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Foregut surgery

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https://www.readbyqxmd.com/read/28332075/roux-en-y-gastric-bypass-following-nissen-fundoplication-higher-risk-same-reward
#1
Michael D Watson, J Hunter Mehaffey, Bruce D Schirmer, Peter T Hallowell
BACKGROUND: Roux-en-Y gastric bypass (RYGB) effectively treats obesity and gastroesophageal reflux disease (GERD). As more surgeons recommend RYGB to treat GERD in patients with obesity, there are concerns about this approach in patients with previous non-bariatric foregut surgery. This study aims to evaluate the effect of previous non-bariatric foregut surgery on subsequent RYGB. METHODS: Retrospective review of 2089 patients undergoing RYGB between January 1985 and June 2015 was conducted to identify all patients with previous non-bariatric foregut surgery...
March 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28325198/the-evaluation-and-management-of-suspicious-gastric-lesions-following-bariatric-surgery
#2
REVIEW
Guillermo Gomez
Obesity has reached epidemic proportions worldwide and is associated with a higher mortality from several diseases, including adenocarcinoma of the esophagus and of the gastric cardia. Increased body mass index is associated with an increased incidence of gastroesophageal reflux disease (GERD), Barrett metaplasia, and adenocarcinoma of the cardia. Bariatric surgery remains the most effective therapy for morbid obesity and has the potential to improve weight-related GERD. A high index of suspicion is paramount for early detection of foregut neoplasia after bariatric surgery...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28277591/the-role-of-fluorescent-angiography-in-anastomotic-leaks
#3
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, Michael J Stamos
Anastomotic leaks following colorectal anastomosis has substantial implications including increased morbidity, longer hospitalization, and reduced overall survival. The etiology of leaks includes patient factors, technical factors, and anastomotic perfusion. An intact anastomotic blood supply is especially crucial in the physiology of anastomotic healing. To date, no established intraoperative methods have been developed that reliably and reproducibly identify and prevent leak occurrence. Recently, fluorescent angiography (FA) with indocyanine green (ICG) has emerged as an innovative modality for intraoperative perfusion assessment...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28242087/surgeons-perceptions-on-industry-relations-a-survey-of-822-surgeons
#4
Maria S Altieri, Jie Yang, Lily Wang, Donglei Yin, Mark Talamini, Aurora D Pryor
BACKGROUND: The relationships between industry and medical professionals are controversial. The purpose of our study was to evaluate surgeons' current opinions regarding the industry-surgery partnership, in addition to self-reported industry ties. METHODS: After institutional review board approval, a survey was sent via RedCap to 3,782 surgeons across the United States. Univariate and multivariable regression analyses were performed to evaluate the responses. RESULTS: The response rate was 23%...
February 24, 2017: Surgery
https://www.readbyqxmd.com/read/28237320/a-perspective-on-metabolic-surgery-from-a-gastroenterologist
#5
REVIEW
Yu-Fong Syu, Akio Inui, Chih-Yen Chen
Type 2 diabetes (T2D) and obesity are important public health problems. The global prevalence of diabetes mellitus is 8.8%. Interventional diabetology and obesitology have been recently advocated as treatment options for T2D and obesity. The roles of metabolic surgery such as Roux-en-Y gastric bypass, sleeve gastrectomy, gastric banding, and biliopancreatic diversion are focused. Different types of metabolic surgeries have different glucose-lowering and weight loss effects. Endoscopic treatments include the intra-gastric balloon (to restrict the gastric volume) and duodenal-jejunal bypass liner (DJBL, as a malabsorptive procedure)...
January 19, 2017: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/28212976/functional-lumen-imaging-probe-for-the-management-of-esophageal-disorders-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#6
REVIEW
Ikuo Hirano, John E Pandolfino, Guy E Boeckxstaens
The functional luminal imaging probe is a Food and Drug Administration-approved measurement tool used to measure simultaneous pressure and diameter to guide management of various upper gastrointestinal disorders. Additionally, this tool is also approved to guide therapy during bariatric procedures and specialized esophageal surgery. Although it has been commercially available since 2009 as the endolumenal functional lumen imaging probe (EndoFLIP), the functional luminal imaging probe has had limited penetrance into clinical settings outside of specialized centers...
March 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28120274/advanced-gi-surgery-training-a-roadmap-for-the-future-the-white-paper-from-the-ssat-task-force-on-advanced-gi-surgery-training
#7
Matthew M Hutter, Kevin E Behrns, Nathaniel J Soper, Fabrizio Michelassi
There is the need for well-trained advanced GI surgeons. The super specialization seen in academic and large community centers may not be applicable for surgeons practicing in other settings. The pendulum that has been swinging toward narrow specialization is swinging the other way, as many trained subspecialists are having a harder time finding positions after fellowship, and if they do find a position, the majority of their practice can actually be advanced GI surgery and not exclusively their area of focused expertise...
January 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28097332/effect-of-incentive-spirometry-on-postoperative-hypoxemia-and-pulmonary-complications-after-bariatric-surgery-a-randomized-clinical-trial
#8
Haddon Pantel, John Hwang, David Brams, Thomas Schnelldorfer, Dmitry Nepomnayshy
Importance: The combination of obesity and foregut surgery puts patients undergoing bariatric surgery at high risk for postoperative pulmonary complications. Postoperative incentive spirometry (IS) is a ubiquitous practice; however, little evidence exists on its effectiveness. Objective: To determine the effect of postoperative IS on hypoxemia, arterial oxygen saturation (Sao2) level, and pulmonary complications after bariatric surgery. Design, Setting, and Participants: A randomized noninferiority clinical trial enrolled patients undergoing bariatric surgery from May 1, 2015, to June 30, 2016...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28050458/congenital-cystic-adenomatoid-malformation-a-tertiary-care-hospital-experience
#9
Asmita Anilkumar Mehta, Naveen Viswanathan, Anil Kumar Vasudevan, Roopa Paulose, Mohan Abraham
INTRODUCTION: Congenital Cystic Adenomatoid Malformation (CCAM) is an uncommon developmental deformity affecting the terminal respiratory structures. It is characterized by broncho pulmonary foregut malformations. The reason behind it is an arrest in lung development between 4(th) and 7(th) week of fetal life. AIM: The present study was conducted to assess the clinical and radiological profile and also to study the role of surgical intervention in patients with CCAM...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28028750/early-clinical-experience-with-the-da-vinci-xi-surgical-system-in-general-surgery
#10
Monika E Hagen, Minoa K Jung, Frederic Ris, Jassim Fakhro, Nicolas C Buchs, Leo Buehler, Philippe Morel
The da Vinci Xi Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) has been released in 2014 to facilitate minimally invasive surgery. Novel features are targeted towards facilitating complex multi-quadrant procedures, but data is scarce so far. Perioperative data of patients who underwent robotic general surgery with the da Vinci Xi system within the first 6 month after installation were collected and analyzed. The gastric bypass procedures performed with the da Vinci Xi Surgical System were compared to an equal amount of the last procedures with the da Vinci Si Surgical System...
December 27, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27995433/direct-percutaneous-endoscopic-jejunostomy-dpej-tube-placement-a-single-institution-experience-and-outcomes-to-30-days-and-beyond
#11
Andrew T Strong, Gautam Sharma, Matthew Davis, Michael Mulcahy, Suriya Punchai, Colin P O'Rourke, Stacy A Brethauer, John Rodriguez, Jeffrey L Ponsky, Matthew D Kroh
INTRODUCTION: Patients with prior foregut surgery requiring long-term enteral access typically undergo operative jejunostomy tube placement; however, direct percutaneous endoscopic jejunostomy (DPEJ) is a viable alternative. METHODS: All de novo DPEJ procedures performed by surgical and advanced endoscopists from May 2003 to June 2015 were retrospectively reviewed following approval by the Institutional Review Board. There were 59 cases identified. RESULTS: Our cohort had a mean age of 50...
December 19, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27980002/the-role-of-nutrient-sensing-in-the-metabolic-changes-after-gastric-bypass-surgery
#12
Sandra Steensels, Matthias Lannoo, Bert Avau, Jorien Laermans, Laurien Vancleef, Ricard Farré, Kristin Verbeke, Inge Depoortere
Taste receptors coupled to the gustatory G-protein, gustducin, on enteroendocrine cells sense nutrients to regulate gut hormone release. During Roux-en-Y gastric bypass (RYGB) surgery, the altered nutrient flow to more distal regions can affect gustducin-mediated gut hormone release, and hence energy and glucose homeostasis. We studied the role of gustducin-mediated signaling in the metabolic improvements and intestinal adaptations along the gut after RYGB surgery in wild-type (WT) and α-gustducin(-/-) (α-gust(-/-)) mice...
December 15, 2016: Journal of Endocrinology
https://www.readbyqxmd.com/read/27805961/intraoperative-adverse-events-in-abdominal-surgery-what-happens-in-the-operating-room-does-not-stay-in-the-operating-room
#13
Jordan D Bohnen, Michael N Mavros, Elie P Ramly, Yuchiao Chang, D Dante Yeh, Jarone Lee, Marc de Moya, David R King, Peter J Fagenholz, Kathryn Butler, George C Velmahos, Haytham M A Kaafarani
OBJECTIVE: We sought to assess the impact of intraoperative adverse events (iAEs) on 30-day postoperative mortality, 30-day postoperative morbidity, and postoperative length of stay (LOS) among patients undergoing abdominal surgery. We hypothesized that iAEs would be associated with significant increases in each outcome. SUMMARY OF BACKGROUND DATA: The relationship between iAEs and postoperative clinical outcomes remains largely unknown. METHODS: The 2007 to 2012 institutional ACS-NSQIP and administrative databases for abdominal surgeries were matched then screened for iAEs using the Agency for Healthcare Research and Quality's 15 Patient Safety Indicator, "Accidental Puncture/Laceration"...
November 1, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27787481/complications-of-robotic-foregut-surgery-risks-and-advantages
#14
Ran B Luo, Domingo Montalvo, Toshiaki Suzuki, Bryan J Sandler, Garth R Jacobsen, Santiago Horgan
INTRODUCTION: Laparoscopic foregut surgeries are highly complex procedures that carry a high potential for morbidity and mortality should complications should occur. The robotic-assisted platform offers improved visualization of anatomy, optimal fine motor control, and a higher degree of instrumentation range of motion, which may potentially lead to better outcomes. This paper reviews the risks and benefits of the robotic platform in foregut procedures. EVIDENCE ACQUISITION: A web-based literature search was performed, in August 2016 using Pubmed, EMBASE, and Google Scholar from cited English publications from 1996 to 2016...
February 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/27785539/computed-tomography-and-upper-gastrointestinal-series-findings-of-esophageal-bronchi-in-infants
#15
Gabrielle C Colleran, Ciara E Ryan, Edward Y Lee, Brian Sweeney, David Rea, Clare Brenner
BACKGROUND: Esophageal bronchus is a rare form of communicating bronchopulmonary foregut malformation and a rare but important cause of an opaque hemithorax on chest radiography. A higher incidence of esophageal bronchus is associated with esophageal atresia, tracheo-esophageal fistula (TEF) and VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. In the presence of these conditions, the pediatric radiologist may be the first to consider the diagnosis of esophageal bronchus or esophageal lung...
February 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/27781093/gut-chemosensing-implications-for-disease-pathogenesis
#16
REVIEW
Christopher J Berg, Jonathan D Kaunitz
The ability of humans to sense chemical signals in ingested substances is implicit in the ability to detect the five basic tastes; sweet, sour, bitter, salty, and umami. Of these, sweet, bitter, and umami tastes are detected by lingual G-protein-coupled receptors (GPCRs). Recently, these receptors were also localized to the gut mucosa. In this review, we will emphasize recent advances in the understanding of the mechanisms and consequences of foregut luminal chemosensing, with special emphasis on cell surface GPCRs such as the sweet and proteinaceous taste receptors (TASRs), short- and long-chain fatty acid (FA) receptors, and bile acid receptors...
2016: F1000Research
https://www.readbyqxmd.com/read/27667913/first-101-robotic-general-surgery-cases-in-a-community-hospital
#17
Rodolfo J Oviedo, Jarrod C Robertson, Sharifah Alrajhi
BACKGROUND AND OBJECTIVES: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. METHODS: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27526345/surgical-management-of-achalasia-in-a-patient-with-previous-gastric-bypass
#18
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/27479885/clinical-application-of-spect-ct-with-99mtc-tektrotyd-in-bronchial-and-thymic-neuroendocrine-tumors-nets
#19
Sonya Sergieva, Bozhil Robev, Milena Dimcheva, Albena Fakirova, Radka Hristoskova
Neuroendocrine tumors (NETs) of the thorax including bronchial and thymic tumors belong to foregut NETs. Limited loco-regional thoracic NETs can be resected with surgery, but in extensive metastatic disease the treatment is mainly palliative. A high incidence and density of somatostatin receptors (SSTR2, SSTR3, and SSTR5) are found in thoracic NETs. The purpose of this study was to evaluate the role of SPECT-CT somatostatin receptor scintigraphy (SRS) with 99mTc-Tektrotyd for imaging, staging and follow up of patients with bronchial and thymic neuroendocrine tumors...
2016: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/27387670/pseudoachalasia-presenting-20%C3%A2-years-after-nissen-fundoplication-a-case-report
#20
Chuong N Lai, Kumar Krishnan, Min P Kim, Brian J Dunkin, Puja Gaur
BACKGROUND: Pseudoachalasia is a rare diagnosis manifested by clinical and physiologic symptoms of achalasia, with alternative etiology for outflow obstruction. While malignancy is a frequent cause of pseudoachalasia, prior surgical intervention especially surgery involving the esophagogastric junction, may result in a misdiagnosis of achalasia. CASE PRESENTATION: We present a case of a 70 year-old male with dysphagia and weight loss after undergoing a Billroth I and Nissen fundoplication several decades ago...
July 7, 2016: Journal of Cardiothoracic Surgery
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