Τρίτη, 30 Ιουλίου 2019

Obesity Surgery

Timing of Gestation After Laparoscopic Sleeve Gastrectomy (LSG): Does it Influence Obstetrical and Neonatal Outcomes of Pregnancies?


Ivor Lewis Oesophagectomy for a Distal Adenocarcinoma of the Oesophagus 10 Years After Roux-en-Y Gastric Bypass (RYGB)


Correction to: Longitudinal Impacts of Gastric Bypass Surgery on Pharmacodynamics and Pharmacokinetics of Statins

In the original article the authors failed to include the following footnote:



Christine Ren Fielding


Correction to: Incidence and Risk Factors for Cholelithiasis After Bariatric Surgery

Due to a metadata tagging error the name of author Andrés Esteban San Martín was indexed incorrectly. The author's given name is Andrés Esteban and his family name is San Martín.



Correction to: Surgical Morbidity in the Elderly Bariatric Patient: Does Age Matter?

Due to a metadata tagging error the name of author Andrés Esteban San Martín was indexed incorrectly. The author's given name is Andrés Esteban and his family name is San Martín.



Response to Letter to the Editor: Impact of Bariatric Surgery on Outcomes of Patients with Sickle Cell Disease: a Nationwide Inpatient Sample Analysis, 2004–2014


Endoscopic Tunneled Stricturotomy with Full-Thickness Dissection in the Management of a Sleeve Gastrectomy Stenosis

Abstract

Introduction

Laparoscopic sleeve gastrectomy is becoming the most commonly performed bariatric surgery. Despite clinical efficacy, adverse events have gradually increase due to its rapid adoption. Sleeve stenosis is the second most common adverse event, occurring in 0.7 to 4% of patients undergoing laparoscopic sleeve gastrectomy (LSG). Endoscopic management with pneumatic balloon dilation (PBD) or stent placement is commonly performed, with a success rate of up to 88%. Recently, Moura et al. (VideoGIE 4(2):68–71, 2018) described a new technique, named as endoscopic tunneled stricturotomy. In this video, we demonstrated the evolution of this technique including full-thickness dissection with staple line disruption.

Methods

A 28-year-old woman with a BMI of 35.3 kg/m2 who underwent LSG, presented with dysphagia to solid food. An upper GI series showed a stenosis at the level of the incisura angularis. The patient was then referred for endoscopic evaluation.

Results

She underwent three endoscopic PBD in an attempt to treat the stenosis. Unfortunately, her symptoms did not improve. After failed PBD treatment, an endoscopic tunneled stricturotomy with full-thickness dissection was performed. The procedure is performed in 6 steps: (1) identification of the stenosis, (2) submucosal injection 3–5 cm before the stenosis, (3) incision, (4) submucosal tunneling, (5) stricturotomy with full-thickness dissection, and (6) mucosal closure. During follow-up, the patient maintained a 1200-cal diet, without recurrence of symptoms.

Conclusion

Endoscopic tunneled stricturotomy with full-thickness dissection is feasible and appears to be safe and effective in the management of stenosis after sleeve gastrectomy. This procedure may be an option after conventional treatment failure or may be considered as a primary alternative.



Patient Recall of Education about the Risks of Alcohol Use Following Bariatric Surgery

Abstract

Patients who undergo bariatric surgery are at increased risk of developing alcohol problems. The purpose of this study was to evaluate whether patients who underwent bariatric surgery recalled receiving education about alcohol prior to having surgery and to investigate their alcohol use patterns. Patients (N = 567) who underwent bariatric surgery completed a survey regarding their knowledge of risks related to post-surgical alcohol use. Although most patients recalled receiving education about abstinence from alcohol after surgery, at least one-third of patients do not appear to understand the risks involved with alcohol consumption, suggesting that patients did not retain the information. Despite recalling receiving education, many patients still consumed alcohol after surgery. It appears that additional interventions are needed to decrease alcohol use after bariatric surgery.



Internal Hernia and Roux-en-Y Gastric Bypass: Should the Routine Closure of Defects Still Be a Matter of Debate?


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

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