Laparoscopic management of pathologic gastroesophageal reflux after sleeve gastrectomy using the magnetic sphincter augmentation (MSA) device-a Video Vignette.

Purpose: The development of gastroesophageal reflux disease (GERD) has been shown to be not infrequent after laparoscopic sleeve gastrectomy (LSG). Management may vary from medical therapy to Roux-en-Y gastric bypass (RYGB) conversion. Magnetic sphincter augmentation (MSA) device has been shown to be a promising option with excellent results.

Staple Line Reinforcement During Laparoscopic Sleeve Gastrectomy: Systematic Review and Network Meta-analysis of Randomized Controlled Trials.

Purpose: Staple line reinforcement (SLR) during laparoscopic sleeve gastrectomy (LSG) is controversial. The purpose of this study was to perform a comprehensive evaluation of the most commonly utilized techniques for SLR.

Materials And Methods: Network meta-analysis of randomized controlled trials (RCTs) to compare no reinforcement (NR), suture oversewing (SR), glue reinforcement (GR), bioabsorbable staple line reinforcement (Gore® Seamguard®) (GoR), and clips reinforcement (CR).

Techniques for reconstruction after distal gastrectomy for cancer: updated network meta-analysis of randomized controlled trials.

Background: The choice of the best reconstruction technique after distal gastrectomy (DG) remains controversial and still not defined. The purpose was to perform a comprehensive evaluation within the major type of intestinal reconstruction after DG for gastric cancer.

Methods: Systematic review and network meta-analyses of randomized controlled trials (RCTs) to compare Billroth I (BI), Billroth II (BII), Billroth II Braun (BII Braun), Roux-en-Y (RY), and Uncut Roux-en-Y (URY).

Magnetic sphincter augmentation device removal: surgical technique and results at medium-term follow-up.

Background: The magnetic sphincter augmentation (MSA) device has become a common option for the treatment of gastroesophageal reflux disease (GERD). Knowledge of MSA-related complications, indications for removal, and techniques are puzzled. With this study, we aimed to evaluate indications, techniques for removal, surgical approach, and outcomes with MSA removal.

Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis.

Introduction: The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer.

Materials And Methods: Systematic review and meta-analysis.

Systematic review and updated network meta-analysis of randomized controlled trials comparing open, laparoscopic-assisted, and robotic distal gastrectomy for early and locally advanced gastric cancer.

Background: The role of minimally invasive surgery for the treatment of early and locally advanced gastric cancer remains controversial. The purpose of this study was to perform a comprehensive evaluation of major surgical approaches for operable distal gastric cancer.

Methods: Systematic review and network meta-analyses of randomized controlled trials were performed to compare open distal gastrectomy, laparoscopic-assisted distal gastrectomy, and robotic distal gastrectomy.

Total extraperitoneal (TEP) versus laparoscopic transabdominal preperitoneal (TAPP) hernioplasty: systematic review and trial sequential analysis of randomized controlled trials.

Purpose: To examine the updated evidence on safety, effectiveness, and outcomes of the totally extraperitoneal (TEP) versus the laparoscopic transabdominal preperitoneal (TAPP) repair and to explore the timely tendency variations favoring one treatment over another.

Methods: Systematic review and trial sequential analysis (TSA) of randomized controlled trials (RCTs). MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.

Intracorporeal Versus Extracorporeal Anastomosis in Laparoscopic Right Colectomy: An Updated Systematic Review and Cumulative Meta-Analysis.

The effect of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in laparoscopic right hemicolectomy is controversial. The aim of this study was to evaluate the safety, effectiveness, and functional outcomes of IA compared with EA and to explore the timely tendency variations favoring one treatment over another. PubMed, EMBASE, and Web of Science were consulted.

Expanding the role of bitter taste receptor in extra oral tissues: TAS2R38 is expressed in human adipocytes.

Increasing evidence indicates that taste receptors mediate a variety of functions in extra-oral tissues. The present study investigated the expression of bitter taste receptor TAS2R38 in human adipocytes, the possible link with genetic background and the role of TAS2R38 in cell delipidation and lipid accumulation rate . Subcutaneous (SAT) and visceral (VAT) adipose tissues were collected in 32 obese and 18 lean subjects.

Key Points for Cholelithiasis and Gallstone Ileus Prevention Following Biliointestinal Bypass.

BACKGROUND Biliointestinal bypass is a malabsorptive procedure for surgical treatment of morbid obesity. It is the evolution of jejunoileal bypass, and it is characterized by a cholecysto-jejunostomy on the proximal end of the excluded jejunum, therefore, allowing bile flow through the excluded bowel loop reducing the risk of postoperative diarrhea and malabsorption syndrome. Obesity is a well-known risk factor for cholelithiasis; moreover, bariatric surgery has been showed to increases the risk of gallstones formation.

Does C-reactive Protein Have a Predictive Role in the Early Diagnosis of Postoperative Complications After Bariatric Surgery? Systematic Review and Bayesian Meta-analysis.

Background: Postoperative leak and intra-abdominal infections are common after bariatric surgery with a significant impact on perioperative outcomes, hospital length of stay, and readmission rates. In the era of enhanced recovery programs, with patients being discharged from the hospital 24-36 h after surgery and potentially before developing any complications, an early indicator of postoperative complications may be decisive. The aim of this study was to evaluate the predictive role of the C-reactive protein (CRP) in the early diagnosis of complications in patients undergoing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).

Ten Years After Bariatric Surgery: Bad Quality of Life Promotes the Need of Psychological Interventions.

This study aims to evaluate long-term quality of life (QoL) and primary clinical outcomes, 10 years after biliointestinal bypass (BIB) surgery. It was expected that, although BIB might show encouraging primary outcomes, long term QoL could be significantly impaired. Ninety patients were contacted for a phone interview [age 41.

Laparoscopic Trans-Abdominal Right Adrenalectomy for a Large Primitive Adrenal Oncocytic Carcinoma: A Case Report and Review of Literature.

BACKGROUND Adrenocortical oncocytic neoplasms (AONs) are extremely rare tumors. AONs are classified as: oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP), and oncocytic carcinoma (AOC). Among the 162 reported cases of AONs in the literature, 30 cases were classified as malignant.

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature.

BACKGROUND Bleeding is a major intraoperative complication during surgical procedures. When conventional methods such as ligature and diathermocoagulation are ineffective for bleeding management, hemostatic agents should be used. Oxidized cellulose is one of the major hemostatic agents used worldwide.

Cardiac tamponade occurred after endoscopic submucosal dissection: conservative management of the esophagopericardial fistula.

We describe the case of an esophagopericardial fistula generated after endoscopic submucosal dissection in a patient affected by a superficial esophageal squamous cell carcinoma immediately treated with percutaneous pericardial drainage and placement of a partially covered self-expanding metal stent that has been removed using the stent-in-stent technique after 35 days.

Gallstone ileus after biliointestinal bypass: report of two cases.

Introduction: Gallstone ileus is an uncommon disease and accounts for 1-4 % of all cases of mechanical intestinal obstruction. The physiopathology is related to the presence of a bilioenteric fistula.

Method: We report two cases of gallstone ileus in patients operated on biliointestinal bypass for morbid obesity.

Cholesterol metabolism after bariatric surgery in grade 3 obesity: differences between malabsorptive and restrictive procedures.

Objective: Malabsorptive bariatric surgery (biliopancreatic diversion and biliointestinal bypass [BIBP]) reduces serum cholesterol levels more than restrictive surgery (adjustable gastric banding [AGB]), and this is thought to be due to greater weight loss. Our aim was to evaluate the changes of cholesterol metabolism induced by malabsorptive and restrictive surgery independent of weight loss.

Research Design And Methods: In a nonrandomized, self-selected, unblinded, active-comparator, bicenter, 6-month study, glucose metabolism (blood glucose and serum insulin levels and homeostasis model assessment of insulin resistance [HOMA-IR] index) and cholesterol metabolism (absorption: serum campesterol and sitosterol levels; synthesis: serum lathosterol levels; catabolism: rate of appearance and serum concentrations of serum 7-α- and serum 27-OH-cholesterol after infusions of deuterated 7-α- and 27-OH-cholesterol in sequence) were assessed in grade 3 obesity subjects undergoing BIBP (n = 10) and AGB (n = 10).

Corneal involvement in Crohn's disease: an in vivo confocal microscopy study.

Purpose: To evaluate the corneal changes of patients with Crohn's disease (CD) using confocal microscopy and to investigate the association among confocal parameters and CD activity and CD treatment.

Methods: Thirty consecutive patients (age: 42 ± 12 years; 19 women and 11 men) affected by CD and 30 control eyes (age matched and gender matched) underwent an ophthalmic examination and, in 1 eye chosen at random, confocal microscopy of the central cornea using the cornea module of Heidelberg Retina Tomograph. The following confocal parameters were evaluated: density of basal epithelial cells, epithelial dendritic cells, anterior and posterior stromal keratocytes, and endothelial cells; the subbasal plexus was assessed for number and tortuosity of the nerve fibers.

[Intestinal neuroendocrine tumor. Case report and review of the literature].

Gastroenteropancreatic (GEP) neuroendocrine tumors are rare neoplasm and have proved to be slow growing malignancies which involve many organs and most frequently the gastrointestinal tract. They have a peculiary biological behaviour: most of them have endocrine function (carcinoid syndrome); many are clinically silent until late presentation. Symptoms are non specific; the most common are abdominal pain, nausea and vomiting, weight loss and gastrointestinal (GI) blood loss.

[Giant angiomyolipoma of the kidney not associated with tuberous sclerosis: a case report and review of the literature].

The authors describe a paradigmatic case of a large renal angiomyolipoma not associated with tuberous sclerosis. The lesion was discovered as an incidental finding during abdominal ultrasound for other pathology. Owing to the extent of the lesion and the appreciable risk of spontaneous rupture and bleeding, we opted for surgical treatment.