well studied to date. Hardly any data are available on this subject with respect to moderately obese patients (body mass index [BMI] 25-35 kg/m2) with insulin-dependent T2D. Our previous studies suggest that, in such patients, treatment with a Roux-en-Y gastric bypass (RYGB) improves diabetic neuropathy...
December 9, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28094573/advanced-gastric-adenocarcinoma-optimizing-therapy-options
#3
Dilsa Mizrak Kaya, Kazuto Harada, Yusuke Shimodaira, Fatemeh G Amlashi, Quan Lin, Jaffer A Ajani
Gastric adenocarcinoma (GAC) is the fifth most common cancer and third leading cause of cancer related mortality worldwide. When localized, cure is achievable with surgery and adjunctive therapies in some patients, however, once advanced, GAC is not a curable condition. Only two targeted agents (trastuzumab and ramucirumab) have been approved and apatinib was approved only in China. Because of the heterogeneous nature of GAC, it is not possible to assess a standard therapeutic approach. Areas Covered: In this review, we aimed to describe the optimal systemic therapy regimens for advanced GAC...
January 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28093571/roux-en-y-gastric-bypass-increases-systemic-but-not-portal-bile-acid-concentrations-by-decreasing-hepatic-bile-acid-uptake-in-minipigs
#4
O Chávez-Talavera, G Baud, V Spinelli, M Daoudi, M Kouach, J-F Goossens, E Vallez, R Caiazzo, M Ghunaim, T Hubert, S Lestavel, A Tailleux, B Staels, F Pattou
Roux-en-Y gastric bypass (RYGB) surgery is widely used in the management of morbid obesity. RYGB improves metabolism independently of weight loss by still unknown mechanisms. Bile acids (BAs) are good candidates to explain this benefit, since they regulate metabolic homeostasis and their systemic concentrations increase upon RYGB. Here we analyzed the mechanisms underlying the increase in systemic BA concentrations after RYGB and the role of the liver therein. To this aim, we used the Göttingen-like minipig, a human-size mammalian model, which allows continuous sampling and simultaneous analysis of pre-hepatic portal and systemic venous blood...
January 17, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28091894/mechanisms-of-action-of-surgical-interventions-on-weight-related-diseases-the-potential-role-of-bile-acids
#5
REVIEW
Mohsen Mazidi, Pedro Paulo P de Caravatto, John R Speakman, Ricardo V Cohen
Surgical interventions for weight-related diseases (SWRD) may have substantial and sustainable effect on weight reduction, also leading to a higher remission rate of type 2 diabetes (T2D) mellitus than any other medical treatment or lifestyle intervention. The resolution of T2D after Roux-en-Y gastric bypass (RYGB) typically occurs too quickly to be accounted for by weight loss alone, suggesting that these operations have a direct impact on glucose homeostasis. The mechanisms underlying these beneficial effects however remain unclear...
January 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28091892/bariatric-roux-en-y-gastric-bypass-surgery-adipocyte-proteins-involved-in-increased-bone-remodeling-in-humans
#6
Maria Fernanda G Biagioni, Adriana L Mendes, Célia Regina Nogueira, Celso V Leite, Loraine Gollino, Gláucia Mfs Mazeto
PURPOSE: Bariatric surgery has been associated with bone remodeling changes. The action of adipokines on the expression of receptor activator of nuclear factor kappa β ligand (RANKL) and osteoprotegerin (OPG) and on an increase in sclerostin could be related to these changes. MATERIALS AND METHODS: This study aimed to assess the repercussions of weight loss, fat mass (FM), and fat-free mass (FFM) loss and biochemical and hormonal changes on bone remodeling markers after Roux-en-Y gastric bypass (RYGB)...
January 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28091851/operative-treatments-for-reflux-after-bariatric-surgery-current-and-emerging-management-options
#7
Daniela Treitl, Derek Nieber, Kfir Ben-David
Gastroesophageal reflux disease (GERD) is a common disorder that has a well-established connection with obesity. To ameliorate the morbidity associated with obesity, bariatric procedures have become an established pathway to accomplish sustained weight loss. In some procedures, such as with the Roux-en-Y gastric bypass surgery, weight loss is also accompanied by the resolution of GERD symptoms. However, other popular bariatric surgeries, such as the sleeve gastrectomy, have a controversial impact on their effect on reflux...
January 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28090502/is-noncurative-gastrectomy-always-a-beneficial-strategy-for-stage-iv-gastric-cancer
#8
Chang Min Lee, In Keun Choi, Jong-Han Kim, Da Won Park, Jun Suk Kim, Seong-Heum Park
PURPOSE: The purpose of this study is to suggest a treatment strategy for stage IV gastric cancer by investigating the behavioral difference between initially and recurrent metastatic disease. METHODS: We reviewed the medical records of the patients who underwent chemotherapy alone for metastatic gastric cancer between January 2006 and September 2013. Patients were divided into those who underwent chemotherapy for metastatic disease since initial diagnosis (IM group) and for metastatic recurrence after curative surgery (RM group)...
January 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28089592/stapleless-laparoscopic-sleeve-gastrectomy-preliminary-report
#9
Jose Luis Leyba, Salvador Navarrete Llopis, Salvador Navarrete Aulestia, Ricardo Ochoa, Eliana Azuaje
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. In undeveloped countries, the linear staples required to create the sleeve are not always available because of their high cost. As an alternative to the staples, the bipolar vessel sealer device could be used in bariatric surgery to divide and temporarily seal the stomach. SETTINGS: Universidad Central de Venezuela, Caracas, Venezuela...
December 7, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089591/evaluation-of-incidence-of-cholelithiasis-after-bariatric-surgery-in-subjects-treated-or-not-treated-with-ursodeoxycholic-acid
#10
Muriel Coupaye, Daniela Calabrese, Ouidad Sami, Simon Msika, Séverine Ledoux
BACKGROUND: The use of ursodeoxycholic acid (UDCA) to prevent gallstone formation after gastric bypass (RYGB) is still debated. Furthermore, only 1 study has assessed the effectiveness of UDCA after sleeve gastrectomy (SG) with mitigated results. OBJECTIVES: To compare the incidence of cholelithiasis (CL) between patients treated or not treated with UDCA after RYGB and SG. SETTING: University hospital, France. METHODS: Since January 2008, a postoperative ultrasound monitoring was scheduled for all patients without previous cholecystectomy who underwent bariatric surgery in our institution...
December 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089590/using-the-presurgical-psychological-evaluation-to-predict-5-year-weight-loss-outcomes-in-bariatric-surgery-patients
#11
Ryan J Marek, Yossef S Ben-Porath, Manfred H M van Dulmen, Kathleen Ashton, Leslie J Heinberg
BACKGROUND: Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent. OBJECTIVES: Examine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory-2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes...
November 11, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089436/the-significance-of-histologic-examination-of-gastrectomy-specimens-a-clinicopathologic-study-of-511-cases
#12
Pavel Kopach, Elizabeth M Genega, Sajani N Shah, Julie J Kim, Yvelisse Suarez
BACKGROUND: Sleeve gastrectomy (SG) is quickly becoming the preferred procedure for bariatric surgery. According to the American Society for Metabolic and Bariatric Surgery guidelines, routine preoperative upper gastrointestinal endoscopies are not recommended universally for bariatric surgery. Some studies have shown that the histologic examination of SG specimens is insignificant and not a cost-effective practice. However, some speculate SG examination may unveil pertinent findings and prevent further progression of precursor lesions...
November 15, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089435/jejunal-gluconeogenesis-associated-with-insulin-resistance-level-and-its-evolution-after-roux-en-y-gastric-bypass
#13
Carolina Gutierrez-Repiso, Sara Garcia-Serrano, Francisco J Moreno-Ruiz, Guillermo Alcain-Martinez, Francisca Rodriguez-Pacheco, Eduardo Garcia-Fuentes
BACKGROUND: Intestinal gluconeogenesis (GNG) may play an important role in glucose homeostasis, but there is little information about the condition in humans. OBJECTIVES: To study the relationship between intestinal GNG and insulin resistance, its association with the evolution of morbidly obese patients after bariatric surgery, and the effect of insulin and or leptin. SETTING: Regional university hospital, Malaga (Spain). METHODS: Jejunal mRNA expression of genes involved in GNG was analyzed in 3 groups of morbidly obese patients who underwent Roux-en-Y gastric bypass: with low insulin resistance (MO-low-IR), with high insulin resistance (MO-high-IR), and with type 2 diabetes treated with metformin (MO-metf-T2D)...
December 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28079245/gastric-and-jejunal-histopathological-changes-in-patients-undergoing-bariatric-surgery
#14
Rosemary Simões Nomelini Rodrigues, Élia Cláudia de Souza Almeida, Júverson Alves Terra, Lucinda Calheiros Guimarães, Ana Cristina da Rocha Duque, Renata Margarida Etchebehere
BACKGROUND: - Morbid obesity is a multifactorial disease that is increasingly treated by surgery. OBJECTIVE: - To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery. METHODS: - This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative. RESULTS: - In the preoperative group, 80...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28079243/serum-levels-of-vitamin-a-visual-function-and-ocular-surface-after-bariatric-surgery
#15
Luana Paula Nogueira de Araújo Brandão, Lucio Vilar, Bernardo Menelau Cavalcanti, Pedro Henrique Amorim Brandão, Tiago Eugênio Faria E Arantes, Josemberg Marins Campos
BACKGROUND: - Bariatric surgery is the most effective treatment for severe obesity, but the surgery increases the risk of developing nutritional deficiencies, such as vitamin A deficiency. In human metabolism, vitamin A plays a role in vision. OBJECTIVE: - To evaluate serum vitamin A, visual function and ocular surface of patients undergoing bariatric surgery. METHODS: - A cross-sectional and analytical study was conduced with 28 patients undergoing bariatric surgery for at least 6 months...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078465/non-inferiority-of-minimally-invasive-oesophagectomy-an-8-year-retrospective-case-series
#16
L Findlay, C Yao, D H Bennett, R Byrom, N Davies
BACKGROUND: The trend towards laparoscopic surgery seen in other specialties has not occurred at the same pace in oesophagectomy. This stems from concerns regarding compromised oncological clearance, and complications associated with gastric tube necrosis and anastomotic failure. We present our experience of minimally invasive oesophagectomy (MIO) compared to open and hybrid surgery. We aim to ascertain non-inferiority of MIO by evaluating impact on survival, oncological clearance by resection margin and lymph node harvest and post-operative complications...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078131/a-novel-management-of-post-oesophagectomy-gastro-pleural-fistula
#17
Javaid Ishtiaq, Jonathan Sutton, Waqar Ahmed
Oesophageal anastomotic leak and fistula are major and life-threatening complications of oesophagectomy with resultant increased mortality. Non-operative approach of such cases should be the initial strategy. Re-operative surgery and/or stent insertion are considered if conservative measures failed. Although oesophageal stenting is a safe option for the leaks, stent migration and failure to completely cover large anastomotic leaks are the main complications and pitfalls of the procedure. These can be overcome by using multiple or larger stents...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28077786/nomogram-analysis-and-external-validation-to-predict-the-risk-of-lymph-node-metastasis-in-gastric-cancer
#18
Shi Chen, Run-Cong Nie, Li-Ying OuYang, Yuan-Fang Li, Jun Xiang, Zhi-Wei Zhou, YingBo Chen, Jun-Sheng Peng
AIM: To identify risk factors for lymph node metastasis using a nomogram for gastric cancer patients to predict lymph node metastasis. RESULTS: The Chi-square test and the logistic regression showed that the Boarrmann type, preoperative CA199 level, T stage and N stage by CT scan were independent risk factors. The concordance index (C-index) was 0.786 in the internal validation of the Nomogram model. In the external validation, the C-index was 0.809, and the AUC was 0...
January 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28077412/microvascular-outcomes-after-metabolic-surgery-moms-in-patients-with-type-2-diabetes-mellitus-and-class-i-obesity-rationale-and-design-for-a-randomised-controlled-trial
#19
Ricardo Vitor Cohen, Tiago Veiga Pereira, Cristina Mamédio Aboud, Pedro Paulo de Paris Caravatto, Tarissa Beatrice Zanata Petry, José Luis Lopes Correa, Carlos Aurélio Schiavon, Mariangela Correa, Carlos Eduardo Pompílio, Fernando Nogueira Quirino Pechy, Carel le Roux
INTRODUCTION: There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). PURPOSE: The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30-34...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28076606/giant-gastric-lipossarcoma-case-report-and-review-of-the-literature
#20
Jacques Matone, Samuel Okazaki, Gabriel Naman Maccapani, Thiago Trolez Amancio, Renée Zon Filippi, Antonio Luiz de Vasconcellos Macedo
Liposarcoma is one of the most common soft tissue sarcomas in adults, occurring in 15 to 20% of all patients with sarcoma. Primary liposarcoma of the stomach is rare. We report a case of patient with giant gastric liposarcoma who underwent surgery after a gastrointestinal bleeding. Preoperative hystopathological diagnosis was not established, even after three biopsy attempts. We discuss differential diagnosis, genetic causes, diagnosis strategies and treatment. RESUMO O lipossarcoma é um tipo comum de sarcomas em adultos, com incidência entre 15 e 20% entre os sarcomas...
October 2016: Einstein
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