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[PMID]: 28470491 [Au] Autor: Ramos AC; Marchesini JC; de Souza Bastos EL; Ramos MG; de Souza MDG; Campos JM; Ferraz AB [Ad] Endereço: Postgraduate Surgery Program, Federal University of Pernambuco, Recife, Brazil. ramos.almino@gmail.com. [Ti] Título: The Role of Gastrojejunostomy Size on Gastric Bypass Weight Loss. [So] Source: Obes Surg;27(9):2317-2323, 2017 Sep. [Is] ISSN: 1708-0428 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The laparoscopic Roux-en-Y gastric bypass (LRYGB) has been considered a reference procedure in the bariatric surgery. The linear-stapled gastrojejunostomy (GJ) has proved to be safe and effective, but its optimal size referred to postoperative weight loss remains poorly understood. OBJECTIVES: Evaluate the role of the linear-stapled GJ size in the mid-term post-LRYGB weight loss and occurrence of complications. MATERIALS AND METHODS: From January to April 2014, 128 patients underwent LRYGB with linear-stapled GJ in a 2-year follow-up. The LRYGB were carried out with the same technical steps, except for the length of the GJ. In GJ-15-mm group (n = 64), the GJ was constructed with white 45-mm cartridge in an extension of only 15 mm whereas in GJ-45-mm group (n = 64), the GJ was achieved using full extension of the cartridge. The body mass index (BMI) reduction was recorded for 24 months after procedure. RESULTS: The mean ages were 38 ± 10.6 and 41.3 ± 12.3 years, and there were 45 (70.3%) and 51 (79.7%) females in the GJ-15-mm and GJ-45-mm groups, respectively. The analysis on raw BMI data showed that both groups had significant reduction of BMI over time (p ≤ 0.05); however, reduction was greater in the GJ-15-mm group from 18 months onwards (p ≤ 0.05). The only complication observed was a case (1.56%) of stenosis in the group GJ-15 mm. CONCLUSION: The global analysis of BMI reduction indicated that the narrower GJ used (GJ-15-mm group) represented a favoring factor decreasing significantly more the BMI when compared to the wider one (GJ-45-mm group). [Mh] Termos MeSH primário: Derivação Gástrica/métodos Jejunostomia/métodos Obesidade Mórbida/cirurgia Estomas Cirúrgicos/patologia Perda de Peso [Mh] Termos MeSH secundário: Adulto Índice de Massa Corporal Feminino Seguimentos Derivação Gástrica/efeitos adversos Derivação Gástrica/reabilitação Seres Humanos Derivação Jejunoileal/efeitos adversos Derivação Jejunoileal/métodos Derivação Jejunoileal/reabilitação Jejunostomia/efeitos adversos Laparoscopia/métodos Laparoscopia/reabilitação Masculino Meia-Idade Obesidade Mórbida/patologia Complicações Pós-Operatórias/epidemiologia Estomas Cirúrgicos/efeitos adversos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE [do] DOI: 10.1007/s11695-017-2686-6

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[PMID]: 28396555 [Au] Autor: Arora A; Singh P; Anand N; Husain N [Ad] Endereço: Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India draditiarora87@gmail.com. [Ti] Título: Heterotopic pancreatic tissue associated with type 1 choledochal cyst, cystolithiasis and gall bladder stones: a rare entity with review of literature. [So] Source: BMJ Case Rep;2017, 2017 Apr 10. [Is] ISSN: 1757-790X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Choledochal cyst is a rare congenital malformation, particularly when associated with stones in cyst (cystolithiasis), gallstones and heterotopic pancreatic tissue within the cyst wall. The current case represents a 5-year-old boy with abdominal pain, pale colored stools, and jaundice. Magnetic resonance cholangiopancreatography showed a cystic lesion, arising from common bile duct with cystolithiasis and cholelithiasis. He underwent excision of choledochal cyst and gallbladder with Roux-en-Y hepaticojejunostomy. Microscopic examination showed a cyst wall composed of fibrocollagenous tissue lined by cuboidal to low columnar epithelium. The subserosal layer of cyst wall showed presence of heterotopic exocrine pancreatic tissue comprising of pancreatic acinar cells and ducts. We report the first case of heterotopic pancreatic tissue associated with choledochal cyst and cystolithiasis and cholelithiasis occurring at the same time. [Mh] Termos MeSH primário: Cisto do Colédoco/diagnóstico por imagem Coristoma/diagnóstico por imagem Cálculos Biliares/diagnóstico por imagem Cálculos da Bexiga Urinária/diagnóstico por imagem [Mh] Termos MeSH secundário: Anastomose em-Y de Roux Procedimentos Cirúrgicos do Sistema Biliar Pré-Escolar Colangiopancreatografia por Ressonância Magnética Cisto do Colédoco/cirurgia Coristoma/cirurgia Cálculos Biliares/cirurgia Seres Humanos Derivação Jejunoileal Masculino Pâncreas Resultado do Tratamento Cálculos da Bexiga Urinária/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170606 [Lr] Data última revisão: 170606 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170412 [St] Status: MEDLINE

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[PMID]: 28133081 [Au] Autor: Ida A; Miyaki A; Miyauchi T; Yamaguchi K; Naritaka Y [Ad] Endereço: Dept. of Surgery, Tokyo Women's Medical University Medical Center East. [Ti] Título: [Three Cases of Unresectable, Advanced, and Recurrent Colorectal Cancer Associated with Gastrointestinal Obstruction That Were Treated with Small Intestine-Transverse Colon Bypass Surgery]. [So] Source: Gan To Kagaku Ryoho;43(12):1632-1634, 2016 Nov. [Is] ISSN: 0385-0684 [Cp] País de publicação: Japan [La] Idioma: jpn [Ab] Resumo: Herein, we report 3cases of unresectable, advanced, and recurrent colorectal cancer associated with gastrointestinal obstruction. The patients were treated with small intestine-transverse colon bypass surgery, which improved the quality of life (QOL)in all cases. Case 1 was an 80-year-old woman who presented with subileus due to ascending colon cancer. After surgery, her oral intake was reestablished, and she was discharged home. Case 2 was an 89-year-old woman whose ileus was caused by cecal cancer with multiple hepatic metastases. After surgery, the patient was discharged to a care facility. Case 3 was an 83-year-old man whose ileus was caused by a local recurrence and small intestine infiltration after surgery for rectosigmoid cancer. He underwent surgery after a colonic stent was inserted. His oral intake was re-established and he was discharged home. Small bowel-transverse colon bypass surgery can be used to manage various conditions rostral to the transverse colon. It is still possible to perform investigations in patients whose general condition is poorer than that of patients who undergo resection of the primary lesion. This avoids creating an artificial anus and allows continuation of oral intake, which are useful for improving QOL in terminal cases. [Mh] Termos MeSH primário: Neoplasias Colorretais/cirurgia Obstrução Intestinal/cirurgia [Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais Neoplasias Colorretais/complicações Neoplasias Colorretais/diagnóstico por imagem Procedimentos Cirúrgicos do Sistema Digestório Feminino Seres Humanos Obstrução Intestinal/diagnóstico por imagem Obstrução Intestinal/etiologia Derivação Jejunoileal Masculino Recidiva Tomografia Computadorizada por Raios X [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170908 [Lr] Data última revisão: 170908 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170131 [St] Status: MEDLINE

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[PMID]: 27621579 [Au] Autor: Zhong MW; Liu SZ; Zhang GY; Zhang X; Hu SY [Ad] Endereço: Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, Xiang Zhang, San-Yuan Hu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China. [Ti] Título: Effects of sleeve gastrectomy with jejuno-jejunal or jejuno-ileal loop on glycolipid metabolism in diabetic rats. [So] Source: World J Gastroenterol;22(32):7332-41, 2016 Aug 28. [Is] ISSN: 2219-2840 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: AIM: To explore the effect of sleeve gastrectomy (SG) with jejuno-jejunal or jejuno-ileal loop on glycolipid metabolism in diabetic rats. METHODS: Diabetic rats, which were induced by high-fat diet (HFD), nicotinamide and low-dose streptozotocin, underwent sham operations, SG, SG with jejuno-ileal loop (SG-JI) and SG with jejuno-jejunal loop (SG-JJ) followed by postoperative HFD. Then, at the time points of baseline and 2, 12 and 24 wk postoperatively, we determined and compared several variables, including the area under the curve for the results of oral glucose tolerance test (AUCOGTT), serum levels of triglyceride, cholesterol and ghrelin in fasting state, homeostasis model assessment of insulin resistance (HOMA-IR), body weight, calorie intake, glucagon-like peptide (GLP)-1 and insulin secretions after glucose gavage at dose of 1 g/kg. RESULTS: At 2 wk postoperatively, rats that underwent SG, SG-JJ and SG-JI, compared with sham-operated (SHAM) rats, demonstrated lower body weight, calorie intake and ghrelin (P < 0.05 vs SHAM), enhanced secretion of insulin and GLP-1 after glucose gavage (P < 0.05 vs SHAM), improved AUCOGTT, HOMA-IR, fasting serum triglyceride and cholesterol (AUCOGTT: 1616.9 ± 83.2, 837.4 ± 83.7, 874.9 ± 97.2 and 812.6 ± 81.9, P < 0.05 vs SHAM; HOMA-IR: 4.31 ± 0.54, 2.94 ± 0.22, 3.17 ± 0.37 and 3.41 ± 0.22, P < 0.05 vs SHAM; Triglyceride: 2.35 ± 0.17, 1.87 ± 0.23, 1.98 ± 0.30 and 2.04 ± 0.21 mmol/L, P < 0.05 vs SHAM; Cholesterol: 1.84 ± 0.21, 1.53 ± 0.20, 1.52 ± 0.20 and 1.46 ± 0.23 mmol/L). At 12 wk postoperatively, rats receiving SG-JJ and SG-JI had lower body weight, reduced levels of triglyceride and cholesterol and elevated level of GLP-1 compared to those receiving SG (P < 0.05 vs SG). At 24 wk after surgery, compared with SG, the advantage of SG-JJ and SG-JI for glucolipid metabolism was still evident (P < 0.05 vs SG). SG-JI had a better performance in lipid metabolism and GLP-1 secretion of rats than did SG-JJ. CONCLUSION: SG combined with intestinal loop induces better glycolipid metabolism than simple SG, with the lipid metabolism being more improved with SG-JI compared to SG-JJ. [Mh] Termos MeSH primário: Diabetes Mellitus Experimental/metabolismo Diabetes Mellitus Experimental/cirurgia Glicolipídeos/metabolismo [Mh] Termos MeSH secundário: Anastomose Cirúrgica Animais Gastrectomia Grelina/sangue Peptídeo 1 Semelhante ao Glucagon/sangue Insulina/sangue Derivação Jejunoileal Jejuno/cirurgia Ratos Ratos Wistar [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Ghrelin); 0 (Glycolipids); 0 (Insulin); 89750-14-1 (Glucagon-Like Peptide 1) [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170424 [Lr] Data última revisão: 170424 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160914 [St] Status: MEDLINE [do] DOI: 10.3748/wjg.v22.i32.7332

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[PMID]: 26922187 [Au] Autor: Hassn A; Luhmann A; Rahmani S; Morris-Stiff G [Ad] Endereço: Department of Surgery, Princess of Wales Hospital, Bridgend, UK. [Ti] Título: Medium-Term Results of Combined Laparoscopic Sleeve Gastrectomy and Modified Jejuno-Ileal Bypass in Bariatric Surgery. [So] Source: Obes Surg;26(10):2316-23, 2016 Oct. [Is] ISSN: 1708-0428 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The ideal bariatric operation achieves 70-100 % maintained excess weight loss, is simple with low operative risks, and maintains absorption of trace elements. Our aim was to find a bariatric procedure that achieves the above while avoiding drawbacks of current options. METHODS: A standard sleeve gastrectomy was combined with a modified jejuno-ileal bypass dividing the small bowel 75 cm distal to the duodeno-jejunal flexure, anastomosing it to the ileum 75 cm proximal to the ileocaecal valve. Operative and follow-up data were collected prospectively between December 2004 and January 2013. RESULTS: One hundred sixty-eight procedures were analysed (110 female, 58 male). Mean patient age was 43 years (IQR 37-47), and median preoperative body mass index (kg/m(2)) was 52 (IQR 49-59). All operations were completed laparoscopically. Excess weight loss was 78 % (IQR 70-83 %, 12 months, n = 168), 79 % (IQR 70-85 %, 24 months), maintained at most recent follow-up with 77 % (IQR 68-84 %, n = 168), and for 8 year follow-up alone 75 % (IQR 66-84 %, n = 18). There was no operative mortality and 5.4 % morbidity. A 6.5 % of patients experienced transient vomiting. No symptoms of dumping or bacterial overgrowth were observed. All had normal liver enzymes. Hypocalcaemia (20.8 %) and zinc deficiency (25.6 %) resolved with oral supplementation. Type 2 diabetes mellitus resolved in 80.3 % and improved in the remainder of patients, hypertension resolved in 92.3 % and improved in the rest. CONCLUSIONS: Whilst currently an investigative procedure, and within the studies limitations combined sleeve gastrectomy with modified jejuno-ileal bypass is safe and effective, and evades many problems associated with current bariatric operations whilst offering maintained excess weight loss. [Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/cirurgia Gastrectomia/métodos Hipertensão/cirurgia Derivação Jejunoileal/métodos Obesidade Mórbida/cirurgia [Mh] Termos MeSH secundário: Adulto Diabetes Mellitus Tipo 2/sangue Diabetes Mellitus Tipo 2/etiologia Feminino Seres Humanos Hipertensão/sangue Hipertensão/etiologia Laparoscopia Masculino Meia-Idade Obesidade Mórbida/sangue Obesidade Mórbida/complicações Resultado do Tratamento Perda de Peso Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 171105 [Lr] Data última revisão: 171105 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160229 [St] Status: MEDLINE [do] DOI: 10.1007/s11695-016-2098-z

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[PMID]: 26895911 [Au] Autor: Ryou M; Aihara H; Thompson CC [Ad] Endereço: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. mryou@partners.org. [Ti] Título: Minimally invasive entero-enteral dual-path bypass using self-assembling magnets. [So] Source: Surg Endosc;30(10):4533-8, 2016 Oct. [Is] ISSN: 1432-2218 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: BACKGROUND: A minimally invasive method of entero-enteral bypass may be desirable for treatment of obstruction, obesity, or metabolic syndrome. We have developed a technology based on miniature self-assembling magnets which create large-caliber anastomoses (incisionless anastomosis system or IAS). The aim of this study was to assess (a) procedural characteristics of IAS deployment and (b) long-term integrity and patency of the resulting jejuno-ileal dual-path bypass. METHODS: Endoscopic jejuno-ileal bypass creation using IAS magnets was performed in 8 Yorkshire pigs survived 3 months. PROCEDURE: The jejunal magnet was endoscopically deployed. However, the ileal magnet required surgical delivery given restraints of porcine anatomy. A 5-mm enterotomy was created through which the ileal magnet was inserted using a modified laparoscopic delivery tool. Magnets were manually coupled. Pigs underwent serial endoscopies for anastomosis assessment. Three-month necropsies were performed, followed by pressure testing of anastomoses and histological analysis. RESULTS: Jejuno-ileal bypass creation using self-assembling IAS magnets was successful in all 8 pigs (100 %). Patent, leak-free bypasses formed in all animals by day 10. All IAS magnets were expelled by day 12. Anastomoses were widely patent at 3 months, with mean maximal diameter of 30 mm. At necropsy, adhesions were minimal. Pressure testing confirmed superior integrity of anastomotic tissue. Histology showed full epithelialization across the anastomosis with no evidence of submucosal fibrosis or inflammation. CONCLUSIONS: Entero-enteral bypass using self-assembling IAS magnets is safe and technically feasible in the porcine model. IAS magnets can be rapidly delivered endoscopically or through a modified laparoscopic device. Expulsion of fused magnets avoids retention of prosthetic material. Anastomoses are widely patent and fully re-epithelialized. Three-month pressure testing reveals anastomotic tissue to be as robust as native tissue, while necropsy and histology suggests minimal/absent tissue inflammation. In human anatomy, a fully endoscopic jejuno-ileal bypass using IAS magnets may be feasible. [Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos Desenho de Equipamento Íleo/cirurgia Derivação Jejunoileal/métodos Jejuno/cirurgia Imãs [Mh] Termos MeSH secundário: Anastomose Cirúrgica/instrumentação Animais Derivação Jejunoileal/instrumentação Laparoscopia Pressão Sus scrofa Suínos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 171010 [Lr] Data última revisão: 171010 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160221 [St] Status: MEDLINE [do] DOI: 10.1007/s00464-016-4789-x

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[PMID]: 26537317 [Au] Autor: Rohde U; Hedbäck N; Gluud LL; Vilsbøll T; Knop FK [Ad] Endereço: Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. [Ti] Título: Effect of the EndoBarrier Gastrointestinal Liner on obesity and type 2 diabetes: a systematic review and meta-analysis. [So] Source: Diabetes Obes Metab;18(3):300-5, 2016 Mar. [Is] ISSN: 1463-1326 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Compared with bariatric surgery, less invasive and reversible techniques to counteract obesity and type 2 diabetes (T2D) have been developed, including the EndoBarrier Gastrointestinal Liner [duodenal-jejunal bypass sleeve (DJBS)]. We conducted a systematic review and meta-analyses of eligible trials to evaluate the efficacy and safety of the DJBS. Five randomized controlled trials (RCTs; 235 subjects) and 10 observational studies (211 subjects) were included. The risk of bias was evaluated as high in all studies. The mean body mass index ranged from 30 to 49.2 kg/m(2) and 10-100% of the subjects had T2D. Meta-analysis showed that the DJBS was associated with significant mean differences in body weight and excess weight loss of -5.1 kg [95% confidence interval (CI) -7.3, -3.0; four trials; n = 151; I(2) = 37%] and 12.6% (95% CI 9.0, 16.2; four trials; n = 166; I(2) = 24%), respectively, compared with diet modification. The mean differences in glycated haemoglobin (-0.9%; 95% CI -1.8, 0.0) and fasting plasma glucose (-3.7 mM; 95% CI -8.2, 0.8) among subjects with T2D did not reach statistical significance. Adverse events consisted mainly of abdominal pain, nausea and vomiting. No deaths occurred. Future high-quality long-term RCTs are needed to further assess efficacy and safety. [Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/cirurgia Derivação Jejunoileal/instrumentação Obesidade/cirurgia [Mh] Termos MeSH secundário: Dor Abdominal/etiologia Adulto Glicemia/análise Índice de Massa Corporal Diabetes Mellitus Tipo 2/sangue Diabetes Mellitus Tipo 2/etiologia Duodeno/cirurgia Jejum/sangue Feminino Hemoglobina A Glicada/análise Seres Humanos Derivação Jejunoileal/efeitos adversos Derivação Jejunoileal/métodos Jejuno/cirurgia Masculino Meia-Idade Náusea/etiologia Obesidade/complicações Estudos Observacionais como Assunto Ensaios Clínicos Controlados Aleatórios como Assunto Resultado do Tratamento Vômito/etiologia Perda de Peso [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Blood Glucose); 0 (Glycated Hemoglobin A); 0 (hemoglobin A1c protein, human) [Em] Mês de entrada: 1611 [Cu] Atualização por classe: 171116 [Lr] Data última revisão: 171116 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 151106 [St] Status: MEDLINE [do] DOI: 10.1111/dom.12603

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[PMID]: 26323659 [Au] Autor: Melissas J; Peirasmakis D; Lamprou V; Papadakis J [Ad] Endereço: Bariatric Unit, Department of Surgical Oncology, University of Crete, 164 Erythreas str, Heraklion, 71409, Greece. melissas@med.uoc.gr. [Ti] Título: Is a Simple Food-Diverting Operation the Solution for Type 2 Diabetes Treatment? Experimental Study in a Non-Obese Rat Model. [So] Source: Obes Surg;26(5):1010-5, 2016 May. [Is] ISSN: 1708-0428 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The feasibility of a side-to-side jejunoileal anastomosis (SJA) to control type 2 diabetes mellitus (T2DM) was studied in non-obese diabetic Goto-Kakizaki (GK) rats. METHODS: Seventeen 14-week-old male GK rats were divided into three groups: SJA bypassing 60% of the small bowel length, sham-operated jejunoileal bypass (Sham group), and control animals. Rats were observed for 10 weeks after surgery. Fasting blood glucose (FBG) levels and oral glucose tolerance test (OGTT) were measured before and after the procedure. RESULTS: Animals with SJA exhibited normalization of FBG levels from the 1st and up to the 10th postoperative week when the experiment terminated. OGTT compared with sham-operated and control groups was also significantly better at 3 and 8 weeks postoperatively. CONCLUSIONS: A simple SJA, diverting the food and biliopancreatic secretion to the distal small bowel, was able to normalize both FBG levels and OGTT in a non-obese diabetic rat model. [Mh] Termos MeSH primário: Diabetes Mellitus Experimental/cirurgia Diabetes Mellitus Tipo 2/cirurgia Derivação Jejunoileal [Mh] Termos MeSH secundário: Animais Glicemia/metabolismo Diabetes Mellitus Experimental/metabolismo Diabetes Mellitus Experimental/patologia Diabetes Mellitus Tipo 2/metabolismo Diabetes Mellitus Tipo 2/patologia Estudos de Viabilidade Teste de Tolerância a Glucose Insulina/sangue Intestino Delgado/cirurgia Masculino Ratos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Blood Glucose); 0 (Insulin) [Em] Mês de entrada: 1612 [Cu] Atualização por classe: 171105 [Lr] Data última revisão: 171105 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150902 [St] Status: MEDLINE [do] DOI: 10.1007/s11695-015-1871-8

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[PMID]: 26205216 [Au] Autor: Li M; Li H; Zhou Z; Zhou Y; Wang Y; Zhang X; Liu T; Zhong M; Han H; Liu S; Hu S [Ad] Endereço: Department of General Surgery, Qilu Hospital of Shandong University, No. 107, Wenhuaxi Road, Jinan, 250012, Shandong, People's Republic of China. [Ti] Título: Duodenal-Jejunal Bypass Surgery Ameliorates Glucose Homeostasis and Reduces Endoplasmic Reticulum Stress in the Liver Tissue in a Diabetic Rat Model. [So] Source: Obes Surg;26(5):1002-9, 2016 May. [Is] ISSN: 1708-0428 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Duodenal-jejunal bypass (DJB) has been shown to be an effective surgical treatment for type 2 diabetes mellitus (T2DM). However, the underlying mechanisms are poorly understood. Recently, accumulating evidences suggest that endoplasmic reticulum (ER) stress plays an important role in the development of insulin resistance in T2DM. The present study was designed to investigate the effect of DJB on glucose homeostasis, the ER stress state in the liver tissue, and the involving signaling independently of weight loss. METHODS: Thirty adult male T2DM Sprague-Dawley (SD) rats induced by high-fat diet and low dose of streptozotocin (STZ) were randomly divided into DJB and sham groups. Ten age-matched male SD rats were assigned as the control group. The parameters of body weight and calorie intake were measured at indicated time points. The glucose tolerance and insulin resistance were detected to evaluate the glucose homeostasis. Serum insulin was determined by enzyme-linked immunosorbent assay (ELISA). The markers of ER stress, the activity of c-Jun N-terminal kinase (JNK) and serine phosphorylation of insulin receptor substrate 1 (IRS-1) in the liver tissue, were determined by Western blotting. RESULTS: DJB induced significant improvements in glucose homeostasis and insulin sensitivity, but without weight loss. DJB improved the ER stress state indicated by decreased protein kinase RNA (PKR)-like ER protein kinase (PERK) and inositol-requiring enzyme 1 (IRE-1) phosphorylation in the liver tissue. The JNK activity and serine phosphorylation of IRS-1 in the liver tissue were significantly reduced after DJB. CONCLUSIONS: DJB ameliorates glucose homeostasis. Meanwhile, our study helps to reveal that the reduced hepatic ER stress and the decreased JNK activity may contribute to the improved glucose homeostasis after DJB. [Mh] Termos MeSH primário: Diabetes Mellitus Experimental/cirurgia Diabetes Mellitus Tipo 2/cirurgia Estresse do Retículo Endoplasmático Glucose/metabolismo Derivação Jejunoileal Fígado/metabolismo [Mh] Termos MeSH secundário: Animais Diabetes Mellitus Experimental/metabolismo Diabetes Mellitus Experimental/patologia Diabetes Mellitus Tipo 2/metabolismo Diabetes Mellitus Tipo 2/patologia Duodeno/cirurgia Homeostase Resistência à Insulina Derivação Jejunoileal/métodos Jejuno/cirurgia Fígado/patologia Masculino Ratos Ratos Sprague-Dawley Estreptozocina [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 5W494URQ81 (Streptozocin); IY9XDZ35W2 (Glucose) [Em] Mês de entrada: 1612 [Cu] Atualização por classe: 171105 [Lr] Data última revisão: 171105 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150725 [St] Status: MEDLINE [do] DOI: 10.1007/s11695-015-1816-2

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[PMID]: 26731867 [Au] Autor: Siemion L; Bandurski J; Malinger S [Ti] Título: [The results of treatment of gastric cancer in the Provincial Hospital in Zielona Góra]. [Ti] Título: Wyniki leczenia raka zoladka w Szpitalu Wojewódzkim w Zielonej Górze.. [So] Source: Przegl Lek;72(3):120-5, 2015. [Is] ISSN: 0033-2240 [Cp] País de publicação: Poland [La] Idioma: pol [Ab] Resumo: INTRODUCTION: Gastric cancer is the third leading cause of death from cancer worldwide in both sexes, following lung and breast cancer. The incidence of gastric cancer in Poland is approximately 5% in men and approximately 2.5% in women, among the complete incidence of cancers. Deaths from gastric cancer in men in Poland in 2009 amounted to 6.6%, while in women--4.6%. The highest mortality rate in men is observed in the Lubuskie, Podkarpackie, Slaskie and Opolskie provinces. European average 5-year survival in the EUROCARE-4 study is 24.5%. AIM: The aim of this paper was to assess the treatment of gastric cancer in the Department of General and Oncological Surgery of the Provincial Hospital in Zielona Góra. MATERIALS AND METHODS: The retrospective analysis of 109 patients with gastric cancer, operated in the years 2003-2007, was performed. The analysis included patients scheduled for admission with the histopathological confirmation of adenocarcinoma, prepared to and subjected to laparotomy. The post-operative intrahospital deaths were estimated up to 30 days after surgery. The analysis of the survival rates was performed up to 1, 6, 12, 36 and 60 months since lapatoromy. All the continuous variables with the standard distribution were expressed as the mean ± standard deviation, while the total survival rates were assessed by means of the Kaplan-Meier method. RESULTS: 55 patients (50.5%) underwent the radical surgical procedure intended to cure them. The remaining 54 patients (49.5%) could not be qualified for the radical surgical procedures. In 35 cases (32%) underwent laparotomy with biopsy, in 19 cases (17%) palliative surgery (intestinal bypass, gastrostomy, palliative resection). Out of 55 patients underwent the radical surgical procedure 9 patients died after the procedure (16.4%). The survival rates calculated for all the patients revealed that 21.1% patients survived 5 years after the surgery. CONCLUSIONS: Almost a half of the patients (49.5%) who were admitted for treatment had an advanced stage of the disease that could not be qualified for the radical surgical procedures. The distant results of surgical treatment are non-satisfactory due to the fact that the disease was so advanced. 5-year-long survival rates (21.1% in our data) are higher that the ones listed in the EUROCARE-4 test for Poland (14.4%), but lower than the European average (24.5%). [Mh] Termos MeSH primário: Adenocarcinoma/mortalidade Adenocarcinoma/cirurgia Neoplasias Gástricas/mortalidade Neoplasias Gástricas/cirurgia [Mh] Termos MeSH secundário: Adenocarcinoma/patologia Adulto Idoso Idoso de 80 Anos ou mais Feminino Gastrostomia Seres Humanos Derivação Jejunoileal Laparotomia Masculino Meia-Idade Estadiamento de Neoplasias Cuidados Paliativos Polônia/epidemiologia Prognóstico Estudos Retrospectivos Neoplasias Gástricas/patologia Análise de Sobrevida Taxa de Sobrevida Resultado do Tratamento [Pt] Tipo de publicação: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Mês de entrada: 1602 [Cu] Atualização por classe: 160106 [Lr] Data última revisão: 160106 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160107 [St] Status: MEDLINE

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