期刊文献+
共找到6,446篇文章
< 1 2 250 >
每页显示 20 50 100
Novel subtype of obesity influencing the outcomes of sleeve gastrectomy:Familial aggregation of obesity
1
作者 Ze-Yu Wang Yun-Fei Qu +4 位作者 Tian-Ming Yu Zeng-Lin Liu Yu-Gang Cheng Ming-Wei Zhong San-Yuan Hu 《World Journal of Gastroenterology》 SCIE CAS 2024年第13期1887-1898,共12页
BACKGROUND Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy(SG)between patients with familial aggregation of obesity(FAO)and patients with sporadic obesity(SO)have not ... BACKGROUND Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy(SG)between patients with familial aggregation of obesity(FAO)and patients with sporadic obesity(SO)have not been elucidated.AIM To explore the impact of SG on weight loss and the alleviation of obesity-related comorbidities in individuals with FAO.METHODS A total of 193 patients with obesity who underwent SG were selected.Patients with FAO/SO were matched 1:1 by propensity score matching and were categorized into 4 groups based on the number of first-degree relatives with obesity(1 SO vs 1FAO,2SO vs 2FAO).The baseline characteristics,weight loss outcomes,prevalence of obesity-related comorbidities and incidence of major surgeryrelated complications were compared between groups.RESULTS We defined FAO as the presence of two or more first-degree relatives with obesity.Patients with FAO did not initially show significant differences in baseline data,short-term postoperative weight loss,or obesity-related comorbidities when compared to patients with SO preoperatively.However,distinctions between the two groups became evident at the two-year mark,with statistically significant differences in both percentage of total weight loss(P=0.006)and percentage of excess weight loss(P<0.001).The FAO group exhibited weaker remission of type 2 diabetes mellitus(T2DM)(P=0.031),hyperlipidemia(P=0.012),and non-alcoholic fatty liver disease(NAFLD)(P=0.003)as well as a lower incidence of acid reflux(P=0.038).CONCLUSION FAO patients is associated with decreased mid-to-long-term weight loss outcomes;the alleviation of T2DM,hyperlipidemia and NAFLD;and decreased incidence of acid reflux postoperatively. 展开更多
关键词 OBESITY Bariatric surgery sleeve gastrectomy Family history Weight loss
下载PDF
Functional Roux-en-Y Gastric Bypass (F-RYGB), with Preservation of Duodenal Access: Report of Two Revisional Cases of Sleeve Gastrectomy
2
作者 Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso +3 位作者 Paulo Reis Esselin de Melo Rui Ribeiro Paula Volpe Carlos Eduardo Domene 《Surgical Science》 2024年第3期135-158,共24页
Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce ... Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution was obtained in both cases, confirmed by endoscopic and functional esophageal assessment, together with symptoms questionnaire. Conclusion: The association of Latarjet nerves sectioning or truncal vagotomy with re-sleeve gastrectomy plus gastrointestinal anastomosis (antrojejunal), in a revision for a failed sleeve, can represent a technical approach, to reproduce RYGB results, without exclusions and with duodenum endoscopic accessibility maintenance. It maybe could be applied for primary surgeries. Additional studies are necessary to confirm this hypothesis. 展开更多
关键词 Roux-en-Y Gastric Bypass sleeve Gastrectomy Jejuno Gastric Bypass Vagus Nerve VAGOTOMY Bariatric Surgery
下载PDF
Association between operative position and postoperative nausea and vomiting in patients undergoing laparoscopic sleeve gastrectomy
3
作者 Zhao-Peng Li Yan-Cheng Song +3 位作者 Ya-Li Li Dong Guo Dong Chen Yu Li 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第7期2088-2095,共8页
BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of ... BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained,and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.AIM To explore the effect of the operative position during bariatric surgery on PONV.METHODS Data from obese patients,who underwent laparoscopic sleeve gastrectomy(LSG)in the authors’hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed.Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.RESULTS There were 15 cases of PONV in the supine split-leg group(incidence rate,50%)and 11 in the supine group(incidence rate,36.7%)(P=0.297).The mean operative duration in the supine split-leg group was 168.23±46.24 minutes and 140.60±32.256 minutes in the supine group(P<0.05).Multivariate analysis revealed that operative position was not an independent risk factor for PONV(odds ratio=1.192,95%confidence interval:0.376-3.778,P=0.766).CONCLUSION Operative position during LSG may affect PONV;however,the difference in the incidence of PONV was not statistically significant.Operative position should be carefully considered for obese patients before surgery. 展开更多
关键词 Postoperative nausea and vomiting Bariatric surgery Laparoscopic sleeve gastrectomy Operative positions OBESITY
下载PDF
Research on Sleeve Grouting Density Detection Based on the Impact Echo Method
4
作者 Pu Zhang Yingjun Li +5 位作者 Xinyu Zhu Shizhan Xu Pinwu Guan Wei Liu Yanwei Guo Haibo Wang 《Structural Durability & Health Monitoring》 EI 2024年第2期143-159,共17页
Grouting defects are an inherent challenge in construction practices,exerting a considerable impact on the operational structural integrity of connections.This investigation employed the impact-echo technique for the ... Grouting defects are an inherent challenge in construction practices,exerting a considerable impact on the operational structural integrity of connections.This investigation employed the impact-echo technique for the detection of grouting anomalies within connections,enhancing its precision through the integration of wavelet packet energy principles for damage identification purposes.A series of grouting completeness assessments were meticulously conducted,taking into account variables such as the divergent material properties of the sleeves and the configuration of adjacent reinforcement.The findings revealed that:(i)the energy distribution for the highstrength concrete cohort predominantly occupied the frequency bands 42,44,45,and 47,whereas for other groups,it was concentrated within the 37 to 40 frequency band;(ii)the delineation of empty sleeves was effectively discernible by examining the wavelet packet energy ratios across the spectrum of frequencies,albeit distinguishing between sleeves with 50%and full grouting density proved challenging;and(iii)the wavelet packet energy analysis yielded variable detection outcomes contingent on the material attributes of the sleeves,demonstrating heightened sensitivity when applied to ultrahigh-performance concrete matrices and GFRP-reinforced steel bars. 展开更多
关键词 Prefabricated building steel grouting sleeve impact echo method wavelet packet energy grouted defect
下载PDF
Left lower lobe sleeve resection for the clear cell variant of pulmonary mucoepidermoid carcinoma:A case report
5
作者 Xiao-Hui Yu Wen-Xiang Wang +1 位作者 De-Song Yang Liang-Hui Gong 《World Journal of Clinical Cases》 SCIE 2024年第8期1422-1429,共8页
BACKGROUND Pulmonary mucoepidermoid carcinoma(PMEC)is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree.The clear cell variant of PMEC is exceptionally uncommon and presents not... BACKGROUND Pulmonary mucoepidermoid carcinoma(PMEC)is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree.The clear cell variant of PMEC is exceptionally uncommon and presents notable diagnostic challenges,primarily attributable to its morphological similarity to other tumors containing clear cells.CASE SUMMARY A 22-year-old male,formerly in good health,came in with a two-month duration of persistent cough and production of sputum.Subsequent imaging and bronchoscopy examinations revealed a 2 cm tumor in the distal left main bronchus,which resulted in complete atelectasis of the left lung.Further assessment via positron emission tomography/computed tomography scans and endoscopic biopsy confirmed the primary malignant nature of the tumor,charac-terized by clear cell morphology in most of the tumor cells.The patient underwent a left lower lobe sleeve resection accompanied by systematic mediastinal lymph node dissection.Molecular pathology analysis subsequently revealed a CRTC3-MAML2 gene fusion,leading to a definitive pathological diagnosis of the clear cell variant of PMEC,staged as T2N0M0.After surgery,the patient experienced a smooth recovery and exhibited no signs of recurrence during the one-and-a-half-year follow-up period.CONCLUSION This article describes an unusual case of a clear cell variant of PMEC characterized by the presence of a CRTC3-MAML2 gene fusion in a 22-year-old male.The patient underwent successful left lower lobe sleeve resection.This case underscores the distinctive challenges associated with diagnosing and treating this uncommon malignancy,underscoring the importance of precise diagnosis and personalized treatment strategies. 展开更多
关键词 Pulmonary mucoepidermoid carcinoma Clear cell variant CRTC3-MAML2 gene fusion sleeve lobectomy Case report
下载PDF
Nerve growth factor-basic fibroblast growth factor poly-lactide co-glycolid sustained-release microspheres and the small gap sleeve bridging technique to repair peripheral nerve injury 被引量:3
6
作者 Ming Li Ting-Min Xu +7 位作者 Dian-Ying Zhang Xiao-Meng Zhang Feng Rao Si-Zheng Zhan Man Ma Chen Xiong Xiao-Feng Chen Yan-Hua Wang 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第1期162-169,共8页
We previously prepared nerve growth factor poly-lactide co-glycolid sustained-release microspheres to treat rat sciatic nerve injury using the small gap sleeve technique.Multiple growth factors play a synergistic role... We previously prepared nerve growth factor poly-lactide co-glycolid sustained-release microspheres to treat rat sciatic nerve injury using the small gap sleeve technique.Multiple growth factors play a synergistic role in promoting the repair of peripheral nerve injury;as a result,in this study,we added basic fibroblast growth factors to the microspheres to further promote nerve regeneration.First,in an in vitro biomimetic microenvironment,we developed and used a drug screening biomimetic microfluidic chip to screen the optimal combination of nerve growth factor/basic fibroblast growth factor to promote the regeneration of Schwann cells.We found that 22.56 ng/mL nerve growth factor combined with 4.29 ng/mL basic fibroblast growth factor exhibited optimal effects on the proliferation of primary rat Schwann cells.The successfully prepared nerve growth factor-basic fibroblast growth factor-poly-lactide-co-glycolid sustained-release microspheres were used to treat rat sciatic nerve transection injury using the small gap sleeve bridge technique.Compared with epithelium sutures and small gap sleeve bridging alone,the small gap sleeve bridging technique combined with drug-free sustained-release microspheres has a stronger effect on rat sciatic nerve transfection injury repair at the structural and functional level. 展开更多
关键词 biomimetic microfluidic chip growth factor in vitro biomimetic microenvironment nerve function peripheral nerve injury sciatic nerve small gap sleeve bridging sustained-release microspheres
下载PDF
Endoscopic sleeve gastroplasty in class Ⅲ obesity:Efficacy, safety, and durability outcomes in 404 consecutive patients 被引量:1
7
作者 Daniel Barry Maselli Anna Carolina Hoff +13 位作者 Ashley Kucera Emily Weaver Laura Sebring Lori Gooch Kathleen Walton Daniel Lee Taylor Cratty Selena Beal Srikar Nanduri Kendall Rease Christina S Gainey Laura Eaton Brian Coan Christopher E McGowan 《World Journal of Gastrointestinal Endoscopy》 2023年第6期469-479,共11页
BACKGROUND Endoscopic sleeve gastroplasty(ESG) is an effective therapy for class Ⅰ-Ⅱ obesity, but there are knowledge gaps in the published literature about its implementation in patients with class Ⅲ obesity [body... BACKGROUND Endoscopic sleeve gastroplasty(ESG) is an effective therapy for class Ⅰ-Ⅱ obesity, but there are knowledge gaps in the published literature about its implementation in patients with class Ⅲ obesity [body mass index(BMI) ≥ 40 kg/m2].AIM To evaluate the safety, clinical efficacy, and durability of ESG in adults with class Ⅲ obesity.METHODS This was a retrospective cohort study that used prospectively collected data on adults with BMI ≥ 40 kg/m2who underwent ESG and longitudinal lifestyle counseling at two centers with expertise in endobariatric therapies from May 2018-March 2022. The primary outcome was total body weight loss(TBWL) at 12 mo. Secondary outcomes included changes in TBWL, excess weight loss(EWL) and BMI at various time points up to 36 mo, clinical responder rates at 12 and 24 mo, and comorbidity improvement. Safety outcomes were reported through the study duration. One-way ANOVA test was performed with multiple Tukey pairwise comparisons for TBWL, EWL, and BMI over the study duration.RESULTS 404 consecutive patients(78.5% female, mean age 42.9 years, mean BMI 44.8 ± 4.7 kg/m2) were enrolled. ESGs were performed using an average of 7 sutures, over 42 ± 9 min, and with 100% technical success. TBWL was 20.9 ± 6.2% at 12 mo, 20.5 ± 6.9% at 24 mo, and 20.3 ± 9.5% at 36 mo. EWL was 49.6 ± 15.1% at 12 mo, 49.4 ± 16.7% at 24 mo, and 47.1 ± 23.5% at 36 mo. There was no difference in TBWL at 12, 15, 24, and 36 mo from ESG. TBWL exceeding 10%, 15%, and 20% was achieved by 96.7%, 87.4%, and 55.6% of the cohort at 12 mo, respectively. Of the cohort with the relevant comorbidity at time of ESG, 66.1% had improvement in hypertension, 61.7% had improvement in type Ⅱ diabetes, and 45.1% had improvement in hyperlipidemia over study duration. There was one instance of dehydration requiring hospitalization(0.2% serious adverse event rate).CONCLUSION When combined with longitudinal nutritional support, ESG induces effective and durable weight loss in adults with class Ⅲ obesity, with improvement in comorbidities and an acceptable safety profile. 展开更多
关键词 Endoscopic sleeve gastroplasty OBESITY BARIATRIC Endobariatrics Class III obesity COMORBIDITIES
下载PDF
Numerical study on erosion behavior of sliding sleeve ball seat for hydraulic fracturing based on experimental data
8
作者 Xuan-Li Zhou Yan-Bao Guo +2 位作者 Qiu-Ju Xie De-Guo Wang Hyun C.Yoon 《Petroleum Science》 SCIE EI CAS CSCD 2023年第1期515-525,共11页
The sleeve sealing ball seat is one of the important components in the multistage fracturing process of horizontal wells.The erosion and wear of the surface will decrease the sealing performance of the fracturing ball... The sleeve sealing ball seat is one of the important components in the multistage fracturing process of horizontal wells.The erosion and wear of the surface will decrease the sealing performance of the fracturing ball and the ball seat.This leads to pressure leakage during the fracturing process and fracturing failure.In this paper,combined with the actual ball seat materials and working conditions during the fracturing process,the erosion tests of ductile iron and tungsten carbide materials under different erosion speeds,angles,and mortar concentrations are carried out.Then the erosion test results were analyzed by mathematical fitting,and a set of erosion models suitable for sliding sleeve setting ball seat materials were innovatively established.For the first time,this paper combines the erosion model obtained from the experiment and the computational fluid dynamics(CFD)with Fluent software to simulate the erosion of the ball seat.Based on the simulation results,the morphology of the sliding sleeve seat ball after erosion is predicted.Through analysis of the test and simulation results,it is showed that the erosion rate of tungsten carbide material is lower and the wear resistance is better under the condition of small angle erosion.This research can offer a strong basis for fracturing site selection,surface treatment methods,and prediction of failure time of ball seats. 展开更多
关键词 Multistage fracturing Sliding sleeve ball seat Erosion wear Erosion model Fluent simulation
下载PDF
Laparoscopic Sleeve Gastrectomy following Pylorus-Preserving Pancreaticoduodenectomy
9
作者 Chien-Hua Lin Jing-Jim Ou +1 位作者 Yueh-Tsung Lee Hurng-Sheng Wu 《Surgical Science》 2023年第5期355-359,共5页
Background: A 35-year-old married female (68 kg, 150 cm, BMI: 30.2) with pancreatic divisum complicated chronic pancreatitis and underwent pylorus-preserving pancreaticoduodenectomy in 2010. After that, her condition ... Background: A 35-year-old married female (68 kg, 150 cm, BMI: 30.2) with pancreatic divisum complicated chronic pancreatitis and underwent pylorus-preserving pancreaticoduodenectomy in 2010. After that, her condition was well. However, body weight gained progressively to 76 kg (BMI: 33.7) and hypertension developed. During these two years, tried exercise and medication control for hypertension, but in vain. She received a laparoscopic sleeve gastrectomy in October 2013. The post-operative course was uneventful. Methods: We applied three ports for laparoscopic operation, including two 12 mm and one 5 mm trocars. The liver was not needed to be elevated due to adhesion. The operative time was 75 minutes. Results: The patient’s body weight was 10 kg reduced in the first two months and reduced to 59 kg 6 months later. Conclusions: We report a case that received laparoscopic sleeve gastrectomy following pylorus-preserving pancreaticoduodenectomy due to pancreatic divisum. This case encourages us to extend the indication of laparoscopic sleeve gastrectomy. 展开更多
关键词 sleeve Gastrectomy Morbid Obesity OBESITY PANCREATECTOMY
下载PDF
Effect of laparoscopic sleeve gastrectomy on related variables of obesity complicated with polycystic ovary syndrome
10
作者 Xiao-Tao Wang Yi-Sen Hou +6 位作者 Hao-Liang Zhao Jian Wang Chen-Hao Guo Jie Guan Zhi-Gan Lv Peng Ma Jian-Li Han 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第11期2423-2429,共7页
BACKGROUND Polycystic ovary syndrome(PCOS)is closely related to obesity,and weight loss can significantly improve the metabolic,endocrine and reproductive functions of obese individuals with PCOS.However,the efficacy ... BACKGROUND Polycystic ovary syndrome(PCOS)is closely related to obesity,and weight loss can significantly improve the metabolic,endocrine and reproductive functions of obese individuals with PCOS.However,the efficacy of laparoscopic sleeve gastrectomy(LSG)for obesity with PCOS are unclear.AIM The purpose of the study was to investigate the effect of LSG on related variables in obese patients with PCOS.METHODS A retrospective analysis was performed on 32 obese patients with PCOS who received LSG treatment at the Third Hospital of Shanxi Medical University from 2013 to 2020.The changes in anthropometric indices,insulin,testosterone,estradiol,follicle stimulating hormone(FSH),luteinizing hormone(LH),menstrual cycle and LH/FSH ratio before and 1 mo,3 mo,6 mo and 12 mo after the operation were statistically analyzed.RESULTS At 1 mo,3 mo,6 mo and 12 mo after surgery,the anthropometric indices,such as body weight and body mass index,of all patients were lower than those before the operation.The percentage excess weight loss(EWL%)at 1 mo,3 mo,6 mo and 1 year of follow-up were 25,40,46 and 65,respectively.The PCOS-related indices,such as insulin,testosterone,estradiol,follicle stimulating hormone(FSH),luteinizing hormone(LH)and menstrual cycle,were improved to varying degrees.During the 1-year follow-up,the average serum testosterone decreased from preoperative 0.72 ng/mL to 0.43 ng/mL(P<0.05),average fasting insulin level(9.0 mIU/mL,preoperative 34.2 mil,LH level,4.4 mIU/mL,preoperative 6.1 mIU/mL).The level of FSH(3.8 U/L,4.8 U/p0.05)and the ratio of LH/FSH(0.7,1.3/p0.05)were more relieved than those before surgery.During the postoperative follow-up,it was found that the menstrual cycle of 27 patients(nasty 27)returned to normal,and 6 patients(18%)who intended to become pregnant became pregnant within 1 year after surgery.CONCLUSION The weight loss effect of LSG is obvious and affirmative,and the endocrine index of obese patients with PCOS is also improved to some extent,although the mechanism is not clear.Laparoscopic sleeve gastrectomy is expected to become a backup choice for patients with polycystic ovaries in the future. 展开更多
关键词 Laparoscopic sleeve gastrectomy Polycystic ovary syndrome HYPERANDROGENISM Insulin resistance
下载PDF
Sleeve Gastrectomy Associated with Antral Lesion Resection and Roux-en-Y Antrojejunal Reconstruction
11
作者 Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso +4 位作者 Carlos Eduardo Domene Paulo Reis Esselin de Melo Rui Ribeiro Gabriela Trentin Scortegagna Elinton Adami Chaim 《Surgical Science》 2023年第5期360-376,共17页
Obesity has been growing worldwide, reaching epidemic proportions. Bariatric surgery is the most effective and durable treatment for severe obesity and related diseases. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gast... Obesity has been growing worldwide, reaching epidemic proportions. Bariatric surgery is the most effective and durable treatment for severe obesity and related diseases. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are the most frequently performed bariatric operations, with long-term good results, in terms of weight loss and comorbidities control. Gastroesophageal Reflux Disease (GERD) is commonly associated with obesity. In general, it precludes the indication of sleeve gastrectomy, since this technique has a refluxogenic potential, as shown in many studies. In such cases, RYGB is considered the best surgery, reaching good weight loss and gastroesophageal reflux disease control. The drawback of this technique is that it leaves the remnant stomach, the duodenum, and the proximal part of the jejunum inaccessible. Besides, RYGB makes transoral endoscopic access to the biliary tree impossible. For all these reasons, this bariatric technique is not indicated in cases of gastric polyposis, gastric dysplasia, or strong family history of cancer, among others. We report a case of a morbidly obese patient with intense GERD, for whom a RYGB was precluded due to her strong family history of cancer, even knowing that it would be the best choice for reflux disease control. Instead, SG was chosen, even knowing it could worsen the gastroesophageal reflux disease. The patient signed an informed consent, after being fully enlightened about the risks. During the surgery, a small subserosal whitish lesion was detected, near the pylorus, on the anterior wall of the antrum. Thinking in a Gastrointestinal Stromal Tumor (GIST), it was resected, with a 2 cm safety margin, leaving a 4 to 5 cm hole on the gastric wall. The decision to maintain the proposed sleeve gastrectomy was made, to avoid leaving a remnant stomach, in a patient with such a strong family history of cancer. In the area of the resected lesion, an intraoperative decision was made not to just close the big gastric hole, being afraid of causing some anatomic or functional disturbance in gastric emptying. Instead, we decided to use the gastric opening to construct a Roux-en-Y antrotrojejunal anastomosis, with a 50 cm alimentary limb and a 200 cm biliopancreatic limb. Accordingly, it was performed a sleeve gastrectomy, associated with an antrojejunostomy in a Roux-en-Y fashion. The patient had an uneventful postoperative course. In the second year, she achieved normal weight and good nutritional status, without gastroesophageal reflux symptoms complaints. Seriography study shows that most of the contrast material passes through the antrojejunal anastomosis, instead of the pylorus, while the duodenum is endoscopically patent. This case report shows an unexpected surgical finding that led to a tactic of adding a Roux-en-Y gastric bypass in the antrum, associated with a sleeve gastrectomy, a strategy that may be adopted in cases of morbidly obese patients with important GERD, for whom gastrointestinal exclusions are contraindicated. To confirm this hypothesis, controlled studies are needed. 展开更多
关键词 Roux-en-Y Gastric Bypass sleeve Gastrectomy Jejunum Gastric Bypass Bariatric Surgery
下载PDF
Fibroblast growth factor 15,induced by elevated bile acids,mediates the improvement of hepatic glucose metabolism after sleeve gastrectomy
12
作者 Meng Wei Wei-Bo Cao +7 位作者 Ru-Dong Zhao Dan-Ping Sun Yi-Ze Liang Ya-Di Huang Ze-Wei Cheng JunOuyang Wen-Shuo Yang Wen-Bin Yu 《World Journal of Gastroenterology》 SCIE CAS 2023年第21期3280-3291,共12页
BACKGROUND Fibroblast growth factor(FGF)15/19,which is expressed in and secreted from the distal ileum,can regulate hepatic glucose metabolism in an endocrine manner.The levels of both bile acids(BAs)and FGF15/19 are ... BACKGROUND Fibroblast growth factor(FGF)15/19,which is expressed in and secreted from the distal ileum,can regulate hepatic glucose metabolism in an endocrine manner.The levels of both bile acids(BAs)and FGF15/19 are elevated after bariatric surgery.However,it is unclear whether the increase in FGF15/19 is induced by BAs.Moreover,it remains to be understood whether FGF15/19 elevations contribute to improvements in hepatic glucose metabolism after bariatric surgery.AIM To investigate the mechanism of improvement of hepatic glucose metabolism by elevated BAs after sleeve gastrectomy(SG).METHODS By calculating and comparing the changes of body weight after SG with SHAM group,we examined the weight-loss effect of SG.The oral glucose tolerance test(OGTT)test and area under the curve of OGTT curves were used to assess the anti-diabetic effects of SG.By detecting the glycogen content,expression and activity of glycogen synthase as well as the glucose-6-phosphatase(G6Pase)and phosphoenolpyruvate carboxykinase(Pepck),we evaluated the hepatic glycogen content and gluconeogenesis activity.We examined the levels of total BA(TBA)together with the farnesoid X receptor(FXR)-agonistic BA subspecies in systemic serum and portal vein at week 12 post-surgery.Then the histological expression of ileal FXR and FGF15 and hepatic FGF receptor 4(FGFR4)with its corresponding signal pathways involved in glucose metabolism were detected.RESULTS After surgery,food intake and body weight gain of SG group was decreased compare with the SHAM group.The hepatic glycogen content and glycogen synthase activity was significantly stimulated after SG,while the expression of the key enzyme for hepatic gluconeogenesis:G6Pase and Pepck,were depressed.TBA levels in serum and portal vein were both elevated after SG,the FXR-agonistic BA subspecies:Chenodeoxycholic acid(CDCA),lithocholic acid(LCA)in serum and CDCA,DCA,LCA in portal vein were all higher in SG group than that in SHAM group.Consequently,the ileal expression of FXR and FGF15 were also advanced in SG group.Moreover,the hepatic expression of FGFR4 was stimulated in SG-operated rats.As a result,the activity of its corresponding pathway for glycogen synthesis:FGFR4-Ras-extracellular signal regulated kinase pathway was stimulated,while the corresponding pathway for hepatic gluconeogenesis:FGFR4-cAMP regulatory element-binding protein-peroxisome proliferator-activated receptorγcoactivator-1αpathway was suppressed.CONCLUSION Elevated BAs after SG induced FGF15 expression in distal ileum by activating their receptor FXR.Furthermore,the promoted FGF15 partly mediated the improving effects on hepatic glucose metabolism of SG. 展开更多
关键词 sleeve gastrectomy Fibroblast growth factor 15 Bile acids Hepatic glucose metabolism Type 2 diabetes mellitus
下载PDF
State of art on the mechanisms of laparoscopic sleeve gastrectomy in treating type 2 diabetes mellitus
13
作者 Fa-Shun Liu Song Wang +3 位作者 Xian-Shan Guo Zhen-Xiong Ye Hong-Ya Zhang Zhen Li 《World Journal of Diabetes》 SCIE 2023年第6期632-655,共24页
Obesity and type-2 diabetes mellitus(T2DM)are metabolic disorders.Obesity increases the risk of T2DM,and as obesity is becoming increasingly common,more individuals suffer from T2DM,which poses a considerable burden o... Obesity and type-2 diabetes mellitus(T2DM)are metabolic disorders.Obesity increases the risk of T2DM,and as obesity is becoming increasingly common,more individuals suffer from T2DM,which poses a considerable burden on health systems.Traditionally,pharmaceutical therapy together with lifestyle changes is used to treat obesity and T2DM to decrease the incidence of comorbidities and allcause mortality and to increase life expectancy.Bariatric surgery is increasingly replacing other forms of treatment of morbid obesity,especially in patients with refractory obesity,owing to its many benefits including good long-term outcomes and almost no weight regain.The bariatric surgery options have markedly changed recently,and laparoscopic sleeve gastrectomy(LSG)is gradually gaining popularity.LSG has become an effective and safe treatment for type-2 diabetes and morbid obesity,with a high cost-benefit ratio.Here,we review the mechanism associated with LSG treatment of T2DM,and we discuss clinical studies and animal experiments with regard to gastrointestinal hormones,gut microbiota,bile acids,and adipokines to clarify current treatment modalities for patients with obesity and T2DM. 展开更多
关键词 OBESITY Type-2 diabetes mellitus Laparoscopic sleeve gastrectomy Gastrointestinal hormones ADIPOKINES Gut microbiota Bile acids
下载PDF
Methodology for Obtaining Optimal Sleeve Friction and Friction Ratio Estimates from CPT Data
14
作者 Erick Baziw 《International Journal of Geosciences》 CAS 2023年第3期290-303,共14页
Cone penetration testing (CPT) is a cost effective and popular tool for geotechnical site characterization. CPT consists of pushing at a constant rate an electronic penetrometer into penetrable soils and recording con... Cone penetration testing (CPT) is a cost effective and popular tool for geotechnical site characterization. CPT consists of pushing at a constant rate an electronic penetrometer into penetrable soils and recording cone bearing (q<sub>c</sub>), sleeve friction (f<sub>c</sub>) and dynamic pore pressure (u) with depth. The measured q<sub>c</sub>, f<sub>s</sub> and u values are utilized to estimate soil type and associated soil properties. A popular method to estimate soil type from CPT measurements is the Soil Behavior Type (SBT) chart. The SBT plots cone resistance vs friction ratio, R<sub>f</sub> [where: R<sub>f</sub> = (f<sub>s</sub>/q<sub>c</sub>)100%]. There are distortions in the CPT measurements which can result in erroneous SBT plots. Cone bearing measurements at a specific depth are blurred or averaged due to q<sub>c</sub> values being strongly influenced by soils within 10 to 30 cone diameters from the cone tip. The q<sub>c</sub>HMM algorithm was developed to address the q<sub>c</sub> blurring/averaging limitation. This paper describes the distortions which occur when obtaining sleeve friction measurements which can in association with q<sub>c</sub> blurring result in significant errors in the calculated R<sub>f</sub> values. This paper outlines a novel and highly effective algorithm for obtaining accurate sleeve friction and friction ratio estimates. The f<sub>c</sub> optimal filter estimation technique is referred to as the OSFE-IFM algorithm. The mathematical details of the OSFE-IFM algorithm are outlined in this paper along with the results from a challenging test bed simulation. The test bed simulation demonstrates that the OSFE-IFM algorithm derives accurate estimates of sleeve friction from measured values. Optimal estimates of cone bearing and sleeve friction result in accurate R<sub>f</sub> values and subsequent accurate estimates of soil behavior type. 展开更多
关键词 Cone Penetration Testing (CPT) Optimal Estimation Geotechnical Site Characterization sleeve Friction Cone Bearing Friction Ratio Iterative Forward Modelling (IFM) Soil Behavior Type (SBT)
下载PDF
Infusa Sleeve导管血管内局部给药的实验研究 被引量:3
15
作者 兰燕平 朱建国 +2 位作者 崔长琮 徐仓宝 戴强 《中国循环杂志》 CSCD 北大核心 1999年第2期81-83,共3页
目的:评价InfusaSleeve(IS)导管局部给药的可行性。方法:13只家兔随机分成A组(n=8)和B组(n=5),给药压力分别为607.9kPa(6个标准大气压)(A组)和202.6kPa(2个标准大气压)(B... 目的:评价InfusaSleeve(IS)导管局部给药的可行性。方法:13只家兔随机分成A组(n=8)和B组(n=5),给药压力分别为607.9kPa(6个标准大气压)(A组)和202.6kPa(2个标准大气压)(B组),用标准血管成形导管损伤腹主动脉下端后,经IS导管向腹主动脉下端球囊损伤处局部注入1ml放射性同位素锝标记的甲氧基异丁基异腈(99mTc-MIBI)注射液。术后30分钟、6小时、24小时分别处死动物后,取两组动物靶点血管(腹主动脉下端)、心、肝、骨骼肌、小肠、血液、非靶点血管(肺动脉)组织,用γ计数仪计数后称组织重量。结果:A组和B组给药后30分钟靶点血管局部的放射强度分别占给药总量的49.250%和22.000%、分别是血液的45倍和8倍、是非靶点血管的70倍和12倍。靶点血管局部放射强度A组大于B组(P<0.05)。6小时和24小时后靶点血管局部放射强度占给药总量的0.343%(A组)和0.255%(A组)。结论:IS导管可经血管局部靶向给药。IS导管局部导入的药物浓度呈压力依赖性。 展开更多
关键词 血管成形术 术后 再狭窄 预防 局部给药 IS导管
下载PDF
Research and Design of Sleeve Detach and Reunion Drive Mechanism of Screw Melt Extruder Equipment
16
作者 张秀德 《Agricultural Science & Technology》 CAS 2012年第9期2034-2036,共3页
The design of sleeve detach and reunion drive device of screw melt ex- truder equipment was optimized, based on the present installation of hygraulic drive device to achieve the mechanical opening and closing of the s... The design of sleeve detach and reunion drive device of screw melt ex- truder equipment was optimized, based on the present installation of hygraulic drive device to achieve the mechanical opening and closing of the sleeve, the dynamic model of the sleeve detach and reunion drive was theoretically measured, and it was verified that the device is simple to operate and convenient to maintain, thus it has great social values. 展开更多
关键词 Clutch device Hydraulic cylinder LINKAGE Bearing connection sleeve
下载PDF
Laparoscopic sleeve gastrectomy and gastroesophageal reflux 被引量:13
17
作者 Fabien Stenard Antonio Iannelli 《World Journal of Gastroenterology》 SCIE CAS 2015年第36期10348-10357,共10页
Bariatric surgery is the only effective procedure that provides long-term sustained weight loss. Sleeve gastrectomy(SG) has emerged over the last few years to be an ideal bariatric procedure because it has several adv... Bariatric surgery is the only effective procedure that provides long-term sustained weight loss. Sleeve gastrectomy(SG) has emerged over the last few years to be an ideal bariatric procedure because it has several advantages compared to more complex bariatric procedures,including avoiding an intestinal bypass. However,several published follow-up studies report an increased rate of gastroesophageal reflux(GERD) after a SG. GERD is described as either de novo or as being caused by aggravation of preexisting symptoms. However,the literature on this topic is ambivalent despite the potentially increased rate of GERDs that may occur after this common bariatric procedure. This article reviews the mechanisms responsible for GERD in obese subjects as well as the results after a SG with respect to GERD. Future directions for clinical research are discussed along with the current surgical options for morbidly obese patients with GERD and undergoing bariatric surgery. 展开更多
关键词 GASTROESOPHAGEAL REFLUX sleeve GASTRECTOMY MORBID
下载PDF
Laparoscopic sleeve gastrectomy:More than a restrictive bariatric surgery procedure? 被引量:10
18
作者 David Benaiges Antonio Más-Lorenzo +4 位作者 Albert Goday José M Ramon Juan J Chillarón Juan Pedro-Botet Juana A Flores-Le Roux 《World Journal of Gastroenterology》 SCIE CAS 2015年第41期11804-11814,共11页
Sleeve gastrectomy(SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a sin... Sleeve gastrectomy(SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a single technique have led to a rise in its use, and it is currently the second most performed technique worldwide. SG achieves clearly better results than other restrictive techniques and is comparable in some aspects to the Roux-en-Y gastric bypass, the current gold standard in bariatric surgery. These benefits have been associated with different pathophysiologic mechanisms unrelated to weight loss such as increased gastric emptying and intestinal transit, and activation of hormonal mechanisms such as increased GLP-1 hormone and decreased ghrelin. The aim of this review was to highlight the salient aspects of SG regarding its historical evolution, pathophysiologic mechanisms, main results, clinical applications and perioperative complications. 展开更多
关键词 BARIATRIC surgery sleeve GASTRECTOMY SEVERE obesit
下载PDF
The success of sleeve gastrectomy in the management of metabolic syndrome and obesity 被引量:11
19
作者 Asim Shabbir Dallan Dargan 《The Journal of Biomedical Research》 CAS CSCD 2015年第2期93-97,共5页
The rapid reversal of diabetes,hypertension,hyperlipidaemia and obesity by surgical means has challenged accepted doctrines regarding the management of metabolic syndrome.Sleeve gastrectomy,which developed initially a... The rapid reversal of diabetes,hypertension,hyperlipidaemia and obesity by surgical means has challenged accepted doctrines regarding the management of metabolic syndrome.Sleeve gastrectomy,which developed initially as a preparatory procedure for biliopancreatic diversion with duodenal switch,has seen an exponential rise in popularity as an effective lone laparoscopic bariatric procedure.Superior excess weight loss,a low complication rate,and excellent food tolerance,combined with a short hospital stay,have made this the procedure of choice for patients and surgeons across the globe.High volume centres nurture the ongoing development of experienced and specialized teams,pathways and regimens.Optimum surgical outcomes allow minimization of metabolic syndrome,reducing cardiovascular and cerebrovascular risk. 展开更多
关键词 metabolic surgery sleeve gastrectomy diabetes mellitus OBESITY
下载PDF
Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy 被引量:6
20
作者 Gokulakkrishna Subhas Anupam Gupta +1 位作者 Mubashir Sabir Vijay K Mittal 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2015年第11期345-348,共4页
Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conserva... Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on postoperative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement. 展开更多
关键词 GASTRIC REMNANT Stent sleeve GASTRECTOMY VOLVULUS
下载PDF
上一页 1 2 250 下一页 到第
使用帮助 返回顶部