Surgical standardization to prevent gastric stenosis after laparoscopic sleeve gastrectomy: a case series

Chang, Po‐Chih; Tai, Chi‐Ming; Hsin, Ming-Che; Hung, Chao‐Ming; Huang, Ivy Ya-Wei; Huang, Chih‐Kun

doi:10.1016/j.soard.2016.09.014

Cited by 26 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Gastric cancer (GC) has the highest morbidity and mortality rates in the world, especially in China [ 1 ]. The most common method of GC treatment is surgery, which has a high success rate when diagnosed early [ 2 ]. However, most patients are diagnosed when the cancer has already metastasized.…”

Section: Introductionmentioning

confidence: 99%

miR-551b regulates epithelial-mesenchymal transition and metastasis of gastric cancer by inhibiting ERBB4 expression

et al. 2017

View full text Add to dashboard Cite

Epithelial-mesenchymal transition (EMT) is an important biological process that is characteristic of malignant tumor cells with metastatic potential. We investigated the role of miR-551b in EMT and metastasis in gastric cancer (GC). We found that low miR-551b levels were associated with EMT, metastasis and a poor prognosis in GC patients. Further, two GC cell lines, MNK45 and SGC7901, exhibited lower miR-551b levels than the GES normal stomach cell line. Exposing MNK45 and SGC7901 cells to TGF-β1 resulted in cell morphology changes characteristic of EMT, which was confirmed by Western blot analysis demonstrating low E-Cadherin and high N-Cadherin and Vimentin levels. Treatment with miR-551b mimics inhibited these EMT changes as well as Transwell migration and invasiveness. We identified ERBB4 as a potential target of miR-551b based on patient data from the TCGA. ERBB4 was upregulated in GC specimens, and its high expression correlated with a poor prognosis of GC patients. Dual luciferase assays revealed that miR-551b directly inhibited ERBB4 by binding to its 3′UTR. Moreover, treatment with miR-551b mimics or the ERBB4 inhibitor AST-1306 inhibited EMT in the GC cell lines. Finally, nude mice xenografted with GC cancer cell lines expressing miR-551b mimics exhibited smaller tumors and longer survival than mice engrafted with control GC cancer cells. These data indicate that miR-551b inhibits EMT and metastasis in GC by inhibiting ERBB4. miR-551b and ERBB4 are thus potential therapeutic targets for the treatment of GC.

show abstract

Section: Introductionmentioning

confidence: 99%

miR-551b regulates epithelial-mesenchymal transition and metastasis of gastric cancer by inhibiting ERBB4 expression

et al. 2017

View full text Add to dashboard Cite

show abstract

“…26 another one larger study with longer period of follow-up published by Po-Chih Chang. 27 During the follow-up of 58.1±26.5 month, no patient has experienced GS after LSG till the time of publishing in those they added omentopexy versus those who didn't (0/489 vs. 7/338, p<0.05).Really the LSG procedure is associated with changes in gastric emptying. The incidence of delayed gastric emptying and persistent food intolerance is reported as high as 30%.…”

Section: Resultsmentioning

confidence: 92%

Role of staple line fixation during laparoscopic sleeve gastrectomy

Elbalshy¹,

Fayed²,

Abdelshahid³

et al. 2017

Int Surg J

View full text Add to dashboard Cite

Background: Although sleeve gastrectomy provides a technically simple procedure with minimal effect on digestive tract it deprives the stomach of its ligaments of fixation which results in impairment of gastric functions, vomiting, axial gastric rotation in addition to bleeding or leakage from the stable line. Objective of present study is the effect of stable line fixation during sleeve gastrectomy.Methods: This is a prospective randomized study using closed envelop method carried on 100 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy (LSG) they were divided into two groups each is 50 patient group A underwent classic (LSG) with no fixation and group (B) with staple line fixation.Results: Patients were 68 females and 32 males with a mean age of 32.2±5.7 years, mean (BMI) 48.9±8.6kg/m2. postoperative vomiting, gastric axial rotation, impaired gastric emptying all were significantly higher in group A. Although both staple line bleeding and leakage were higher in the group A, but it was not statistically significant. Also, the operative time was shorter in the group A, but it was not significant.Conclusions: staple line fixation should be a step during sleeve gastrectomy as it regains the stomach its ligaments of fixation anatomically and so functions better less vomiting, less gastric axial rotation, better gastric emptying in addition to decreasing staple line bleeding and leakage with minimal effect on operative time.

show abstract

“…A retrospective case series of 927 patients revealed that adopting a standardized operation to avoid excessive narrowing of the incisura in the final 489 cases resulted in no further episodes of gastric stenosis, compared with their initial experience. 20 Our own standardized technique has produced excellent outcomes in occurrence of early complications with an overall complication rate of 5%. Severe complications (Clavien-Dindo >3a) were seen in 1.7% of patients only.…”

Section: Discussionmentioning

confidence: 99%

“… 12 However, there are few publications in the literature regarding the effect of standardization in reducing the complications and improving the outcomes in LSG. 13 …”

Section: Introductionmentioning

confidence: 99%

Standardised Sleeve Gastrectomy Without Reinforcement

Lynn

Ilczyszyn

Aguilo

et al. 2018

JSLS

View full text Add to dashboard Cite

Background and Objectives:Laparoscopic sleeve gastrectomy (LSG) has some unique complications, the most concerning of which is sleeve leak. Staple line reinforcement (SLR) has been suggested as a means of decreasing the risk of sleeve leak, but it increases the cost. However, there is little in the literature regarding the effect of standardized operative technique in reducing the complications and improving the outcomes in LSG. We sought to demonstrate that standardization of the operative procedure and perioperative care is the key to an excellent 30-day outcome and that SLR is not necessary to ensure a negligible staple line leak and bleeding rate.Methods:A prospectively maintained database was analyzed to identify 303 consecutive patients undergoing LSG between July 2010 and November 2017. Data on patient demographics, length of hospital stay, conversion to open surgery, perioperative complications, and mortality were analyzed. Standardized operative technique and postoperative protocol were followed in all cases. SLR was not used in any case.Results:Among 303 cases, there were 15 complications (5%), 5 (1.7%) of which were severe (Clavien-Dindo grade ≥3a). There were no conversions to open procedure, no staple line leaks, and no inpatient deaths in the cohort. No patient was readmitted with an early stricture.Conclusions:The use of a standardized operative and postoperative protocol led to an excellent early outcome in our LSG cases. Standardization may act to obviate the need for routine SLR techniques which are associated with a significant financial cost to both patient and hospital.

show abstract

Surgical standardization to prevent gastric stenosis after laparoscopic sleeve gastrectomy: a case series

Cited by 26 publications

References 25 publications

miR-551b regulates epithelial-mesenchymal transition and metastasis of gastric cancer by inhibiting ERBB4 expression

miR-551b regulates epithelial-mesenchymal transition and metastasis of gastric cancer by inhibiting ERBB4 expression

Role of staple line fixation during laparoscopic sleeve gastrectomy

Standardised Sleeve Gastrectomy Without Reinforcement

Contact Info

Product

Resources

About