BACKGROUND Colorectal cancer ranks third in global cancer prevalence and stands as the second leading cause of cancer-related mortalities.With obesity recognized as a pivotal risk factor for colorectal cancer,the pote...BACKGROUND Colorectal cancer ranks third in global cancer prevalence and stands as the second leading cause of cancer-related mortalities.With obesity recognized as a pivotal risk factor for colorectal cancer,the potential protective role of bariatric surgery,especially laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy,has garnered attention.AIM To investigate the Roux-en-Y gastric bypass(RYGB)vs sleeve gastrectomy(SG)effect on colorectal cancer incidence in obese individuals.METHODS A systematic review and meta-analysis of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Seventeen studies with a total of 12497322 patients were included.The primary outcome was the relative risk(RR)of developing colorectal cancer in obese patients who underwent weight loss surgery compared to those who did not.Secondary outcomes included determining the RR for colon and rectal cancer separately and subgroup analyses by gender and type of weight loss surgery.RESULTS The meta-analysis revealed a 54%reduction in colorectal cancer risk in morbidly obese patients who underwent bariatric surgery compared to those who did not.A significant 46%reduction in colorectal cancer risk was observed among female patients.However,no significant differences were found in the meta-analysis for various types of bariatric surgery,such as SG and RYGB.CONCLUSION This meta-analysis reveals weight loss surgery,regardless of type,reduces colorectal cancer risk,especially in women,as indicated by RR and hazard ratio assessments.Further validation is essential.展开更多
Diabetes mellitus(DM)is a group of diseases characterized by high blood glucose caused by insufficient absolute or relative secretion of insulin.Once diagnosed,patients need long-term treatment with hypoglycemic drugs...Diabetes mellitus(DM)is a group of diseases characterized by high blood glucose caused by insufficient absolute or relative secretion of insulin.Once diagnosed,patients need long-term treatment with hypoglycemic drugs.Currently,the existing first-line hypoglycemic drugs do not provide effective treatment for DM and its complications.In the past,the first generation and the second generation of weight loss surgery,such as gastric bypass and sleeve gastric surgery,had strict body mass index requirements.Moreover,post-surgery,patients are prone to fluctuating hypoglycemia,gastroesophageal reflux,and dumping syndrome.Hence,the curative effect of this type of surgery was compromised to a certain extent.Jejunoileostomy is a third-generation surgery for patients with DM,which has been shown to improve glucose and lipid metabolism,without changing the original gastrointestinal tract structure.Different from previous weight loss surgeries,jejunoileostomy has been clinically observed to delay the development of DM-related complications.Additionally,the postoperative complications are mild and do not affect the patient’s quality of life.Based on our clinical observations from multi-center large samples,our team developed a consensus on the operative period and perioperative management of jejunoileostomy as a reference for clinical researchers.展开更多
文摘BACKGROUND Colorectal cancer ranks third in global cancer prevalence and stands as the second leading cause of cancer-related mortalities.With obesity recognized as a pivotal risk factor for colorectal cancer,the potential protective role of bariatric surgery,especially laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy,has garnered attention.AIM To investigate the Roux-en-Y gastric bypass(RYGB)vs sleeve gastrectomy(SG)effect on colorectal cancer incidence in obese individuals.METHODS A systematic review and meta-analysis of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Seventeen studies with a total of 12497322 patients were included.The primary outcome was the relative risk(RR)of developing colorectal cancer in obese patients who underwent weight loss surgery compared to those who did not.Secondary outcomes included determining the RR for colon and rectal cancer separately and subgroup analyses by gender and type of weight loss surgery.RESULTS The meta-analysis revealed a 54%reduction in colorectal cancer risk in morbidly obese patients who underwent bariatric surgery compared to those who did not.A significant 46%reduction in colorectal cancer risk was observed among female patients.However,no significant differences were found in the meta-analysis for various types of bariatric surgery,such as SG and RYGB.CONCLUSION This meta-analysis reveals weight loss surgery,regardless of type,reduces colorectal cancer risk,especially in women,as indicated by RR and hazard ratio assessments.Further validation is essential.
文摘Diabetes mellitus(DM)is a group of diseases characterized by high blood glucose caused by insufficient absolute or relative secretion of insulin.Once diagnosed,patients need long-term treatment with hypoglycemic drugs.Currently,the existing first-line hypoglycemic drugs do not provide effective treatment for DM and its complications.In the past,the first generation and the second generation of weight loss surgery,such as gastric bypass and sleeve gastric surgery,had strict body mass index requirements.Moreover,post-surgery,patients are prone to fluctuating hypoglycemia,gastroesophageal reflux,and dumping syndrome.Hence,the curative effect of this type of surgery was compromised to a certain extent.Jejunoileostomy is a third-generation surgery for patients with DM,which has been shown to improve glucose and lipid metabolism,without changing the original gastrointestinal tract structure.Different from previous weight loss surgeries,jejunoileostomy has been clinically observed to delay the development of DM-related complications.Additionally,the postoperative complications are mild and do not affect the patient’s quality of life.Based on our clinical observations from multi-center large samples,our team developed a consensus on the operative period and perioperative management of jejunoileostomy as a reference for clinical researchers.