Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Jun 2012
Randomized Controlled Trial Comparative StudyEffect of Roux-en-Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomised trial.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most common bariatric technique. Laparoscopic sleeve gastrectomy (LSG) is a restrictive procedure; the metabolic and endocrine effects of which remain unknown. We compared the effects of both procedures on glucose metabolism and fasting and meal-stimulated gut hormone levels. ⋯ LRYGB and LSG markedly improved glucose homeostasis. Only LSG decreased fasting and postprandial ghrelin levels, whereas GLP-1 and PYY levels increased similarly after both procedures.
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J. Gastrointest. Surg. · Jun 2012
Comparative StudyEffect of surgical approach on 30-day mortality and morbidity after elective colectomy: a NSQIP study.
The aim of this study was to evaluate the laparoscopic approach and pre- and postoperative conditions as predictors of 30-day mortality and morbidity in elective colectomy. ⋯ Based on this analysis, laparoscopy was associated with a decrease in 30-day postoperative morbidity for colectomy. However, after adjusting for preoperative comorbidities and postoperative morbidities, laparoscopy did not independently influence mortality after colectomy.
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J. Gastrointest. Surg. · Jun 2012
Comparative StudyRisk assessment using a novel score to predict anastomotic leak and major complications after oesophageal resection.
Oesophagectomy is associated with significant morbidity and mortality. A simple score to define a patient's risk of developing major complications would be beneficial. ⋯ Blood-borne markers of the systemic inflammatory response are predictors of AL and major complications after oesophageal resection. When combined they may categorise a patient's risk of developing a serious complication with higher sensitivity and specificity.
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J. Gastrointest. Surg. · Jun 2012
Comparative StudyPrognostic factors in patients with node-negative gastric cancer: a single center experience from China.
Lymph node metastasis was the most important prognostic factor in gastric cancer. Patients with node-negative gastric cancer presented better survival. However, some of them would die of the disease. The aim of this study was to evaluate the prognostic factors of patients with node-negative gastric cancer. ⋯ Among patients with node-negative gastric cancer and higher risk for recurrence, the use of adjuvant therapies should be considered.
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J. Gastrointest. Surg. · Jun 2012
Comparative StudyEfficacy and complications of nasojejunal, jejunostomy and parenteral feeding after pancreaticoduodenectomy.
European nutritional guidelines recommend routine use of enteral feeding after pancreaticoduodenectomy (PD) whereas American guidelines do not. Data on the efficacy and, especially, complications of the various feeding strategies after PD are scarce. ⋯ None of the analysed feeding strategies was found superior with respect to time to resumption of normal oral intake, morbidity and mortality. Each strategy was associated with specific complications. Nasojejunal tubes dislodged in a third of patients, jejunostomy tubes caused few but potentially life-threatening bowel strangulation and TPN doubled the risk of infections.